Understanding D-MER. What you need to know.

Amalhopebirthing
Mar 19, 2025
3 min read

"a sinking feeling in my tummy"

"low mood"

"a brief feeling of hopelessness"

"yucky feelings"

Although every woman can probably relate to one or more of these feelings, some nursing mothers experience an influx of these emotions every time they're breastfeeding their baby. Breastfeeding is supposed to be an enjoyable and pleasant experience- most of the time. So, what's the deal here?

So, what exactly is D-MER?

According to the Womanly Art of Breastfeeding, D-MER (Dysphoric Milk Ejection Reflex) simply put, is when a nursing mother experiences a range of bad feelings just before her milk is released. These feelings may only last a few seconds or few minutes. However, a woman may continue to experience these emotions every time she nurses or whenever her milk is released during the feeding session. Afterwards, it's as if it never even happened.

Lactating women describe their experiences as having unpleasant or uncomfortable moods, being sad, depressed, and feeling anxiety or irritation.

D-MER was first identified in 2007 by Alia Macrina Heise. She established a website, www.d-mer.org to educate the public about it since there was hardly any support available for mothers experiencing this condition.

What causes it?

There are still very few studies done on this phenomena today, since there is not enough evidence to confirm what actually causes it. According to most theories, D-MER is caused by a sudden drop in dopamine levels, which is a hormone and neurotransmitter.

During breastfeeding, a range of hormones are involved. Oxytocin, the love hormone, facilitated by touching and snuggling with one's newborn or even thinking about baby, rises, causing milk to be released. Prolactin, another hormone, is responsible for allowing milk to be made. Usually during nursing, dopamine (the feel good hormone), rises and falls in such a subtle manner that one isn't consciously aware of it. In women who experience D-MER, their dopamine levels doesn't drop properly and causes a brief wave of a negative emotional reaction.

At least, this is the best theory that explains it.

How common is it?

According to a study done by the National Institute of Health in 2019, about 9.1% of nursing mothers may experience D-MER. Not to be confused with postpartum depression, women who experience D-MER, explain that their symptoms come on suddenly and last for less than five minutes. Studies done also show that D-MER is not the same as postpartum depression, yet many are mistakenly diagnosed due to the lack of education and information about it.

How long will it last? Does it go away?

Thankfully, D-MER can be corrected. Some mothers may experience it for only three months while others may experience it until their child is weaned. It all depends on the severity of the condition. Some mothers may experience a mild form of D-MER while others have it more severe. There is not a lot of information as to why this is so.

What can a mother do to prevent it?>Or fix it?

Here are some proven ideas that might help a mother who may be experiencing D-MER.

Herbal remedies such as Rhodiola or Golden Root have been shown to help inhibit the breakdown of dopamine and other neurotransmitters
Make a log to track your symptoms and see what aggravates them (stress, dehydration, caffeine)
Distract yourself while nursing
Stay hydrated
Exercise
Make sure to get enough rest
Reduce caffeine intake
Supplements such as omega-3 and evening primrose oil
Prescription medication is symptoms are severe

To end off...

If you are a nursing mother reading this and you are relating to any of this, I do empathise with your frustration and pain. Know that there is no shame in what you are experiencing. Be comforted that there is hope- it won't last forever.

The issue with D-MER, is that many mothers tend to end their breastfeeding journeys way too early because they just want the negative emotions to stop. This robs you and your baby of all the amazing benefits of breastfeeding.

My words of wisdom would be to share it with someone in your support circle. Your husband, other breastfeeding mothers or your health care provider. Think about hiring a lactation consultant. Tell them what you are experiencing and get the help you need. Maybe all you need is more rest and better nutrition. It's amazing how we forget such basic things when we have a little one demanding all our attention.