D-MER: The dark side of breastfeeding.

This is something I've wanted to write about for a long time, but couldn't bring myself to do it. The emotions associated were too fresh until recently.

But I'm ready to talk now. I have realized my story could help many mothers to keep breastfeeding, even when it's really difficult.

In April 2014, I had my third baby, Clara. After briefly breastfeeding my first child and nursing my second baby for nearly a full year before he weaned, I figured I knew all there was to know about breastfeeding. I thought the beginning might be rough since four years had passed since my last baby, but I believed once I crossed the hurdle of the first few weeks, it would be easy again. Just like riding a bike.

Then came the gloom and doom.

It happened every time Clara latched on, right before my milk let down. You know that feeling you get in your stomach when someone shares tragic news, or when you're really homesick? That gut-wrenching feeling would sneak up on me each time I began to nurse.

This sadness would quickly swell into ultimate sorrow. My heart would race and my breathing would become sharp and fast. Then, I would involuntarily cry; tears would stream down my face, completely beyond my control. Horrific thoughts entered my mind. Often, I wished I could die.

This intense feeling would last about a full minute, sometimes longer, and then gradually subside until I was done feeding my daughter. It didn't matter if I was on my phone, talking to people, watching television or distracted in any way -- it still happened every time I nursed.

At first, I chalked it up to the post-partum blues most moms get right after they give birth. But three months in, it hadn't abated. In fact, it seemed to be getting worse, and I anticipated each feeding with dread. During the rest of the day, I felt pretty normal -- a little tired, sure, but certainly not depressed. But man, when it came time to breastfeed, that awful, grievous feeling would take over. It felt like an evil force was plunging me deep into the darkest abyss of sadness without any hope for escaping.

One day, I was pondering on this strange occurrence when I recalled a thread I had seen on a parenting forum years before. It discussed a condition called D-MER. I'd only skimmed the thread, vaguely remembering something about discomfort associated with breastfeeding. I shamefully remembered how at the time, I thought the woman discussing it was crazy. But now, I know she was not. At the soonest opportunity, I got to my computer and Googled this phrase:

"feeling intense sadness while breastfeeding"

All my questions were answered here.

I found out that D-MER is short for dysphoric milk ejection reflex. I learned it is "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 site explains there are two hormones that regulate milk release. Prolactin is the hormone that signals for milk release or ejection in nursing women. To keep the breast milk from coming out all the time, dopamine (the "happy hormone") regulates the mother's prolactin levels. So, in order for the prolactin to do its job when your baby is hungry, the dopamine must decrease rapidly. In some women, this sudden decrease in dopamine causes the dysphoria associated with D-MER. It can manifest as sadness or homesickness (like I had), anxiety and even anger. As the dopamine levels rise again, those negative feelings dissipate.

Now, it's important to know that D-MER has nothing to do with pain or nausea when nursing. Those are different conditions. It is not psychological, either, like postpartum depression or psychosis. It is simply a hormonal response.

After reading about D-MER, I was relieved to know that what I had was explainable and somewhat normal. But, knowing about it didn't make the feeling go away -- it still came and went, every time. The site did say as my baby got older, the dysphoria would lessen and that most D-MER cases go away by six months postpartum. I clung to that hope and began to notice when it lessened, vanishing completely around Clara's six-month mark. What a relief when I could finally nurse without feeling that awful sadness!

Here's something kind of crazy, though. Despite delivering three babies, D-MER was something I had never personally been told about. Not by obstetricians, pediatricians, midwives, nurses or even lactation consultants. It was not in any of the literature I brought home from three different hospitals or obstetric practices. I had only ever seen it mentioned in passing on a message board, many years prior. Yet it was something so terrible, it almost made me give up on breastfeeding!

I mean, who wants to go through that torture 5 - 8 times every day? Nobody. But since I'd never been warned it could happen, I wondered if I had some significant problem with breastfeeding, or if I was experiencing some kind of psychosis. Thank goodness Google cleared that all up.

Something DID help me get through it, though, and that was talking about it. Once I knew what I had, I began telling people -- my husband, my mom and my close friends. Their sympathy alone made a difference.

Also, being aware of the D-MER and understanding what caused it didn't make it go away, but it helped me handle it better. I knew that it would end after a few minutes and I would feel happy again soon.

If you have these feelings when your baby is nursing, just know you're not alone. You are not crazy; you do not belong in a psych ward. You have D-MER. It will go away eventually. The intense sadness/anxiety/anger you are feeling during breastfeeding is not rooted in reality but is simply a hormonal response. Remember that, and don't let it get to you.

And maybe it's just too much and you want to quit breastfeeding. Only you can make that call. If you feel it's best for you and your baby to switch to formula because the D-MER is making you miserable, go for it. Breast isn't always best, and maybe severe D-MER is an example of a situation that warrants bottle-feeding. I fully support moms who do what is best for their family, whatever that may be.

Have you or a loved one ever experienced D-MER?