DMER

DMER (or Dysphoric Milk Ejection Reflex) is most often described as experiencing waves of nausea, feelings of doom, feeling like crying, “icky, weird feeling,” overwhelming anxiety, or any other unpleasant feelings when having a letdown.  Though the mechanism of action is poorly understood, it likely is related to paradoxically negative response to oxytocin (a hormone that normally makes people feel good) and dysregulation of other receptors in the brain and breast such as serotonin or dopamine.

Moms can also experience DMER for no reason in between letdowns.  It also can present with significant pain (often described as “excruciating” or “toe curling” pain when an infant first latches.  This pain is associated with these other feelings (sometimes overlapping or sometimes in sequence).  The entire experience can range from horrific to some moms (who feel instantly better when they stop breastfeeding) to more manageable without medication.  Mostly, it can make moms very confused and conflicted about why they are having these feelings when nursing or holding their baby.  They may have intrusive thoughts at other times as well.

Nursing aversion occurs when moms have negative feelings in general toward breastfeeding that can include annoyance, rage, and a feeling of wanting to escape touch.  While they are not technically considered PMADs, both DMER and nursing resolve with the SSRI class of drugs, so it is important to see treatment rather than stop breastfeeding because of these feelings.