For some women, breastfeeding comes with clinical levels of anxiety, a condition known as dysphoric milk ejection reflex, or D-Mer. Here, Allie Barnes — a mother of two — shares her story with Scary Mommy writer Kate Morgan.
There’s a terrible thing that happens to just under 10% of moms who breastfeed. It’s called dysphoric milk ejection reflex — or D-MER — and for the minutes surrounding a letdown, it can make you feel lower than you’ve ever been. In a dozen years as a mental health professional, I’d never heard of anything like this. Then, I became part of the 10%.
I remember the very first time really well. Everything had been fine at the hospital, and we’d just gotten home. I was sitting on the couch with my 3-day-old daughter, getting ready to nurse her. I’d had a C-section, so my husband was helping me get situated and get the pillow adjusted. She latched, I got the pins and needles feeling you get when your milk lets down, and all of a sudden, I had this feeling of intense doom come over me.
The best way I can describe it is I felt like I was getting bad news. It was the kind of dread you get when you’re finding out someone you love has cancer, or that you’re getting fired from your job. Imagine you’re getting a call that you know is going to be really, really bad, and the pit in your stomach you get when that phone rings.
I had no idea what it was. I thought maybe I just had out-of-control anxiety about being a parent. My husband was planning to go out and mow the lawn after he helped us get set up, so I thought maybe it was happening because I was petrified to be alone with my own baby. It seemed like something I shouldn’t be feeling, so I didn’t say anything. I didn’t know how to tell my husband, or how to describe what was going on.
That went on for the first four or five months of my daughter’s life; I was too embarrassed to say anything. It would start about 15 to 30 seconds into a letdown, and last anywhere from 30 seconds to a minute. That seems like nothing, until you consider that it’s a minute of feeling like you’re anticipating the worst news of your life. Imagine how long that minute would stretch on. It felt like an eternity, though it wasn’t ever longer than a minute. But I didn’t make the connection at first between the way I was feeling and my milk letting down. In those early months, you’re nursing all the time, so it was like I just felt that way all the time.
But — and now I know this is classic D-MER — when it’s not happening, you feel totally fine. So, I’d go to checkups with my obstetrician and say, “Yup, everything’s great!” Sure, an hour ago when I nursed my daughter, I felt like my world caved in and everyone around me was going to die but… everything’s great!
I vividly recall the moment I figured it out. I read a post in a moms’ group on Facebook, from someone else describing exactly what was happening to me. It said something like, “Hey, do you ever get a sense of doom while you’re nursing? Anxiety that feels indescribable? You may have D-MER!” I clicked that link so fast.
There’s no definitive explanation for what causes D-MER, but they suspect it has a physiological cause and is tied to a momentary drop in hormones at the moment of letdown.
Suddenly, the thing that was happening to me had a name, and I wasn’t the only one who felt it. Knowing what it was helped me cope. It was such a horrible feeling to know that what was happening wasn’t just plain anxiety, but not knowing why it felt so bad. When I could finally put my finger on it and I knew it was all just a hormonal drop and would stop eventually, I was relieved.
But knowing that didn’t do anything to make it go away.
I tried everything — all the suggestions, all the things that other people said worked for them: drink cold water, watch TV, eat chocolate, stay really hydrated. Nothing really helped other than to focus on my baby and try to remember I was doing it for her, and it was all just temporary.
I breastfed my daughter for a total of seven months. It wasn’t really the D-MER that made me stop. By that time, she had teeth and was biting me. I was tired of pumping at work. It was just time.
Once she was weaned, I put the D-MER behind me. I almost think it was like after you give birth and you’re like, “That was the worst, I’m never doing that again.” Then, time passes and you just forget. I didn’t think about the D-MER at all. It didn’t even cross my mind.
And then, two years later, I had a baby boy, and it came back right away, as soon as my milk came in at the hospital. And this time it was worse.
Not only was it the anxiety and dread and nervousness, but I would also get ridiculously nauseous. I’d feel like I might throw up, and then 15 seconds later I’d get the pins and needles of a letdown, and that’s when the anxiety would kick in.
I could have stopped — I knew it wasn’t going to get better — but he was so attached to the boob. He was a total nursling. He just wanted to be close to me, and it was an easy way to comfort him.
I’d have days where I’d wake up and be like, “This is the last day.” And then I’d nurse him and go, “OK, that’s it, he’s getting the bottle!” And then he’d snuggle into me and want to nurse. Each day turned into another, and turned into another. I remember thinking, “OK, it’s really bad this time. I’m probably not going to get past six weeks. And then thinking, “I’m not going to get past maternity leave.” I’d set tiny goals and start surpassing them.
I’d get a lot of jealousy that not everyone had D-MER. I hated that I had to have this horrible relationship with breastfeeding. I was jealous that it was simple for other people. They could just nurse and it was a pleasant experience. But at the same time, when you’re not having a letdown, you can’t remember how bad it was. I’d look at it fondly when I wasn’t doing it. Like, “Oh, I love nursing, I could never give it up! I hope he wakes up soon! I can’t wait to nurse him!” And then I’d actually be nursing and be like oh… no. But I still loved it.
Before I knew it, he was 7 months and biting just like his sister. I recently stopped nursing and I am so happy. I’ll still have a letdown about once a day, and every time it happens, I think, thank God I stopped. I could not do this another moment.
I can’t believe I lived with that for a total of 14 months. It’s by far the hardest thing I’ve ever done. And to this day, I’ve never spoken to a single OB who knows what D-MER is. If I hadn’t come across that random Facebook post, who knows if or when I’d have figured it out.
Because of that, I actually went and got a certification in perinatal mood disorder treatment. I see moms who are struggling, and I’ve been able to help some women identify that what they’re struggling with is D-MER. It’s all very full circle.
My daughter just turned 3, and my son is 7 months, and I know we’re finished having kids. There are a few reasons for that. One and two on the list are probably age and money, but number three is D-MER. When I’m thinking clearly about it and removed from the hormones, I know I have to be done. I can’t ever, ever do it again.
