Dysphoric Milk Ejection Reflex (D-MER) is a condition that causes sudden negative feelings during milk letdown while breastfeeding. Unlike typical emotional responses, D-MER is a physiological reaction triggered by the release of milk, making it difficult for some mothers to fully engage in breastfeeding. D-MER is an underresearched area of lactation; however, it is estimated that this condition affects 9.1% of breastfeeding women.1

Understanding D-MER

D-MER occurs when the body’s natural release of milk causes negative emotional symptoms. These feelings usually last for a few minutes during letdown and can be distressing, but they typically subside once the milk flow stabilizes. It is important to note that DMER is not linked to postpartum depression or anxiety, although it can feel similar.

Managing D-MER

  1. Recognize the Symptoms: Knowing that D-MER is a physiological reaction can help you manage expectations. Symptoms of D-MER include anxiety, sadness, nervousness, irritability, nausea, chills, palpitations and a hollow feeling in the stomach.1
  2. Work with a Lactation Provider: A lactation provider can guide you on techniques to both help manage the feelings of D-MER as well as support you to reach your breastfeeding goals. 
  3. Practice Self-Care: Stress-reduction techniques like deep breathing, mindfulness, and relaxation can help ease the emotional discomfort associated with D-MER.
  4. Talk to Your Healthcare Provider: In some cases, medication or herbal remedies may be recommended to help manage D-MER symptoms. Always speak with your healthcare provider for guidance. 

While D-MER can make breastfeeding challenging, understanding the condition and implementing strategies for self-care can help parents cope and continue breastfeeding successfully.