DMER

Understanding Dysphoric Milk Ejection Reflex (DMER): When Letdown Feels Like Letdown

Breastfeeding is often described as a beautiful and bonding experience, but for some lactating parents, it comes with an unexpected emotional response. Dysphoric Milk Ejection Reflex (DMER) is a condition that causes sudden and intense feelings of sadness, anxiety, or irritability just before milk letdown. While the experience is brief—lasting only a few minutes—it can be distressing and confusing for those who experience it.

What Causes DMER?

DMER is believed to be a physiological response rather than a psychological condition. It occurs due to a rapid drop in dopamine levels when prolactin (the hormone responsible for milk production) rises during milk letdown. This sudden shift in brain chemistry can trigger negative emotions before stabilizing again. 

Signs and Symptoms

Lactating parents with DMER may experience:

- A wave of sadness, despair, or dread

- Anxiety or nervousness

- Irritability or anger

- A sense of emotional disconnect

These feelings typically last only a few minutes and resolve on their own once the milk ejection reflex is complete.

Managing DMER

Understanding DMER is the first step in managing it. Strategies that may help include:

- Tracking Symptoms: Keeping a journal can help identify patterns and triggers

- Mindfulness & Deep Breathing: Relaxation techniques can ease emotional distress

- Support & Education: Talking to a lactation consultant or support group can provide reassurance and guidance

- Hydration & Nutrition: Maintaining overall health may help regulate hormone fluctuations

-Skin to skin with baby: keeping baby close can lower overall cortisol levels

If DMER is significantly impacting your breastfeeding experience, reach out to a lactation consultant at Wisco for additional strategies and support.  We’re here to help! Book a visit with Wisco Lactation on our website. We offer home & office visit in SE Wisconsin and NE Illinois. We also offer virtual visits worldwide.

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