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What is D-MER? I'm glad you asked.
Picture this: It's a rainy Sunday afternoon, chilly outside and cozy and warm indoors. Christopher is studying in his office. The boys are watching Charlie Brown. I am in my comfy recliner, snuggled up nursing the baby, reading a new library book and eating sourdough toast. Everything is perfect. (For everyone except the baby, who is probably getting toast crumbs all over him.)
Suddenly my stomach drops in a feeling of sickening dread. Sadness rolls over me. I can't chew the food in my mouth any more than I could chew a mouthful of gravel. I can't read my book. I feel hopeless.
About ten seconds later the feeling passes. I can eat and read again. I feel fine. What just happened?
That is what it is like to experience D-MER. D-MER stands for Dysphoric Milk Ejection Reflex. D-MER.org defines it as
a condition affecting lactating women that is characterized by an abrupt dysphoria, or negative emotions, that occur just before milk release and continuing not more than a few minutes.
The condition was identified fairly recently in 2007 by Alia Macrina Heise, who manages the D-MER website and wrote a case study on the condition and also a book. She has a theory that D-MER is caused by an innappropriate drop in dopamine levels just before the milk lets down. The sudden drop in dopamine could cause the instant negative emotions. They fade as dopamine levels return to normal. As far as I know, this is not known for certain but the author was able to treat herself by taking supplements to increase dopamine availability.
You can read her case study here.
One interesting question she poses is if D-MER has always existed and was never properly distinguished from say, postpartum depression or breastfeeding aversion, or if it is something that has started happening commonly to women only in recent years. The answer is not quite clear yet.
I nursed both Silas and Micah and did not suffer from D-MER. It started with Julian and it took me a few weeks to put the puzzle pieces together. Of course, we spent 2 weeks in the hospital before he was 3 weeks old and you usually feel homesick in a hospital. The feelings D-MER produces are very much like being homesick. Once we were home, I thought I felt horrible while nursing because I was sitting in my recliner chair looking at our messy living room that I couldn't clean up because I was taking care of a new baby. I hate having a messy living room. But after awhile I was able to recognize the pattern of the waves of negative emotions. As soon as I felt that familiar unhappy, sick feeling in my stomach I could count on the pins and needles of milk letdown within 30 seconds. The two were unquestionably connected.
Thankfully, I already knew D-MER was a thing because my sister had told me about it. She suffered from it severely and could not continue breastfeeding as a result. Like any other condition, D-MER has a range of severity. "Reflex" is an appropriate word to use because it is not something the mother has any control over.
I think it is kind of hard to understand if you haven't experienced it for yourself. Once you know what is going on you can appreciate how bizarre it is to suddenly feel paralyzed by sadness and hopelessness for no reason at all, only to be yourself again within a few minutes. My sister and I wondered if you could somehow turn it into a weapon to disable an entire army. On the other hand, some women (not all) experience anger with D-MER so you could potentially find yourself with an army of berserkers for oh, 2 or 3 scary minutes.
Julian is 5 months old now, so I've had D-MER for nearly half a year. It's unpleasant but it's not unbearable, especially when you know what is going on. Much like painful birth contractions, it's helpful to think of D-MER as a wave that crests and drops. The negative emotions wash over me and I know I have to sort of "ride the wave" until they disappear. For me, the feelings do not last several minutes as they do in some other women, but only about 30 seconds, almost always less than a minute. Overall I enjoy breastfeeding for the convenience, for being able to snuggle with my baby, and for the excuse to sit down and take a rest during the day.
Have I wanted to quit sometimes? Definitely. The D-MER can get to me, especially when I feel tired or lonely. Julian was on antibiotics for 5 weeks in the beginning of his life and a pediatrician told me the best thing I could possibly do to mitigate any long-term negative effects was just to breastfeed. So I'm thankful God has given the strength to keep going. I hope to nurse Julian for 10-12 months like I did with Micah.
Alia Macrina Heise ends her case study with a quote from a mother who compares D-MER to the dementors in Harry Potter. An apt description. Dementors, in the Harry Potter books, are said to "drain the peace, hope and happiness out of the air around them... Get too near a Dementor and every good feeling, every happy memory will be sucked out of you." That is what it's like. For a minute or two anyway. It is something that can make nursing costly and difficult, sometimes impossible.
"Fought 'em off, did you, son?" said Uncle Vernon loudly, with the appearance of a man struggling to bring the conversation back onto a plane he understood. "Gave 'em the old one-two, did you?"
"You can't give a dementor the old one-two," said Harry through clenched teeth.
I find D-MER very interesting. And also a lesson in how closely body and spirit are linked, whether we want them to be or not!