A few weeks after welcoming my third child into our home, I thought we were settling into a comfortable routine. Nursing had been a struggle, and I often dreaded feeding time, but I was determined to make it work. After some trial and error, we found a breastfeeding position that suited her, and despite the soreness, I felt a sense of accomplishment.
Then came a Saturday morning that I will never forget. The baby was happily swinging, the twins were playing on the floor, and I was indulging in a book—what a rare treat! Suddenly, a wave of panic washed over me. My heart raced, my vision blurred, and I felt as if my body was trembling uncontrollably. I dropped my Kindle and screamed in fear.
My husband rushed over as I gasped for air, tears streaming down my face. “What’s going on?” he asked, panic in his voice. Just like that, it was over. I was left shaky and confused, still feeling the effects of what had just happened when, out of nowhere, my milk let down.
“I think I just had a panic attack,” I told him, before nursing the baby.
Hours later, I found myself in the kitchen, a plate of food slipping from my hands. This time, I didn’t scream; I just crumpled to the floor, sobbing. My husband was there again, and once more, the panic subsided, only to be followed by that familiar letdown sensation.
By the end of that weekend, I had experienced a series of panic attacks—each one only lasting a minute or so, but each followed by a letdown. I was utterly bewildered.
It took months before I discovered what I was dealing with. I sank into deep depression, my thoughts edging toward despair. Despite nursing my daughter only a few times a day, those panic attacks persisted and grew in intensity. Yet, my milk supply remained intact, and my daughter refused a bottle, so I continued to nurse.
I was grappling with a severe case of a condition known as D-MER (Dysphoric Milk Ejection Reflex).
Typically, breastfeeding evokes feelings of joy and connection. During a healthy letdown, the brain releases prolactin alongside oxytocin. Oxytocin tends to elevate mood, fostering affection and bonding between mother and baby. It’s a feeling I cherished during my previous nursing experiences.
However, dopamine inhibits prolactin. When dopamine levels are too high, prolactin can’t reach sufficient levels to trigger a letdown, which leads the lactating brain to cut back on dopamine production. Low dopamine can trigger symptoms like anxiety, confusion, fatigue, and depression. Moreover, oxytocin, in elevated levels, can provoke feelings of fear.
This creates a vicious cycle. The initial lack of dopamine leads to anxiety, which is then exacerbated by high oxytocin levels, reinforcing the panic response during subsequent letdowns. Each episode becomes etched in memory, making the cycle harder to break.
While most cases of D-MER are mild—manifesting as slight discomfort or unease—some, like mine, can be truly debilitating.
D-MER is a relatively new condition in the medical field, and while research is still evolving, we now have a better understanding of it than when I was struggling in 2012. The most significant advancement is that effective treatments are now available.
During my ordeal, there was uncertainty about the safety of prescribing medications. The advice I received was often limited to, “You’re not crazy,” which, though comforting, did little to alleviate my panic. The most common suggestion was to stop nursing altogether.
Having successfully nursed my twins without issue, I found it hard to accept that I should give up just because I was feeling miserable. I fought through five months without understanding what was happening and another four months after finally identifying the problem. But knowing the name of my condition didn’t equate to having a solution. I believed I had to endure this hardship for the sake of my daughter’s nutrition, thinking that nursing had somehow driven me to the brink of insanity.
Now, I understand that D-MER isn’t a psychiatric issue; it’s a hormonal imbalance that can be corrected through medication. Those experiencing D-MER don’t have to simply endure it—they can seek help and continue nursing their children without fear.
If you’re affected by D-MER, don’t hesitate to speak with your doctor. Since D-MER is still gaining recognition in medical literature, your physician may not be familiar with it yet. This doesn’t negate its reality. Bring along articles about D-MER and encourage them to research it further if needed. Awareness is growing rapidly, making it easier to learn about this condition now than it was back in 2012.
You don’t have to be suffering from severe D-MER to seek assistance. No one should feel distressed and confused while feeding their child. It’s crucial to prioritize your emotional well-being while providing the best for your little one.
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Summary:
D-MER (Dysphoric Milk Ejection Reflex) is a challenging and often misunderstood condition that can cause panic and anxiety during breastfeeding. While typically associated with feelings of joy, some mothers may experience severe distress due to hormonal imbalances affecting dopamine and oxytocin levels. If you find yourself struggling with these feelings while nursing, it’s important to seek help. Advances in treatment options now allow mothers to continue nursing without fear or discomfort.