Dysphoric Milk Ejection Reflex (D-MER) and Me

Perhaps I had experienced some symptoms of D-MER before I had my first child, but I have no memory of it. When my son was born 6 years ago, I struggled as a new mom with severe postpartum depression and anxieties mixed with all the natural changes and worries that come with the territory of being a brand-new mother. When specific symptoms roared their heads while I nursed my sweet little man, I assumed it was part of my depression. I assumed it was the hormonal changes that occur after childbirth. I didn’t realize that most women don’t feel severe anxiety and think self-damaging thoughts in the moments before their milk lets down. I didn’t know why I was in tears each time I pumped milk out of engorgement desperation. I spoke with my doctor about my depression and was given a medication. At this point, I can’t remember if it helped, but that was the beginning of my experience with this terrible condition.

Dysphoric Milk Ejection Reflex, also known as D-MER, is a medical problem in lactating women who experience a sadness or anxiousness right before milk release, which only lasts about 30 seconds to 2 minutes. The definition of Dysphoria is, “a state of mental discomfort or suffering”. It’s the opposite of Euphoria, which is a “state of joy or bliss”. Which of these feelings are obviously preferable? Which of these feelings should you absolutely 100% not be feeling while feeding your baby? Breastfeeding is something that should bond you as mother and child, an experience that typically releases a chemical called oxytocin, which gives the mother a sort of high, or that feeling of euphoria. Of course, nursing is difficult no matter who you are, but once you get the hang of things and pass through chapped or cracking nipples, escape mastitis, even out your flow, you should be good to go. Right? Unfortunately for those women who suffer with D-MER, this isn’t the case.

By my third child, I felt almost completely prepared. I had recognized that this thing I was experiencing had a pattern. I had spoken with my midwives about my situation, but they didn’t know what to tell me. One of them suggested that I might have an oxytocin intolerance, so each time this chemical was released inside of my body while I was breastfeeding, I would feel a torture. I decided to really keep track and pay attention to what was happening each time I fed my baby.

It’s important to note that for myself, and others who suffer with D-MER, these feelings come in flows and not just while you’re nursing, but during the entire period of lactation. I could be driving around and have this sinking feeling take over my thoughts and mind. I learned how to recognize this for what it was and could stop and remind myself, “it’s alright, my milk is about to come in.” Sure enough, a couple seconds later it comes and I feel normal again. (Unfortunately, recognizing it for what it is in the moment, isn’t always possible.) When I’m feeding my son and someone was trying to carry on a conversation with me, my brain felt bipolar. I’m talking, thinking, and then suddenly everything is covered in this dark cloud of confusion and frustration. My thoughts are jumbled and I’m annoyed or angry or something makes me feel emotionally sick. I remember specifically trying to decide what we would have for dinner, my sister was asking me for ideas and each time, I could not answer. All food sounded terrible and I was so upset about it. It wasn’t long before I recognized this and could say, “just a moment, I can answer when this fades”. My milk comes and I’m able to think clearly and answer any previous questions.


My youngest is now 2 years old and we’re expecting our 4thson. I was determined to get some specific answers so I spoke with my midwife again, about this “oxytocin intolerance” possibility, and she decided to research my situation a little bit more. As it happened, 3 other women had come to her about experiencing the same exact issues so she was determined to get to the bottom of it. A couple months later, she informed me that I had Dysphoric Milk Ejection Reflex. This means my brain isn’t producing enough Dopamine when it was needed the most, and the side effect of this drop is that terrible sinking depression. She told me if things become debilitating, I can try a specific depression medication that raise the levels of Dopamine in the brain. I very much want to avoid this and became determined to find all the possible natural things to help myself.

I got on Instagram and found nothing on D-MER. I logged into Facebook and discovered a wonderful support group of about 1200 women who have finally gotten answers like I have and ask questions as well as post about their own experiences. It’s incredibly comforting to know you’re not alone. The fact that very few doctors have heard about this condition is disheartening. I googled and researched on my own for years, I even emailed a professor at Northwestern University who had published a study they were doing on rats that became depressed from oxytocin intolerance. I worked so hard to get to where I am and am determined to help spread the word so that others won’t have to suffer in silence or feel helpless in their situation like I did.

D-MER is not psychological as one might assume, but physiological. Knowing that this condition isn’t from an unstable mind can really give you added confidence and strength to continue. D-MER is NOT postpartum depression, it is completely in and of itself. It isn’t not something you can control, but a reflex. You can’t talk yourself out of this dysphoria, but you can be aware of your situation. One of the very first ways to get help is educate yourself. Learn all you can about the whys and the hows, tracking your symptoms, taking note of things that may worsen or ease them.

As for myself, I dove into learning what natural things can help ease my symptoms as I’m preparing to nurse my 4thchild in a few months. If it is successful, I’ll continue. If things get debilitating, I will gladly welcome more medical help and not be ashamed of that. Here is what I’ve discovered:


Foods that will help raise your Dopamine levels:

-All animal products (meat, poultry, fish, eggs, dairy)








-Green and leafy veggies



-Olive oil




-Pumpkin and sesame seeds


Oils that help raise your Dopamine levels:

-Frankincense (under your tongue each morning and night.)

-doTERRA’s Clary Calm (Young Living also has hormone balancing options.)


Supplements that help raise your Dopamine levels:

-Sepia 30c

-Mucuna pruriens


-Fish oil



Other ways to naturally raise your Dopamine levels:


-Drink lots of water.

-Exercise, even if it is just a short walk.

-Practicing mindfulness.

-Cut down on sugar and processed food intake.


If you’ve been suffering from these symptoms, talk to your doctor. Unfortunately, they may have never heard of D-MER, so spreading the word is critical. My midwife told me it is starting to come to light because women are just now starting to open up about it. There are answers, support, and help for those struggling with this condition. It isn’t just in your head and it isn’t postpartum depression or nursing aversion. Don’t wait. You’re not alone.


Sources for more info on D-MER:



Before the Letdown: Dysphoric Milk Ejection Reflex and the Breastfeeding Mother by Alia Macrina Heise (Found on Amazon).

A wonderful D-MER Facebook support group.


Photos by Fauset Photography

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