Breast feeding with D-mer (when Breastfeeding isn’t all warm and fuzzy)
Anyone who knows me, knows I am pro-breastfeeding, well actually pro mum’s mental health. Breastfeeding is such an amazing gift to give to your baby, but.. It doesn’t mean it is easy! In fact I feel this is more common than we realise, many women giving up on breastfeeding without knowing it isn’t their fault or that there is help out there. I also stand up for anyone who decide that it is just not worth the anxiety, distress on both mother and baby, mental health getting in the way of a healthy happy newborn phase of a babies life. Health, happiness and a positive experience is priority.
This article is to highlight one of the challenges women face with a new baby. I am writing this as I believe awareness, understanding and knowledge is empowering to anyone suffering. This is for all those women who feel something isn’t feeling right while breastfeeding, who aren’t getting the loved up feeling everyone talks about. Just to know you are not alone and it is a ‘real thing’ so, THIS IS FOR YOU. This is also for all the women and their families to give some clarity, tools and self care to survive a really difficult challenge.
This is my story.
Andrea and Willow’s Story
My baby girl was born naturally at a beautiful birth house on international midwives day – 5th May 2017 She was perfect. She was born eyes wide open and drank immediately.
The first days of breastfeeding Willow were challenging but not impossible, I just felt neither of us knew what to do. My daughter did very well to latch and seemed to drink all she needed, but like many women I found it a strange feeling and very sore. I admit I really didn’t like the feeling, the sucking, the pulling, the contraction of my uterus but knew that it would take time for my body to adapt to this very new function. Once my milk came in, I had a lot of milk, and luckily Willow was a drinker! I felt proud I was breastfeeding but it was not like I expected. I learnt to breathe through tenderness and hoped it would get easier. It really hurt at first I would wince as she latched, though her latch was fine and every blooming resource I read said it shouldn’t hurt if I am doing it right. It did get better, and my nipples got toughened but also with the help of lots of cold compresses and Lanosil- mamas breast-friend.
I was always relieved when she finished feeding, then I would gaze lovingly at her, feeling bad that I was not loving the whole bf thing.
As a postnatal yoga teacher, in my baby classes I always encouraged women to stay present and connect to their babies while feeding but suddenly I realised how theoretical this idea was, for me it was practically near impossible. I started feeling waves of nausea, ‘homesickness’, loneliness, even despair. Instead the fuzzy oxytocin love high I was expecting, I felt irritable, anxious and resentful!! I wanted to climb out of my skin and body. At night I would play on my phone, listen to music, in day time, watch TV. Anything to distract me. Around 5 weeks postpartum I sought help. Maybe I was spiraling into postnatal depression? My anxiety was rising, but I felt good most of the time, exception for the normal exhaustion, I just was struggling with feeding (which if you are feeding a newborn, is a lot!). With a push from my concerned and very supportive midwife, Heather a great breastfeeding consultant, Anchen and lots of Google research, I was diagnosed with D-MER, and Mild PND (Postnatal Depression). Awareness was key to my management and support. To know I wasn’t going mad, and I wasn’t really bad at this mum thing!
So what is D-mer?
It stands for Dysphoric Milk Ejection Reflex.
Alia Macrina Helse, author of ‘Before the Letdown’ is the forerunner in research of this condition, a former sufferer herself, she now is the main authority in D-mer and works with education, awareness and supporting mothers. https://d-mer.org She writes;
‘D-MER is a newly recognized condition affecting lactating, women that is characterized by an abrupt dysphoria, or negative emotions that occur just before milk release and continue not more than a few minutes’
There are varying degrees of severity. The most mild can be a feeling of uneasy, to the most severe can tip many women over the edge and a danger to themselves.
Many women have reported sensations of-
- Hollow feelings in the stomach
- Emotional upset
Mmm Fun hey? , as if looking after a newborn wasn’t hard enough!
So What causes D-MER?
D-MER is physiological NOT psychological.
-which means it isn’t all in your head, or something to snap out of. It isn’t related to past events, trauma, or abuse. It is purely a physical hormone mess up! To understand it better it is important to know what the milk ejection or the ‘let down’ reflex actually is.
‘By sucking at the breast, your baby triggers tiny nerves in the nipple. These nerves cause hormones to be released into your bloodstream. One of these hormones (prolactin) acts on the milk-making tissues. The other hormone (oxytocin) causes the breast to push out or ‘let down’ the milk’.
The hormone Dopamine inhibits the release of prolactin (the milk producing hormone) , so dopamine levels must drop just enough for prolactin levels to rise. In D-mer it is speculated that dopamine drops too far leaving all spectrum of negative and emotional feelings. More research needs to be done, so for now..we must collect our remedies, survival stories, support each other and spread awareness.
So how did I get through it?
Stubbornness and determination! I so wanted to keep breastfeeding as long as I could, I found amazing support through Alia’s
The awareness for me was the start. I tried various things to get through a feed, my personal experience of the condition is as unique as the next woman’s.
Personally I did go on to develop a breastfeeding aversion, so my symptoms could continue past the initial let down, this may or may not have been connected.. More research on the subject needs to be done, and as mentioned I also had mild PND (I think the stress and continuing negative feelings although physiological tipped into psychological..Just think how constant pain can send you spiralling in your head!)
I was grateful for all my experience in self care, awareness work, yoga, meditation and postnatal support gave me a good foundation to start.
What helped? What didn’t?
I found my husband talking to me through the feed, or holding my hand helped. Other times I listened to music to distract myself. Understanding it was a ‘dopamine drop’ I put on music I loved and made me happy tried to help me raise that bliss feeling.
”I remember listening to Glastonbury live on my headphones, rocking to Foo Fighters while my little one blissfully unaware fed!”
As time went on I started to notice what made it worse, my triggers and tried and tested remedies. From a personal view and backed by other sufferers. Here are my top tips.
What can add and Triggers worse attacks than others.
- Too much caffeine, alcohol, sugar
- Tiredness, Exhaustion
- Low blood sugar.
- Too much stimulation
- A messy house
- Mouth noises (mysophobia)
- Being alone with baby
- Being with people
- Not enough alone time
- The dog barking or cat meowing
- Excess baby sucking
- The wind blowing (OK not this one.. But you get how delicate the balance is!)
Nights were the worst for me and lack of alone time and self care made things worse.
So what helped?
It is hard to know what helped my D-mer, my aversion and my PND, but a combination of many things helped all of them. My conclusion is that a regular self care practice was my saviour.
Immediate care- (whilst having an attack and directly after)
- Distraction or mindfulness (a paradox depending on the day!)
- Happy heart-felt Music
- Simple puzzle games on my phone.
- Scrolling through happy baby photos, watching funny things.
- Drinking cold water
- Eating a biscuit or a couple of sweets (but lot overloading on sugar) ” or small fruit juice.
- Rescue Remedy.
- Letting go of guilt knowing it would pass then moving on past any episodes.
- Feeling love, supported and accepted.
- Self acceptance
- Having a good cry
- Letting go and moving on
- Knowing my baby loved me Unconditional and she was. Thriving and unaware through all of this.
General self care throughout the day to support my D-mer, Aversion and PND
- Knowing it was a thing, it had a name and I wasn’t just mad or not doing it right!
- Talking about it and sharing my story helping others.
- Asking for help and accepting it!
- Not letting myself dehydrate or blood sugar drop.
- Herbal womens teas.
- Water water water.
- Empty bladder
- Being clean (getting regular showers or baths)
- Having a tidy house or breastfeeding environment. (I am sure these bf hormones are so primal! Tidy and safe caves right?!)
- Feeling love, supported and accepted.
- Yoga nidra
- Plenty of rest and sleep.. I did sleep when my baby slept!
- Gentle yoga
Self Care Self Care Self Care
- Warm baths alone,
- I pumped One bottle feed, so i could sleep or bath.
- Hormone hacking–celebrate small goals and wins to raise dopamine, skin to skin with baby to raise oxytocin, sunlight and laughter to raise serotonin and endorphins
- Healthy regular whole food.
- Support for fellow mums and support groups
- Getting out and connecting with others and nature (park walks with friends was great)
- A good cry to my mum, my sister or friend.
- Taking to a doctor and accepting medication for PND.
- Supplements – continuing with my prenatal vitamins, vitamin B complex magnesium, fish oils/omegas etc.
- Knowing a happy and positive experience of bonding with my baby trumps any agenda or proving anything to myself or others.
What happened next?
Month by month, I navigated through my symptoms, they would spike and subside, some days I would not get any problems.. I actually started to get that warm fuzzy oxytosin! Finally I felt a success.(not that I was failing before) I had almost forgotten the challenges I faced in the early days. From not thinking i could get through 6 weeks, i had Breastfed exclusively, on demand (which was a lot!) to 6 month.. I know I would not have gotten this far without all the support, love, care and compassion I received, especially from my husband, but not taking aware from my own determination, (stubbornness) and inner awareness that what I was doing was bigger than me, it was for Willow. I had a happy healthy, chubby daughter.
I am awe of anyone else who went through what I did. I praise and honour those who continue to breastfeed and those who make a different choice not to continue, I completely stand with you and know in this situation there is not an easy choice. This was my journey this time; if I had to go through it again, I may have taken a different route..Until we go through it ourselves we have no place to judge. So to all D-mer sufferers and survivors.. May your hormone re-balance and know you are amazing strong and brave women!
This story isn’t quite over.. There is a second part to this story and I want to save it for the following article.. As things changed again when we introduced solid food. If you know me it involves my favourite topic- Menstrual Cycle Awareness!
Sources, Resources and Reference
Womanly art of breastfeeding – La Leche League international
Dysphoric milk ejection reflex:A case report Alia M Heise and Diane Wiessinger
https://doi.org/10.1186/1746-4358-6-6© Heise and Wiessingerhttps://
Photos and Diagrams by Andrea White