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Frequently Asked Questions

Why does is take so long for some mothers to connect they way they are feeling to breastfeeding?

D-MER can easily go unrecognized since 1) some mothers have so many closely spaced letdowns per feeding that the feelings do not have a chance to dissipate before the next D-MER is upon her, making her feel that she experiences on long D-MER through most of, if not all of, the feeding 2) many mothers do not physically feel a letdown in their breasts and so does not connect the feeling as to being just prior to letdown and 3) given the fact that D-MER happens with spontaneous letdowns as well, a mother may not immediately connect the way she is feeling to being a breastfeeding phenomenon.

Why is D-MER a newly recognized condition?

There are many answers to this question.

The biggest cause has been that no one ever guessed so many women were being affected. There were not enough mothers coming forward to speak about their emotions while breastfeeding. Mothers were embarrassed and thought they were the only ones. It has been one of breastfeeding's best kept secrets, but it's time for that to end.

Also, this is something that has been "swept under carpet" as one lactation consultant admitted. This is because when a medical professional came across a mother experiencing negative emotions when breastfeeding sometimes that practitioner told themselves it was "just one mother" and was able to dismiss it without further probing.

It is also likely that many mothers were not associating their waves of depression with milk release and were diagnosed with PPD incorrectly.

Lastly, when a medical professional did come across a mother complaining of this problem, it was assumed the mother was suffering from a psychological issue. It took great amounts of information and research and a vast number of mothers with D-MER to be found for professionals to finally realize that D-MER is physiological.

What affects the intensity of D-MER?

We feel that the drop of dopamine that happens with D-MER is on a continuum, meaning in mild cases of D-MER the drop in dopamine is closer to normal. In more severe cases of D-MER the action of dopamine is more abnormal.

In conjunction with that, something interesting about D-MER is that it seems no matter how "low" a mother may start out a feeding feeling; the D-MER will bring her lower, making D-MER seem much more severe on a "bad day."

This can manifest itself in another way as well: in a mother who naturally has a more challenging day to day living situation, this mother may find D-MER to be more severe than a mother in a stable well-supported household.

Will D-MER get better without treatment?

Some mothers find that D-MER gets less severe and slowly dissipates as the baby ages until they suddenly realize they don't feel it anymore. Most mothers notice their D-MER within the first couple weeks postpartum and for some, usually those with mild cases, it will be gone by the time the baby is three months old.
For others, without treatment, it remains past the first year, sometimes until weaning regardless of the age. This happens more often in the severe cases. We have learned however that even once a mother's D-MER has self corrected, she will be prone to occasional relapses. As her hormones naturally fluctuate there may be times when she experiences one or more D-MERs "out of the blue", even if D-MER itself had been gone for months.

Do D-MER and other nipple stimulation go hand in hand?

The D-MER sensation outside the context of lactation and within a sexual context has been dubbed "Sad Nipple Syndrome."

When D-MER mothers were polled regarding if they experienced Sad Nipple Syndrome:

11% replied "Yes, I do, and always have"
replied "Yes, I do, but didn't before"
40% replied "No, I do not, and I never have"
8% replied "Yes, I used to, but no longer do"
22% replied "Not Applicable"
4% replied "Other"

There will need to be more research in there area before any conclusions can be made.

Is there concern for violence in the form of self harm or child abuse with D-MER?

Some mothers feel uncontrollable emotions, uncontrollable anger, perhaps an urge to hurt themselves with the brief but intense feeling of D-MER, but not at any other times. These are often called invasive thoughts or suicidal ideation. The majority of mothers with D-MER do not feel these emotions towards their nursling, but instead towards themselves. The few mothers that do seem to focus these emotions towards their baby also seem to have D-MER coupled with other concerns such as anxiety problems or postpartum depression. If either of these are the case the mother needs to talk to someone. There are solutions; mothers shouldn't have to feel this way when breastfeeding and generally shouldn't have to wean because of it, if they aren't ready. Most importantly the mother needs to find someone who understands her and does not judge her as they help her problem solve without pushing weaning if the mother isn't ready.

What happens to D-MER with the return of the first postpartum period?

It seems to be different for every woman. Sometimes D-MER gets better when a mother's period returns (10%) sometimes it stays the same (25%) and rarely it worsens (2%.) During these times the hormones are fluctuating again and it seems there is no consistency on how they will affect the mother, though it seems frequent that a mother's period does not return until after D-MER has self corrected (11%.) The majority of mothers with D-MER have not had their first postpartum period (53%.)

Is there a connection between D-MER and the breastfeeding aversion? 

Breastfeeding aversion is a term used for when women dread breastfeeding because they get irritated feelings throughout the feeding, starting with latch on. It is true that often mothers who are nursing while pregnant resonate with how D-MER is described, mostly with the anxiety experience that includes irritability. But it's currently the thought that these mothers are "annoyed" or "irritated" when they first sit down to nurse, probably because of nipple contact  (sometimes the feelings dissipate with milk release, for many it is throughout the whole feeding.) In D-MER, mothers feel fine with latch on and when the milk release process is triggered their feelings emerge. It is thought that mothers with nursing aversion handle the dopamine drop normally, and that its nipple sensitivity that prompts them to feel irritated.
Hilary Flower, author of Adventures in Tandem Nursing, suggests that breastfeeding aversion could be a result of our mammalian roots, and notes that maternal aggression is not uncommon in the animal world at weaning time. Perhaps it is a female body's way of protecting itself and the unborn child. 

One mother tells who has had both us: they (D-MER and breastfeeding aversion) were actually quite different. While I was pregnant, when my son wanted to feed I dreaded having to do it, felt almost repulsed the whole time, it made my skin crawl, I felt ‘wrong’ and it lasted during the whole feed, sometimes getting worse during the feed. With D-MER it’s not a repulsion, it’s more of a deep, sad, dark feeling but it’s over really quickly. I don’t dread feeding, I just have a feeling of dread before the let down. I still enjoy breastfeeding, whereas whilst pregnant I did it because I knew it was good for my son and he enjoyed it. I felt the aversion was a good enough reason to wean my son, but I don’t feel D-MER is bad enough for me to need to wean this baby.

How is postpartum depression different from D-MER?

D-MER is not postpartum depression, and it often seems that this can not be emphasized enough. In fact the medications most commonly prescribed for PPD have no effect on D-MER. D-MER is a separate condition from PPD. It is an emotional overload that is fleeting, that sweeps over a mother like a wave, before letdown. A mother can have PPD and D-MER,  but most (75%) don't. Those who do have a mood disorder in conjunction with D-MER can always distinguish D-MER from their perhaps "regularly dysphoric" mood with a wave at letdown that it even more dysphoric. It is very likely many mothers have been diagnosed with PPD when if fact they have D-MER, as many mothers say that, before they knew it was D-MER, they thought that they had "PPD now and again" or "postpartum depression that comes and goes." Postpartum depression does not come and go, but D-MER does.
Are there physical manifestations with D-MER?

D-MER does not have any physical manifestations. Some mothers with D-MER describe a stomach malaise with their emotional response, but it is not nausea. Any other physical response (itching, headaches, drowsiness, thirst etc.) has not been connected to dopamine or D-MER. A women can have any of these physical symptom in conjunction with D-MER, but it is not part of the D-MER.

What causes some mothers to have D-MER and not others?

This is currently unknown and we may never know. It could be that some mothers may be physiologically predisposed to an inappropriate drop in dopamine, that some mothers have dopamine receptor mutation, or that a D-MER mother is just more sensitive to the drop in dopamine. Right now it seems like it is just a form of hormonal "russian roulette" with no common link from one mother to a next that would explain this particular dopamine behavior.

Can D-MER "Rebound?"

Rebounding D-MER is different then a relapse with D-MER. Mothers with self corrected or even treated D-MER may have relapses, time when for a single letdown, feeding or even day or two, their D-MER is more prevalent. But this is short lived and seems to be due to the natural flux in hormones. Rebound would be a mother with self corrected D-MER that has a re onset of symptoms that persist for several days or more. There have been only a few reports on this, and so it seems that it can, though it's rare. Possible triggers of rebounding D-MER are: an increase in milk supply/prolactin, a change in nursing frequency (usually an increase), a return of the first postpartum period, a pregnancy, a change in caffeine intake, a sudden decrease in sleep, dehydration, a severe and persistent change in stress or a change in medication (counter active meds, birth control etc.)

Is D-MER normal?

It is seems to be somewhat common, early numbers are showing a prevalence above what we imagined, but is it normal because it is common? Let's look at an example; having an allergy is considered common, but allergies are not considered normal. We try to fix allergies, prevent allergies and take meds or natural remedies for allergies. They are uncomfortable and irritating. D-MER is like that. It is common, but not normal. Nature did not intend for mothers to feel upset when feeding their babies, the survival of man kind was dependent on mothers finding breastfeeding enjoyable, or else infants would not have been cared for or fed properly. That does not mean that some mothers after learning their feelings are being caused by D-MER do not take a different attitude. There have been a handful of mothers who were upset by feelings while nursing that they did not understand but after being able to label them as D-MER actually were able to accept the feelings as their "normal." An interesting quote about this: "my feelings when breastfeeding, despite being uncomfortable, are there for a reason. Like the pains I feel in child birth, or the blues in the days after birth are there, have a place and are mine."

Do mothers compare the feelings of D-MER to anything else?

There are several comparisons and it's likely becuase dopamine is acting in a similar fashion in these scenarios.

There are comparisons made between the sensations of D-MER and the feeling prior to having a seizure. But concerning seizures, letdown has never brought on a seizure for the women that have been interviewed with this connection, but mothers with seizure history do have a dejavu feeling with D-MER that makes them feel like a seizure is coming.

Comparisons have been made between the emotional feelings of D-MER and the feelings while experiencing restless leg syndrome.

Many mothers say D-MER is a more intense version of what they experience during PMS or PMDD.

There are comparisons to D-MER and a negative emotional feeling some get after experiencing an orgasm.

"Sad Nipple Syndrome" is another comparison, that is address in another FAQ. Tandem nursing and nursing while pregnant is a comparison that has also been made and is addressed in another FAQ on this page.

Are there issues with recurrence and a mother with D-MER?

Out of the women polled:

55% were experiencing it with their first baby.

30% were issues of re occurrence; mothers who had it with their first, as well as at least one subsequent child.

14% were mother who were experiencing D-MER for the first time, with a subsequent child, 2nd or later.

1% of mothers had it with their first baby, but not with a subsequent child.

If a woman does not feel letdown in her breasts, does that mean anything?

Some mothers do feel this, some don't, and you can suffer from D-MER either way. The troubling thing about women who do not feel a tingling sensation with letdown is that if they have D-MER it is much harder for them to connect their feelings to letdown/breastfeeding. The best tool for helping a mother with D-MER to connect her feelings to milk release is with pumping. By having her pump she can see the letdown through the pump flange and correspond the timing of her feelings to the release of the milk that she sees. This is not necessary for her to do, but may help reaffirm her feelings.


Is a general dislike of breastfeeding considered D-MER?

Mothers can dislike breastfeeding for many reasons. For example, they may find it inconvenient, it could hurt, they don't like to sit still, there is trouble with feeding, they have to do it more often than they thought they would,  it's harder than they would like, they are uncomfortable with their breasts, etc. But disliking breastfeeding is not D-MER. In fact, some mothers with D-MER find they end up coping quite well and would not say they "dislike" it. D-MER has a very specific diagnosing criteria, and disliking breastfeeding is not part of it.

Mothers Ask

I am not suffering from a psychological response to breastfeeding, I do have D-MER, So why do I feel D-MER is because I was sexually abused or because of my baby's traumatic birth?

When you experience D-MER the emotions you feel may cause you to remember these upsetting times in your life, but the experiences are not triggering the D-MER.

The emotions you experience with D-MER can be reminiscent of how you felt during these other times, and are therefore making you think back to them because the feeling is similar.

Some think of when they were homesick as a child, others remember the guilt they felt when they made a bad decision. To send this point home I will give you two more examples. One mother, every time she had a letdown, was reminded of the way she felt in Catholic school when the nuns suggested she become a nun herself one day, but she didn't want to! Another mother remembered the way she felt when her baby brother died when she was a young girl. These are dejavu feelings, these mothers are not having psychological responses to breastfeeding because they chose not to become nuns!

So point made, this dejavu feeling is likely because D-MER by itself causes this dopamine drop in your body, perhaps along with another hormonal milieu, making you feel this way regardless of your past life experiences. So if you happened to have a life experience in the past that caused the same "hormone cocktail" along with this dopamine drop, then you may be likely to have a dejavu feeling with each D-MER as that hormone reaction repeats itself.

Since I am thinking and feeling bad things when I nurse, will the milk harm my baby?

Absolutely not. Even if you find yourself feeling negative emotions, or thinking bad thoughts during breastfeeding, it is not going to make your milk "bad." They are just thoughts and feelings that don't really mean anything. It is simply the hormones sending mixed messages to your brain. Thoughts and feelings, real or not, can never make milk "bad" for the baby.

I feel like D-MER must be my fault in some way. I always feel so guilty and horrible when I experience it, did I do something to cause it?

Mothers can't cause D-MER, it's a hormonal problem. Even though it feels like it's in your head, it's not, it's hormonal. You did nothing to cause it. It's not because of a history of depression, or a history of sexual abuse, or because of your birth experience. It's not because you don't love your baby enough or because you're a bad mother. The feelings are not justified; they are hormones that are tricking you.

My D-MER is so bad, I may have to wean, but I don't think my baby or I are ready, what can I do?

No one should ever have to wean their baby if they are not ready, but D-MER makes mothers feel so uncomfortable when breastfeeding, that many are weaning. Maybe knowing that's it's just a hormonal problem will help you understand the feelings better. Talking to others and understanding that they are not alone can help a lot. Remembering that just because you don't experience the "warm fuzzies" associated with breastfeeding doesn't make you weird; D-MER can be classified as medical condition/physiological phenomenon. It can also get better with time, so maybe you will choose to hang in there and find some tricks that work for you. If you are seriously considering weaning, it would be good to consider seeking a prescription to treat D-MER. If you decide to wean, find people who understand and will support you, there is no need to replace the feelings of D-MER with the guilt you may place on yourself for weaning when you weren't ready.