There is no current treatment recommendation for D-MER. However, these are some of the things that other mothers have found to ease their D-MER experience.
Education about D-MER, validation of the D-MER experience, connection with other mothers with D-MER, self-care, deep breathing, vitamin D, Magnesium, vitamin B complex, probiotics, focus on breastfeeding goals, ignoring the feelings of D-MER, remembering that it is transient, distraction and drinking cold water with letdown..
The thing about D-MER is that no matter how low you are, D-MER will make you feel even worse. These are things that other mothers have found to make their D-MER experience worse.
Lack of D-MER education, lack of self-care, isolation, galactagogues, low carb diets, being around people, touch, birth control, caffeine, stress, negative environment, too long between feedings, menstrel cycle changes and a messy and cluttered environment,
I always expected to get postpartum depression. I planned for it. I knew the warning signs. With my history of regular depression, I was sure the birth of my child would exacerbate my long standing mental health issues.
As such, I was not surprised to find myself sitting in utter despair; feeling like the world was crashing down around me, clutching my wailing newborn to my breast just a few short days after arriving home from the hospital. I felt horrible, like my throat had dropped to the pit of my stomach. I was desperately thirsty, yet could not keep the water from leaking out of my eyes and down my face. There was a crushing sense of impending doom, though I had no idea what it was that I was afraid of. But I knew I needed help.
Fast forward fifteen minutes. My snuggled up baby was delightfully "milk drunk", and my loving husband and I lay on the floor beside her, marveling at her tiny perfect fingers, lips, everything. I could smell the turkey soup my mother was making in my kitchen, and I smiled. Being a new parent was exhausting, but wonderful. I wouldn't trade it for anything.
I expected to get postpartum depression. I planned for it. I knew the warning signs. At least, I thought I did. But somehow, all of my preparation had not prepared me for what I was experiencing. Ninety five percent of my day was a picture perfect "new parent" experience, filled with sleepy baby snuggles and lots of baby poop. The other five percent of my day was pure hell, and it usually happened when I was breastfeeding.
My husband was also keeping a watchful eye out for postpartum depression, and would ask how I was doing. Most of the time, my answer was "exhausted but great". If he tried to talk to me while I was nursing the baby, my response was sharp, rude, and distracted. It was clear even to him that something about breastfeeding was not right.
The hospital where my daughter was born had provided a lactation consultant while we were there. Being a very private person, the idea of another woman looking at my swollen breasts and talking about my nipples made me very uncomfortable. I spent as little time with her as I could get away with, and I sure wasn't going to call her for help after I got home.
"Call your doctor", my husband urged. "And talk about how I cry when my baby nurses? She will just think I'm depressed, but I really don't think I am," I replied.
"What about the psychiatrist?" My husband suggested. "I'm certainly not going to talk about women boob problems to him!" I snapped.
Days, maybe weeks, went by. Finally, after a particularly horrible nursing session late one night, I turned to Google for answers. "Feeling horrible while breastfeeding" was my first Google search, and I half expected to find nothing. But instead, right in front of me, I found evidence that my experience was not unique. Here were stories of other women who described how I felt. There was a whole website describing the condition, and providing a physiological explanation for the whole thing. I wasn't crazy, and I wasn't depressed.
The relief of knowing was immense. I read everything Google could find me on this condition, called D-MER. As I read, I wondered: Why had no one warned me about this? If this was really a thing, why didn't the hospital tell me about it?
Just knowing there was an explanation for how I felt, and possible strategies that might help was so freeing. I felt free to disregard the exaggerated emotions I felt. I felt free to stop worrying that I secretly hated my baby. I felt free to ask not to be disturbed, even by my husband, while I nursed. I felt free to continue breastfeeding my baby for as long as I chose to.
I would be my happy self, enjoying my baby and feeling like the luckiest girl alive. That is, until I had to feed him. I would sit with my eyes shut while my letdown happened and the dark, homesick feeling would crash over me like I wave. I genuinely believed it was happening because I didn’t love my baby and couldn’t bear him to be near me. But I couldn't understand why I felt that only when I fed him. Surely, I should feel nothing but joy and pride while my baby drank this amazing substance I had produced from my breasts?
After about four long months of suffering will this horrible feeling, my mother and I decided I must go to the doctor and see if anything could be done.
Approaching the doctor I felt ashamed and embarrassed. I was afraid she might think I didn’t love my new baby; that she could think it's because I was only ninteen and was struggling with becoming a parent. What if she even considered involving the social services? As I sat and explained the dreadful feeling that took me every time I fed for around thirty to forty seconds, she nodded and labeled me as suffering from postnatal depression. I was so relieved that I finally had a label for the feeling, and that there was medication for it.
Weeks went on after I started my new medication that treated depression, and nothing had changed. That poisonous feeling was still at the pit of my stomach, swallowing me up with every feed. I decided to go back to the doctors, thinking she must have given me the wrong medication, and that must be why it hadn’t fixed me. When I told the doctor this time that I was still having those feelings five, six, seven, times a day, she was confused and told me to stay on the medication, and that it should fix me soon.
I felt like a failure and that no one could ever fix me. I felt as though I needed to just admit to myself that I didn't have a bond with my baby. I seriously considered just weaning him onto bottles and keeping him at arm's length. But what stopped me was when I wasn't feeding or having a letdown, I loved my baby more than life itself. So I bore through it all alone. Alone, except still with this nasty monster waiting in the pit of my stomach to pounce when I fed my beautiful young baby.
One morning I was happier than usual, ready to have a great day with my partner and our bundle of joy, until I had to feed my baby before we left. When that wave hit me, I finally decided to Google 'feeling sad when breastfeeding' and see if anyone suffered with it too. As soon as I saw that other ladies had written about that lingering feeling of guilt and despair, a wave of relief came over me and I couldn't help but cry. I still don't know if they were happy tears from knowing that someone knew how I felt, or whether it was because this 'thing' had a label, D-MER. I felt so much better knowing that it had a label. Though I did wonder, why did my doctor not know this? Why did they not diagnose me?
The following week I decided to go to a breastfeeding support group and speak to a health visitor about my condition. When I did, she was shocked and actually disgusted. She had never heard of this condition and told me she was sure it didn’t exist. Enraged, I told her I was living proof that it exists and I’d lived with this demon condition since the day my baby was born. It had made me feel alone, deranged and unfit to be a mother. This condition nearly stopped me from doing what I had loved doing for my baby, giving him my home made ingredients for life. I told the health visitor how D-MER made me feel. I showed her the D-MER website and how relieved I was that my condition had a label, that I could tell myself it was just a physiological response, and that I was not a bad mother, and that I loved my baby.
My hope is that all health professionals that are supposed to have the knowledge to support us breastfeeding mothers come to learn about this condition, and to understand it. I hope that D-MER is talked about, and that mothers know where to turn, without feeling like a liar or a freak. I hope that they do not suffer alone, behind closed doors, worrying about being judged and incorrectly labeled.
When people hear that I’ve never had any nipple pain, latch issues, or supply issues, their first reaction is to exclaim how lucky I am…But they have no idea that I would trade just about anything to have those problems instead of this condition.
At first I thought my D-MER symptoms were psychological because of how nervous I was to breastfeed. Then I thought it was a conditioned response because my daughter would get very fussy after feeding (colic and reflux). As she got older and the fussiness subsided, I wondered when the negative feelings would go away. As the weeks and months went on, I slowly resigned myself to the possibility it would never go away, and that my body couldn’t handle breastfeeding. I also feared that it meant I didn’t love my daughter and that I wasn’t connecting with her. It’s hard to convey the scope of devastation it causes.
One day, I read about D-MER in “The Womanly Art of Breastfeeding”. I couldn’t believe it! What I was going through had a name! I wasn’t crazy. I immediately told my husband about it and joined the support groups on Facebook. Although it provided some much needed validation, it’s very frustrating that there are no real answers. One of the most difficult aspects of D-MER is the lack of awareness and understanding of its impact. No one I’ve told has ever heard of it. My Doctor’s look at me with confused faces, and loved ones can be a bit dismissive because they don’t know much about it (Side note, my husband is very supportive, as he has witnessed first- hand what happens to me when I let down). I feel betrayed by my body, robbed of what’s supposed to be a joyous experience, and am still grieving what could have been. I want to breastfeed for a year, and I’m 7 months in. It has been one of the most difficult experiences of my life, and I can’t stress enough my yearning for answers and a treatment. Despite all of this, I’m so thankful that my body is able to provide the nourishment my daughter needs, and I’m proud that I’ve made it this far.
My experience with D-MER went so smoothly, I can hardly take credit for finding something that helped. Relief found me.
When I gave birth to my third child, I already had a four year old and two year old at home. We had just bought our first house, and baby number three was born less than a week before Christmas. My life felt like a whirlwind. My older two children seemed to be fighting all the time. I'd sigh as I sat down to nurse their little brother and just feel exasperated, anxious, with butterflies in my stomach. I assumed these feelings stemmed from life changes and being exhausted from little sleep.
Around six or seven weeks postpartum, however, I began to notice that this odd feeling in the pit of my stomach didn't just happen when the older two were fighting, or because I was feeling overwhelmed with parenting three littles, or from still not being fully unpacked from moving. It did, however, happen just about every time I started nursing. Guzzling water for the first minute or so provided some relief from the anxious feelings. Even if I didn't drink water, I noticed that the feeling faded away after a minute or two. I held on to that fact every time I sat to nurse the baby.
The symptoms weren't powerful, but they began to puzzle me. I hadn't experienced it with my first two. So, at my son's eight week check-up, I asked his pediatrician if she had ever heard of such symptoms. She had not, but explained it was likely something physiological happening when my milk let-down. She didn't have a remedy, but I left with the happy reassurance that I probably wasn't crazy. I went home and scoured the internet. Success! A single website, devoted to these odd symptoms associated with let-down. I definitely was not crazy! And I was not alone!
The next day, life went on a little easier. I knew what this thing called D-MER was, that I had it, and that I was fortunate to have a very mild case of it. I visited my chiropractor that day, saying nothing to her about D-MER and having no clue that this visit would be pivotal in my D-MER story. After talking about general health concerns, I left her office with a bottle of vitamin D drops. She recommended I take fourteen drops (7000 i/u) daily—enough to benefit me and my breastfed child.)
Fast forward two weeks. I was nursing the baby in our quiet house when suddenly, it hit me! There weren't any butterflies when I started to nurse him. In fact, I couldn't even pinpoint the last time I had D-MER symptoms. I was shocked! From what I had read, D-MER didn't seem to be something that went away all that quickly. What had changed? Vitamin D drops. I scoured the internet. I already knew that D-MER was most likely related to an intense drop in dopamine levels at the time of let-down. Okay, Google... Dopamine and vitamin D. Wait, what? Vitamin D activates the body's release of dopamine! I'm not a doctor or scientist, but it sure seemed obvious to me that vitamin D was my relief from D-MER.
I continued to take my fourteen drops of vitamin D daily until the bottle was empty. Symptom-free for weeks, I decided to try going without the drops to see if I was completely cured. After several days, I noticed occasional twinges of the butterflies at let-down. So, I purchased more vitamin D and continued taking it for the next few months. At the time I am writing this, my son is thirteen months old and I still nurse him a couple of times each day. I have a bottle of vitamin D on top of my refrigerator, but most days I forget to take any. I don't remember the last time I had any D-MER symptoms, but I will never forget what it felt like: exasperated, anxious, and butterflies in my stomach. Not everyone's D-MER story has as happy of an ending—not everyone will find relief so easily, but I hope my story helps at least a few women through their D-MER journey.
I guess the beginning of my story is deciding to breastfeed in the first place. My partner was very encouraging and adamant that I at least try to breastfeed. I was willing, but always said I would bottle feed when necessary without hesitation. I have a son as well as the daughter I was about to welcome, and I had never attempted to breastfeed him. I suffered a controlled but grievous postpartum depression after my son was born, and was hoping that this time around I could avoid that. As my son wanted, I could feed continuously because breastmilk Is digested so efficiently, and with some luck, I could also get some sleep! So began the journey. About eight hours, after an induced labor, I welcomed my sweet girl. Within five minutes she latched on, and quite literally, now at almost two years old, has been attached to me since! But that first latch and those after began to feel strange to me.
I rationalized that I had just given birth. I was raw and emotional. And so happy! Happier than I had ever been, truly. My daughter was all I had dreamed of and more; I wasn't exhausted, but rejuvenated! But, as time settled into twenty-four hours postpartum, I couldn't shake the odd feeling I had every time she latched on. I would be beyond thrilled to hear that little squeak beside my hospital bed, coming from my swaddled newborn, ready to be with me. I would lay awake, when I should have been resting and long for her to need me. I would bring her to my chest and she would settle in, and then, as if slowly plummeting in a dream to my inevitable death, I would sink into a fog that felt like I had been drugged. I wasn't in the room. My fiancé could sense a change in me from across the room. The second the clouds descended on me, I was changed. My mood was different. I was sad, and thirsty, and needing of something. I felt like I could never be enough for this precious child I had been given. And then, I would feel calm once more, and capable, as if the past few minutes didn't happen. I would hold my baby, burp her, change her, and nurse her some more. And mostly while in the hospital, my symptoms weren't completely unpleasant...some times when my milk would let down, I would be deliriously happy; but almost too happy, a little hysterical, even. And so, I began to mention to my nurses and consultants that I felt strange when my daughter latched on. Every single person I said this to suggested PPD. But this wasn't PPD. I was beyond happy and felt ready to take care of my family...except, that pesky latch. What was going on?
Once we were home and settled in, I continued to experience the bouts of mood shifts while we breastfed. They didn't last long and, for me at least, were manageable; but I was still curious as to what was happening, and lived in a bit of limbo, fearing that at any moment I would spiral into full blown depression. But I never did; my daughter was thriving and I didn't mind feeding her. She slept well, and I myself was relatively rested. But by then I knew that when I needed to breastfeed, I had better brace myself for the inevitable surge of negative emotion that would at times flash all of my greatest fears straight before my eyes. I became frightened not knowing whether I would have a mild episode or if I would have guilt ridden, tormented let down? It was rough for awhile.
But then one day, while browsing my social media, I came across a post about D-MER. I was in a lot of mommy groups online, and breastfeeding support was pretty much all I was reading at the time. All at once, D-MER became manageable for me. It finally had a name, I finally had a name, and what I was experiencing did not mean that I was losing my sanity along with my heart to my daughter. I was going to be ok, because this was real! And while I say D-MER became manageable, it was by an odd turn. Through soaking up information online, I learned that distraction is the key to fighting the negative symptoms of D-MER. I mostly distracted myself by learning as much as possible about this rarely spoken of condition. It helped me to get through the falls by understanding that my body was adjusting for the needs of my child; and that if I just rode it out; I would be longingly looking at my sweet child again soon enough.
Sometimes, D-MER can present as feeling incredibly "touched out" and this has been worse for me as my daughter has grown. She will be two next month and we are at the end of our breastfeeding journey. Although I have breastfed for an honorable amount of time, and I feel like I've given her beyond enough of the benefit from breastfeeding, I still ultimately feel like D-MER played a role in the way we quit. My moods had begun to get touchy again after a year and a half of very satisfying breast only feeding. I started to feel annoyed that she wanted to suck at me and hold on, squeezing my breasts and groping and being a two year old ;and she suddenly didn't seem as satisfied with feeds. I got to where I felt the "yuck" feeling of D-MER again, but through entire feed. It was time to stop in every way.
When I look to the future, I can't help but wonder what menopause will be for me. I've read that D-MER sufferers can have similar symptoms again when they experience menopause. We shall see, I suppose. For now, I would like to help in any way to help others understand their body and what changes occur after birth. That is my wish.
Throughout my pregnancy I dealt with depression off and on. I had discussed this with my OBGYN, who referred me to a counselor so that I would have support during and after pregnancy. A few weeks after giving birth to my first child on Sept 25th, 2016, I began to recognize the negative emotions I was flooded with before “milk let down” as D-MER. I became aware of D-MER through a Breastfeeding Support group on Facebook. Had I not seen a post by another mother suffering, I may have never known what was wrong. I began to research and tried to build the confidence to talk to my doctor.
My first attempt to reach out about my struggle with D-MER was to my counselor. I’m not sure why I thought she would have any idea what I was talking about, but I was suffering and desperate for support. I tried to explain the condition and her first question was, “What is a let down?” I felt more isolated, more alone, and more helpless. A few weeks later I spoke with my primary care physician through blurry eyes, who nodded understandingly and said she had not heard of D-MER but went on to say “it makes sense, since hormones are all out of whack from pregnancy.” That was the extent of the conversation. Finally I built up the courage to attend a Breastfeeding Support Group at my local hospital. I checked in and sat down to nurse my now four month-old daughter. A lactation consultant came over to ask how I was doing. I began to express that I was battling something called D-MER. She asked if I was trying to say “that I have a strong let down.” I shook my head and she could tell there was something more going on. She asked me to wait a minute while she spoke with the other lactation consultant. Moments later a consultant with a warm spirit approached me and began to express her sympathy. She knew exactly what D-MER was and showed compassion towards me. She told me in her twenty years as a lactation consultant, she had only seen three other patients who suffered from D-MER, and I was given a printed handout with information and tips. Before I left that day she caught me and said, “I know it must be hard to come out and nurse in public. I just want you to know you’re doing a great job.” That was the first time I really felt like someone knew what I was going through, and actually cared. I never knew that what I needed to get through D-MER was sympathy: knowing that someone cared, and that someone was proud of me for sticking it out.
I'm hesitant to share my story here because I wasn't sure I was going to make it breastfeeding long enough to make me feel as though my story was significant. So many mommas with D-MER have made it months and years into their breastfeeding journey, and I'm honestly jealous!
I realized over several weeks that I needed to make a different choice if I was going to look back on my son’s first year with happy memories. I dealt with depression as a teenager, and it took me eight years to get though it and manage my own mental/emotional health naturally and without medication. It's been five years since I felt like my life wasn't in my control. Fast forward to the present---My son is now ten weeks old.
The first few days of breastfeeding were wonderful. Even though we had trouble latching, he adjusted fine to using the nipple shield and I was able to pump colostrum for him in the hospital. I felt the warm fuzzies and was amazed at how much I loved breastfeeding. Weeks two through four were marked by sadness though. Every time I sat down to feed or pump I would cry. I chalked it up to my hormones still being out of whack, yet he still struggled to latch so we would nurse half the time, and the rest I just pumped for him. I could pump forty eight ounces a day! Around week six I started searching for information to explain why I still cried, got these terrible thoughts and just basically felt horrible about myself every time I let down. It was like running a mental marathon every time I pumped.
That's when I found out about D-MER. I found comfort in knowing I wasn't nuts and it made some feedings/pumps easier. I decided to stop nursing regularly and only pump every six hours. That way I only had to work through those feelings four times a day. I still nursed my son if he or I needed the comfort from it. My lactation consultant was amazing, but didn’t know much about D-MER. The seventh week was the worst. It seemed like I spent entire days crying. I would have symptoms so bad all throughout my pumps and it would take hours afterwards to feel normal again. I was dealing with crippling guilt because all I wanted to do was stop breastfeeding. But how could I possibly justify stopping when I was able to produce forty or more ounces a day for my baby? How could I deny him that gift? I would stew in this all day long.
Since that week, I became been more proactive about my daily mental health, having good and bad days; and I just made the choice each morning to keep going. I then started supplementing with formula one feeding per day. He took that first formula bottle without any fuss or reaction--it might as well have been breast milk! I then dropped my pumps to three a day and made just enough for his daily intake if I supplement one feeding. My first goal that I set for myself when it started to get hard was that I wanted to make it long enough for him to get his first vaccines. That day came, and I was so proud that I had come that far; but honestly I was ready to be done with it. Every single day seemed like it lasted an eternity, and I felt like I missed out on joyful moments while I was trapped in the D-MER fog or the dread knowing I had to pump soon. I wanted to stop breastfeeding, but was afraid that I would get stuck in the same mom guilt that I had worked so hard to get through the past few weeks.
After that I ended up pumping twice a day until week thirteen, and then I just stopped. It took about two weeks for my milk to "dry up". I'm twenty weeks postpartum now and I've noticed that I still leak a drop here and there--like when showering or inspecting my now deflated and saggy new knockers. I thought for sure I would feel "back to normal" a few weeks after weaning, but instead I couldn’t shake the fog that I was in. In hindsight, I think the fog was always there, but the hormone wave from my letdown intensified it greatly. It took me about a week to work up the nerve to call my doctor and talk about the lingering depression and anxiety I was experiencing. I've been on Bupropion SR twice a day for three weeks now and I'm feeling a lot better. I wouldn't say that I am one hundred percent there, but definitely on my way. For the first time since my baby was born, I am experiencing feelings with him that I had almost forgotten about. The little bursts of joy and feelings of gratitude are returning as I become more present in the moments of my day. I feel like the first four months of his life were such a blur from the constant mental and emotional battles I was fighting inside. It feels like a lifetime has passed at the same time.
I had D-MER with my first son but didn’t know that’s what the dreadful feeling was. I assumed it was postpartum depression and was put on antidepressants. They didn’t help, but I understand why now. When my second son was a week old I Googled “bad feelings with letdown” and was immediately directed to the D-MER website. It was such a huge relief to know there was a medical reason for the way I was feeling. Unfortunately, the feeling of dread and despair was so intense that I weaned him at two weeks old. I was so relieved though, because I was able to formula feed him happily and bond with him without the pressure of breastfeeding and trying to stave off the dread.
When I was pregnant with my third son, I knew that I would likely have the symptoms of D-MER again and so my midwife and I decided we would try encapsulating my placenta to see if that would help. I made it to four months of breastfeeding with him, but the placenta pills didn’t seem to help at all and I was having major issues with oversupply and forceful letdown that was made worse by the anxiety of knowing I would be having the depressing symptoms of D-MER every time I had a letdown (which was about every thirty minutes because of the oversupply!)
When I was pregnant with my fourth child, I started taking a multitude of supplements during pregnancy that I was hoping would help with what I knew was coming. The midwife I saw during this pregnancy was willing to do some blood work and we identified several vitamins I was deficient in. Fortunately, by the time my daughter was born, I was at mostly normal levels and also started taking Rhodiola tincture. The tincture was the most effective at preventing the D-MER symptoms. I believe that since it helps with dopamine, and I have a history of having dopamine imbalances (depression and anxiety since my teen years), which is why it is so effective at helping. My midwife also worked diligently with me to make sure my supply was just right and that my daughter’s tongue tie was revised so that breastfeeding was easier for both of us in every way.
My daughter is now twenty-two months old and still nursing. There are days that the D-MER is worse, and I know that I need to take better care of myself and work on my dopamine problems by increasing my supplements and outdoor time. However at this time, the D-MER symptoms are barely present most of the time, and I don’t think of it very often at all.
I have been experiencing D-MER for nearly five years. I have breastfed two children through it, including three months of tandem feeding. D-MER is the reason I didn’t tandem feed for longer and had to wean my oldest child off the breast.
Breastfeeding is something I am incredibly passionate about. Both professionally (I am a midwife) and personally; I always knew breastfeeding was the only option for me. Artificially feeding was never an option, even after experiencing severe D-MER.
When I first started breastfeeding my oldest daughter nearly five years ago, I would experience a truly horrible feeling. It felt as if my soul, my life force, was being drained from my body. I was an empty shell. I was flat, unmotivated to do anything, uninterested in anything, and even breathing was a chore and a challenge. I was a husk of nothing. This tiny person was draining the life out of me. But then after about a minute, color would return to my world, I was resuscitated and my life returned. This would happen multiple times throughout a feed in varying degrees. Every time letdown would occur, I died a little bit inside. At first, I thought it was normal. I thought it was part of me realizing what my life involved as a new mum. Not once did I ever think of quitting breastfeeding, despite the fact that this feeling never went away. It faded and was less intense as the months and years went on, but was always there, every single feed.
When my oldest daughter was two and a half, my youngest daughter was born. Once again, breastfeeding was my only option and I just did it. I was also still breastfeeding my oldest, although I had encouraged her to limit it to one a day. I tandem fed my girls for three months. In those three months, I never thought the D-MER could be stronger than it was when I first started breastfeeding. I was wrong. Not only was I an empty shell when feeding, that shell began to crack. I began to fall apart in ways I didn’t even know possible. Suicidal thoughts made their way into what was left of me numerous times. But all this always only lasted for about a minute, and I would soon be back to normal.
After three months, I couldn’t do it anymore. The thought of breastfeeding was terrifying. I was so afraid and anxious at the thought of going back into that black hole every time I would sit down to feed. The thought of just not doing it ever again crossed my mind, but that would mean my three month-old wouldn’t get fed. The day the thought of starving my daughter was more appealing than breastfeeding her, I knew something needed to change, and needed to change immediately.
I then weaned my oldest, and it was painfully forced. She went cold turkey with no reason she could understand and no input into the matter. It was horrible and painful and there were tears from all of us. But it was better than the alternative. She still asked for ‘milkies’ daily for the next year. I still experienced the D-MER, but my shell didn’t crack anymore. I was back to the empty husk of nothing only. And I could handle that, because I knew I had handled it before.
I am still breastfeeding my youngest, and over two years later the D-MER has faded, but never gone away. I still get it occasionally if I am extra tired, or stressed or hungry. But I take it. I hold on tight and ride the ride, because I know it won’t last forever.
I am so glad that despite it I was able to still have that special experience with my girls. The breastfeeding relationship is something I can never get back. And for me as a mum, I know I put my girls first, and I always will.
I was lucky: I found out what D-MER was. That is, at least, the second time around. The first time I wasn’t able to keep up feeding past the first few weeks, so D-MER may well have been mixed in amongst the general anxiety I had at that time.
The second time round though, I was more prepared; I’d successfully bottle-fed and weaned my then almost three year old. I started off by combination feeding and, despite continued pain and other medical issues, my son and I started to get the knack of exclusive breastfeeding. New to the breastfeeding world I searched around for reliable and not too didactic information about how to make it a success. Thankfully I happened upon the Kelly Mom website which had all sorts of useful, well researched information – including an article titled ‘Depression or other negative emotions upon milk let-down (D-MER)’. This rang a few bells with me. Even whilst pregnant I was aware of sudden low feeling sweeping across me. But I’d suffered with ante-natal depression and anxiety in both pregnancies, and assumed it was all part and parcel of the same problem. However, since giving birth, my anxiety and depression had significantly improved – yet still these feelings remained.
Finding out that D-MER is an actual, diagnosable condition with a name that others suffer from it was the first step in being able to manage the condition, as was finding out that it’s causes were physiological rather than psychological was step two. It was this that gave me the tools to ‘get through’ D-MER on a daily basis.
With my cloudy memories of that (very) sleepless year, I don’t actually remember much about D-MER whilst feeding. Probably the fact I was feeding my baby or cuddling him whilst he slept, eighty percent of the time meant that it all melded together. It definitely happened, but my memories of D-MER whilst feeding are fuzzy. Although, I remember the spontaneous letdowns that occurred when I had those elusive moments to myself – in the shower or driving for example, and those memories are much clearer. In fact, I knew I would have a letdown and experience D-MER every time I had a shower and became prepared for it.
It would often take me a moment to realize what was happening - when those strangely nostalgic feelings of self-loathing and hopelessness crept up on me. Once I had come to expect it though it became easier to identify it happening. By a few months in I knew I had to grit my teeth and talk myself through to the other side ‘everything is going to be ok’, ‘this isn’t real’, ‘deep breaths’. The times I really was alone I would shout, or grunt in the style of a tennis player, as a cathartic release – that really helped. Then I would wait for the letdown. The letdown would be my reassurance that I was right – my ‘I told you so’ to myself. The despair would try and trick me every time though – it felt so real. The letdown sensation felt like a shield, reminding me that what I’d read was true; D-MER does exist and is a physiological phenomenon instead of a psychological one.
However, I was always left with the fallout afterwards. When such negative feelings have consumed your brain, even only for a minute, it takes a while to shake them off. Whilst the feelings of despair lasted only thirty seconds or so, the sense of disappointment in myself lingered, and again I had to remind myself that it was all a trick, and in reality nothing was different from a few minutes before.
I fear if I had not discovered more about D-MER the ongoing persistence of negative thoughts could well have brought on a resurgence of the anxiety and depression I had suffered from in pregnancy. I am, therefore, forever grateful that I was able to find out more. I sincerely hope that D-MER will become more recognized by medical professionals and breast-feeding consultants in order to help others suffering from this condition in the future.
Those first months of being a momma are a blur, so I don't remember the first time it happened. My first memory of what I later learned was D-MER was sitting on the couch next to my husband crying my eyes out as I nursed my son, who was only a few weeks old. I had no idea why I was crying, and my poor husband didn't either. We both felt helpless, and I just remember him telling our dog, who was leaning his furry head on my lap, "Good boy for comforting Momma."
For me, D-MER most often presented itself with uncontrollable sobbing. The middle-of-the-night feedings were usually the worst. I felt irritated, anxious, and panicky-- like there was no way I could keep doing this. I was never diagnosed by a medical professional, but I also think some of my symptoms were more commonly attributed to breastfeeding aversion. However, I was not breastfeeding while pregnant, or breastfeeding an older child, which are the most common scenarios for breastfeeding aversion. Sometimes the physical feeling of breastfeeding just utterly disgusted me—in a panicky, intolerable way, and I had to suddenly unlatch my poor son, leaving us both sobbing. No matter what symptoms were happening, most times, I would try to 'power through' and sit there nearly hyperventilating, biting my hand, or kicking my legs to numb the other feelings I was having. Then, as quickly as it all started, I would feel fine and cheerful again-- an almost invigorating feeling of relief would come over me. Maybe I could keep breastfeeding for a few more days… maybe even weeks.
My mom visited when my son was about a month old, and helped me call lactation consultants for help, but D-MER was all new to them too. Our son’s pediatrician hadn’t heard of it. At my six week post-natal checkup, I asked my doctor (a male) about it, but he had never heard of such a thing either. He said weaning was an option, but that obviously my son would benefit from continuing breastfeeding; and since it was only happening about once a day, he didn't think it was worth pursuing more diagnosis or treatment. He more or less recommended just "toughing it out." Bu that was easy for him to say.
By this point I had discovered D-MER.org, and at least knew I wasn't alone. I found out my sister-in-law had also gone through it, and we exchanged emails of our experiences -- that helped a little. I also eventually requested a home visit from a lactation consultant. She had only recently heard of D-MER, but came prepared with suggestions to help. (Most of which I had already found, since there are so few resources out there on the subject...)
Some of her suggestions were helpful though: I started a daily log of especially bad D-MER episodes, when I ate food was thought to be a trigger, and other factors such as lack of sleep and dehydration. It eventually helped me to see a little bit of a pattern, so I could at least understand why some days were worse, even if I wasn’t very good at preventing it— getting enough sleep as a new mom? Yeah, right! I also started taking fish oil supplements to see if the extra DHA would help - and I believe it did.
Distraction, by watching TV shows on my tablet helped a little. My mom and I also discussed how, like with panic/anxiety attacks, you can’t talk yourself out of it… but you can talk yourself through it. It helped to remind myself that it would be over soon, and I would feel normal again in just a few minutes.
I was able to keep breastfeeding my son until he was almost eleven months old—with D-MER coming and going right up until the end. I had an abundant supply of breast milk from the start—perhaps from incessant pumping while my son spent his first week of life in the NICU. Up until he was six months old, I was always pumping to add more to the freezer. I don’t know if that extra supply increased my susceptibility to D-MER, but I am grateful to still be able to supplement my son’s whole milk with breast milk even now at thirteen months.
My husband and I plan to have more children, and it already gives me anxiety thinking I will most likely have to go through D-MER again. But I survived it once, and I can do it again!