Today I'm pleased to bring you an email interview with Alia Macrina Heise. Alia is a mother of three who lives in the Finger Lakes region of New York. She is a WIC breastfeeding
counselor, a postpartum doula and a certified lactation counselor in private practice.
Alia has been working with a team of physicians and lactation consultants to identify a problem recently termed Dsyphoric Milk Ejection Reflex, or D-MER. She runs the website, DMER.org.
What is D-MER?
The official definition of D-MER (Dysphoric Milk Ejection Reflex) is a newly recognized condition causing a brief surge of dysphoria, or
negative emotions, that peak before the milk ejection reflex, or letdown, in a
lactating woman and then dissipates quickly after the milk release.
But put more casually, what a mother with D-MER
experiences is a wave of unpleasurable emotion that hits when she begins to breastfeed
and then fades a few minutes later. The feeling varies for each D-MER mother to
some degree but can include a sinking feeling in her stomach, a feeling of
hollowness, anxiety, panic, sadness, restlessness and self disgust. This wave
of feelings corresponds with her release of milk, but many mothers don’t make
that connection. There are three reasons for
this: Firstly, because the mother also has the feelings with
spontaneous releases when she is not breastfeeding; secondly, because not all
mothers feel a letdown tingle in their breasts to connect the emotion with
letdown and thirdly, because the emotional overload happens just prior to
milk release, making it something that is not always easily connected for some
mothers.
What was your experience with D-MER?
I began experiencing what is now known as D-MER when my third baby was born almost a year ago. I did not experience the same reaction to letdown with my first two babies. As a lactation counselor it seemed to me that there ought to be information somewhere on such a phenomenon, but I could not find any. I did find however, within about one month’s time, about 100 other mothers who experienced the same thing and they had all thought they were alone in their experience. So I sought out the more qualified lactation professionals to help me investigate D-MER and since then D-MER has gained a large amount of attention and is continuing to gain recognition.
How common is D-MER?
It seems that it is more common than anyone would have guessed. We are finding is that this is one of breastfeeding’s best kept secrets. Women have been embarrassed, fearful and self conscious about bringing up the negative emotions they feel while breastfeeding, even to their best friend or mother. This is because there is a strong message that breastfeeding feels 100% pleasurable, even warm and fuzzy, and so a mother who experiences the exact opposite, things like guilt, anger, irritation, hopelessness and dread, feels very much like a “freak” and a “weirdo.”
What is known about the causes of D-MER?
We have come very far in a short amount of time, but we surely haven’t come far enough in terms of knowing what the exact mechanism of D-MER is. We probably know 1000 things or more that aren’t the cause of D-MER and that brings us that much closer to finding out what is. Oxytocin is involved, but not as the culprit, more as the messenger. We can know this because mothers experience D-MER before a letdown, probably about the same time oxytocin is being released in the brain. The rest of the puzzle will be figuring out the other parts of the hormonal milieu involved. Prolactin, dopamine, the pituitary, the amygdala and others are all being investigated.
Does D-MER go away?
It can self-correct, but that varies from mother to mother. For mothers with mild D-MER it is likely to self-correct around the third month. For severe D-MER it often won’t self correct until well after the first year, or sometimes not until weaning.
Where can mothers get more information about D-MER?
D-MER.org is the largest source for D-MER support at this time, as D-MER is still gaining recognition. Not only does it contain comprehensive information about D-MER, but it has quotes from other mothers, informational handouts available for download, a forum dedicated to D-MER, a survey for mothers who have experienced D-MER to take to help with the investigation of D-MER, and a lot more.
