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Can Milk Letdown Really Cause Depression? A Grassroots Effort Unfolds

Have you experienced the breastfeeding blues?

Breastfeeding is physically and emotionally difficult. From those first few days in the hospital attempting to get your newborn to latch to later days when you sometimes feel like the Siamese twin of your baby because they are always latched. Then there’s mastitis, thrush, sore nipples, leaky breasts.

All of the above can cause emotional distress, and now there is new evidence that the simple act of milk letdown could cause serious emotional depression in women.

Have you heard “Dysphoric Milk Ejection Reflex” or “D-MER”?

My colleague, Heather Turgeon, has written an excellent article, D-MER And The Breastfeeding Blues, that explains how moms with D-MER are overcome by a sudden wave of emotional pain — dread, sadness, hopelessness, stomach churning — just as breast milk is released. The feelings fade after a few minutes, only to reappear with the next milk letdown.

Turgeon initially didn’t realize that there was an actual name to something she herself suffered from. “I didn’t know there was anyone else out there like me. Every time my son would latch on, I would feel such despair — as if the world were about to end, and me with it. It was very deep and very black”.

Another writer here at Babble, John Cave Osborne, also recognized those symptoms in his wife and wrote about it here.

Although Turgeon and Osborne and hundreds of other women recognize the symptoms, D-MER has only recently been identified by lactation counselor and postpartum doula, Alia Macrina Heise. Heise suffered from the experience with her third child. After researching the issue Heise discovered she was far from alone, began consulting other lactation specialists and eventually started D-MER.org.

Upon learning about D-MER Turgeon embarked on her own research mission to learn if D-MER is, in fact, a real breastfeeding afflcition:

The biological theory of D-MER…has to do with the chemistry of nursing: the neurotransmitter dopamine inhibits the hormone prolactin, needed for milk production. Therefore, levels of dopamine (linked to positive mood) may drop to allow for breast milk production. For some moms, a chemical glitch could cause a steeper drop, canceling out the usual warm, cozy, oxytocin-induced feelings and tripping unpleasant emotions and physical sensations at the time of milk letdown.

Medical literature makes little mention of anything resembling D-MER, however, Turgeon discoverd that two well-respected breastfeeding textbooks have included D-MER in their latest editions:

Lawrence and Lawrence’s Breastfeeding: A Guide for the Medical Professional, whose 7th edition came out last year, has a section that describes D-MER and notes, “clinicians need to be aware of this phenomenon.” And La Leche League’s 8th edition of The Womanly Art of Breastfeeding, also published last year, calls D-MER “a little-recognized ‘glitch’ that most affected women never talk about because they don’t want to be treated for a depression that they suspect they don’t have.”

It’s important to note that D-MER is not related to postpartum depression. It’s a specific, abrupt physiological reflex around milk release. In an interview with Turgeon, Heise clarifies that moms with D-MER feel fine throughout the rest of the day; it’s only during milk ejection that the world becomes momentarily bleak. She doesn’t want women to use D-MER as an excuse to stop breastfeeding but a reason to continue because they know there’s a biological explanation for what’s happening to them and no that it will pas..

Ultimately, after researching D-MER quite thoroughly Turgeon says “I come away from my research on D-MER pretty comfortable with it being a real, physical experience (and what a tough one to have on top of the normal emotional turbulence that accompanies having a newborn).” She does admit to still being skeptical about the precise mix of hormones and neurotransmitters of D-MER.

As for Heise, she and her colleagues have submitted their findings on D-MER for publication which may ultimately draw more research and interest into the breastfeeding affliction.

photo: flickr.com/fikirbaz

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