Breastfeeding with D-Mer

I have been meaning to write a dedicated post to D-Mer (dysphoric milk ejection reflex) for ages now, and haven't got around to it, mainly because it's not something that's at the forefront of my mind, although it's just another breastfeeding "hurdle" that I've dealt with over the past 7 months.
D-Mer is crazily common, but a majority of cases go entirely undiagnosed and aren't very severe. D-Mer, is characterised as a feeling of dysphoria (unhappiness) at the time that milk is released from the breast during breastfeeding (or expressing breast milk as well in some cases). It's incredible the number of Mum's I've spoken to who say "Wow, I feel this but I never knew it had a name."

For me, personally, a few seconds into each feed, when I experience a milk "let down" (when milk is released from the milk ducts in the breast), I feel worried. It's not horrendous, just a sense that I'm mildly panicked about something and can't remember what, or as if I've just received some really shit news. Within 2 minutes, the feeling has completely disappeared.
When I first started breastfeeding I didn't really notice the D-Mer because I was in so much pain due to our early tongue tie experience, that I felt miserable anyway. Once breastfeeding became more comfortable and I felt these periods of anxiety when Quinn latched on, I assumed it was because I'd begun to associate breastfeeding with agonising pain. However, after several months, when I still felt this sense of impending doom at the beginning of every feed, I stumbled upon an article about D-Mer and realised that this must be what happens to me.
It's basically a squiffy reaction to the hormones released at the point of milk ejection. Once baby latches on your body floods with these hormones (mostly prolactin) in a huge and sudden volume, whilst levels of dopamine in the brain have to drop in order to allow this to happen, and some brains go "woooaaah" in response. The actual symptoms experienced differ vastly from one woman to the next. I've met women whose D-Mer has been so severe that they've had suicidal thoughts at the beginning of each breastfeed. A majority of Mum's though have had very similar experiences to mine, and describe their initial reaction to each breastfeed as being like a mild panic attack. 
For me, D-Mer definitely isn't something that makes breastfeeding difficult, and wouldn't ever stand in the way of me and my breastfeeding goals; but for other women it can be really distressing. I'm blessed with very sound mental health these days, and other than those few minutes at the beginning of each feed, I feel great. Some of Quinn's feeds can easily last 90 minutes, so less than 2 minutes at the beginning of that session is a drop in the ocean.
D-Mer is categorised as either mild, moderate, or severe - and can manifest itself as either despondency D-mer, anxiety D-mer, or agitation D-mer. I'd be considered to suffer from moderate anxiety D-mer - with some symptoms of despondency D-mer at some feeds. Mild D-Mer doesn't really effect the sufferer at all but they might feel a very slight dip in mood at the beginning of each feed. Moderate is most common - the sufferer is aware of the dip in their mood but it rarely threatens their breastfeeding relationship. Severe D-Mer on the other hand can be incredibly upsetting. Despondency D-Mer usually manifests as a feeling of self loathing, worthlessness, depression and hopelessness, whilst anxiety D-Mer is more a panicked, worried manifestation. Agitated D-Mer is rare and usually only manifests in cases of severe D-Mer, where the sufferer feels angry, paranoid, aggressive, and often suicidal.
For most sufferers, D-Mer is just weird; inconvenient, a bit of a downer, but mostly just odd. However, for those rare cases where D-Mer symptoms are seriously impacting on a Mum's quality of life, it's essential that doctors are made aware - if you think you may be suffering from severe D-Mer, or symptoms of agitated D-mer might be putting you or your baby at risk of harm, make an appointment with your GP straight away. Even the most severe cases may not mean the end of your breastfeeding journey, but it's essential that you have adequate support in place.

1 comment:

  1. Thanks for your post!! I've had D-MER when breastfeeding all five of my babies. It's crazy how few medical professionals have heard of it. And how belittling and invalidating some can be when you bring up a condition they know nothing about. The more people spread the word like you, the better!