Understanding D-MER: When Breastfeeding Brings Unexpected Emotions
Breastfeeding is often portrayed as a purely joyful experience, but for some, it can come with unexpected emotional challenges. One of these is Dysphoric Milk Ejection Reflex (D-MER) — a lesser-known condition that can cause intense negative feelings just before milk letdown.
What is D-MER?
D-MER is a physiological condition that affects some people who breastfeed. It causes brief but intense negative emotions right before your milk “lets down” — the moment milk moves from your alveoli to your nipples.
Timing: The emotional dip occurs seconds to minutes before milk ejection and usually passes as soon as milk starts flowing.
Duration: Feelings typically last only a short time, but can feel overwhelming in the moment.
Common Emotions: Sadness, anxiety, irritability, a sense of dread, or even nausea. These feelings are not caused by postpartum depression or a reflection of your parenting.
Why does D-MER happen?
Research suggests D-MER is linked to a temporary drop in dopamine, a neurotransmitter involved in mood regulation, just before milk ejection.
This is a biological response, not psychological or emotional weakness.
Understanding the mechanism can help parents separate the feeling from guilt or shame, which is often the hardest part.
How to manage D-MER
While there’s no “cure” for D-MER, several strategies can help you cope:
Knowledge is power: Recognizing that these emotions are physiological can reduce self-blame.
Track your patterns: Noting the times of day or other specific triggers can help predict when D-MER occurs, or when it feels more intense.
Self-talk: “This is a temporary feeling, it will pass. I will be okay.” Repeating this can help you ride the wave of emotions without panic or self-judgment.
Distraction: In the moment, try to engage in an enjoyable (and distracting) activity, like scrolling your phone or reading a book.
Support network: Talking with a partner, friend, or lactation consultant can provide reassurance.
Professional guidance: A therapist familiar with postpartum issues can help you process feelings and prevent anxiety from escalating.
Self-care: Simple grounding techniques — deep breathing, mindfulness, or a short break — can help ride out the moment.
Know you’re not alone: Experiencing D-MER can feel isolating, but it’s more common than most people realize.
When to seek help
D-MER is brief and linked directly to milk letdown, but if you experience persistent sadness, anxiety, or hopelessness outside of breastfeeding sessions, it may indicate postpartum depression or anxiety, which requires professional support.
Bottom line
D-MER is a real, biological phenomenon, not a reflection of your ability to parent or bond with your baby. Awareness, support, and professional guidance can make breastfeeding a more manageable experience — even when D-MER appears.
💡 At Morrow Therapeutics, I support parents navigating postpartum challenges, including breastfeeding struggles and emotional dips like D-MER. If you’re experiencing distressing emotions during breastfeeding, reach out — you don’t have to cope alone.