Breastfeeding Aversion | 7 Questions When Suffering From D-MER

When new mothers encounter breastfeeding challenges, they can experience various negative emotions.

Mothers who are breastfeeding and pregnant at the same time sometimes experience breastfeeding aversion. Although pregnancy does not automatically preclude breastfeeding, breastfeeding aversion during pregnancy could be due to pregnancy hormones, which, in some mothers, make their bodies think it’s time to wean.

If they have knowledgeable and empathetic support, they can often overcome such breastfeeding aversions and their negative emotions become positive ones.

If you’re breastfeeding while pregnant, you might like to read our article Breastfeeding During Pregnancy | 7 Important Facts To Know.

Another uncommon condition that can also cause negative feelings about breastfeeding is Dysphoric Milk Ejection Reflex (D-MER).

Breastfeeding mothers with D-MER suffer sudden intense negative emotions seconds before their milk ejection reflex (also known as the ‘let down reflex’ or milk let down) occurs.

A milk ejection reflex can occur while a mother is breastfeeding or expressing, or it can happen with spontaneous milk releases when a mother isn’t breastfeeding or expressing but is perhaps thinking about her baby.

7 common questions about breastfeeding aversion and Dysphoric Milk Ejection Reflex (D-MER):

Breastfeeding Aversion Questions #1. What are the symptoms of D-MER?

Mothers who suffer from D-MER might experience any of the following feelings when their milk ejection reflex occurs:

• Hollow feelings in the stomach
• Sadness
• Dread
• Apprehension
• Irritability
• Nervousness
• Anxiety
• Hopelessness
• Agitation
• Paranoia.

These feelings are fleeting, lasting from 30 seconds to a couple of minutes. Once the milk lets down and begins to flow, the negative feelings pass.

Breastfeeding Aversion Questions #2. Does D-MER mean I have postpartum depression or an anxiety disorder?

D-MER is not the same as postnatal depression, postpartum depression or any other postpartum mood disorder. A mother with D-MER only experiences negative emotions associated with her milk release.

It’s important to understand that D-MER is physiological reaction to a milk let down, not a psychological reaction.

That’s not to say that D-MER doesn’t affect a mother’s mental health. There is evidence to suggest that any challenging breastfeeding experiences can exacerbate postpartum mental health problems.

Breastfeeding Aversion Questions #3. What causes D-MER?

D-MER can potentially affect any breastfeeding mother, whether it is her first baby or subsequent children. D-MER has not been associated with a traumatic birth or other common breastfeeding difficulties, such as nipple pain.

Although research into D-MER is limited, some findings describe D-MER in terms of disrupted neurotransmitter and hormonal activity.

Theories suggest that the cause might be a hormonal reaction, due to secretion of the hormone prolactin (involved in milk production) and the inhibition of dopamine levels. Dysfunction of neurotransmitters and decreased levels of dopamine can potentially cause symptoms of depression and anxiety.

Breastfeeding Aversion Questions #4. How severe can D-MER be?

Mothers with D-MER describe various symptoms, which range from mild discomfort right up to severe negative thoughts that might include suicidal ideation or other thoughts about self harm.

Due to the lack of research and widely available information to support women, mothers suffering from D-MER often find it to be a confusing and lonely experience.

In severe cases, D-MER can lead to early weaning from breastfeeding.

Breastfeeding Aversion Questions #5. Can D-MER affect breast milk supply?

D-MER is not known to affect breast milk production or supply.

During pregnancy, your breasts are already preparing to feed your baby. When your baby is born, the onset of your milk supply is triggered by the abrupt change in hormones that occurs after you deliver the placenta. Your breast milk supply is fully established and maintained on the principle of supply and demand. This means that the milk that is removed from your body is replaced.

If D-MER is causing a mother to cut breastfeeds short, due to symptoms she is experiencing, it could negatively affect her breast milk supply. Although research in this area is limited, it’s possible that D-MER could lead to a lower milk supply and early weaning from breastfeeding.

Breastfeeding Aversion Questions #6. What can I do about D-MER?

If you think you might have D-MER, it’s important to seek advice from your healthcare provider. If your D-MER is mild to moderate, natural therapies and lifestyle changes can help.

Some mothers have found that stress, dehydration and caffeine can worsen their symptoms. Therefore, reducing stress, staying hydrated, and avoiding caffeine might help.

Other strategies that breastfeeding women suffering from D-MER have found effective are:

• Distraction until the milk ejection reflex or negative feelings have subsided (i.e. reading, scrolling your phone, listening to music, etc)
• Practising mindful breathing and meditation
• Spending time in skin to skin contact with your baby
• Prioritizing rest and sleep over less important activities.

Some breastfeeding mothers have reported that magnesium supplements help to relieve the negative feeling associated with breastfeeding aversion.

For more information, you can read BellyBelly’s article Magnesium While Breastfeeding | 9 Important Questions.

More severe cases of D-MER might require the use of a prescription treatment.

Breastfeeding Aversion Questions #7. How long does D-MER last?

As awful as D-MER can be for some mothers, many find that their symptoms largely subside by 3 months.

For other mothers, however, D-MER continues for as long as they breastfeed. Regardless of how long they experience D-MER, many mothers feel that their symptoms become less severe as their baby gets older.

If the symptoms of D-MER are affecting your breastfeeding relationship with your child, or causing you to consider ending your breastfeeding journey early, seek advice from an International Board Certified Lactation Consultant (IBCLC).

Although there is no known cure for D-MER, professional support, in the addition to the above suggestions to help manage symptoms, can help avoid early weaning.

Recommended Reading: Should You Love Breastfeeding All The Time?