Breastfeeding Challenges
Anyone ever laugh at the thoughts they had as a first time parent?
Me, “What’s so hard about breastfeeding– it’s literally what my breasts were made for.”
Ha.Ha.Ha.Ha.
Literally one of the most unnatural natural things I’ve ever done. We definitely had our fair share of challenges (oversupply, clogged ducts, mastitis, milk blebs to name a few), but the most unexpected was developing dysphoric milk ejection reflex (DMER) and breastfeeding aversion and agitation (BAA).
These are both terms that people are usually unfamiliar with but once hearing the description, they’re like OH! That makes sense. I thought I was just crazy. 🥴
In this blog, we will cover:
What is DMER in breastfeeding
DMER when pumping
How common is DMER
How to fix DMER
When does DMER go away
Coping with DMER
What is breastfeeding aversion and agitation
What causes breastfeeding aversion and agitation
How to help breastfeeding aversion
Does nursing aversion go away
What is DMER in breastfeeding
Dysphoric Milk Ejection Reflex (DMER) is a condition in which women who breastfeed develop negative emotions that begin just before the milk ejection reflex and last less than a few minutes. It is different from postpartum depression, breastfeeding aversion and agitation (BAA), or a dislike of breastfeeding.
This is a result of dopamine being released during a let down as opposed to oxytocin (the love hormone). It feels like a wave of depression every time your milk lets down.
What you expect to happen is a warm fuzzy feeling when your milk lets down as you feed your baby. That’s not always the case.
The severity of this feeling will vary from person to person. These feelings may be described as:
Sadness
Dread
Angst
Irritability
And many more!
DMER when pumping
DMER is definitely possible when pumping since it’s triggered by the let down itself. Let downs can be triggered while actively breastfeeding (initially and throughout a session) multiple times while pumping, and even just by hearing a baby cry.
How nauseating is that? (Very).
How common is DMER
It isn’t a widely known phenomenon, unfortunately. Many physicians are unaware of the condition and it hasn’t been studied very much.
One study found that about 9% of breastfeeding parents will experience DMER.
How to fix DMER
DMER isn’t “fixable” in a traditional sense. There are things you can do to help cope while continuing to breastfeed and it may not last the entire time you breastfeed your little one, but the only “fix” is to no longer breastfeed.
When does DMER go away
DMER may come on really strong initially in the first few weeks and then diminish over time becoming fully resolved by the 3 month mark or so- but that isn’t true for every person. It can stick around until your child is weaned. 😩
(That was my experience; it wasn’t as strong after 6 months, but it was always *there*.)
Coping with DMER
There are some strategies you can use to help you cope through DMER if you want to continue breastfeeding through it. Some tips you can try include:
Just educating yourself on symptoms (knowledge and awareness can bring peace)
Distraction (eating a snack)
Meditation during letdown
Avoiding things that can exacerbate it (stress, dehydration, caffeine)
Get plenty of sleep
A doctor may prescribe supplements or medication depending on severity (like vitamin D, vitamin B complex, magnesium, probiotics)
Other things that may exacerbate DMER or make it feel worse:
Lack of self-care
Galactagogues (things that are marketed to increase milk supply)
Low carb diets
Being overstimulated
Birth control
Going too long between feedings
Menstrual cycle changes
Awareness around possible triggers can help you mentally prepare for intensity of DMER!
What is breastfeeding aversion and agitation
If you’re asking questions like “does breastfeeding make you irritable?”, you may be experiencing BAA.
Breastfeeding aversion and agitation (BAA) is different from DMER. While DMER is only triggered during a let down, BAA will typically last the entire feeding session and may not happen every single time you breastfeed.
The feelings you experience may be similar though– they include:
Anger
Disgust
Rage
Skin itching/crawling
Shame/guilt
Intrusive thoughts (wanting to run away, feeling trapped or touched out, wanting the baby off of you, wanting to pinch the baby)
And then these feelings typically disappear as soon as the infant is unlatched.
You can experience BOTH BAA and DMER at the same time but they do differ slightly in the feelings you have while feeding and of course the trigger is different.
What causes breastfeeding aversion and agitation
There are very few research studies about BAA and none of them investigate the cause of it.
We can gather from other research though that possible causes include:
Hormones (around menstruation or ovulation and/or nursing while pregnant due to increased hormones and nipple sensitivity)
Feeding on demand
Sleep deprivation and lack of self care
Being touched out
Lack of nutrition or vitamin/mineral deficiencies
Postpartum depression
How to help breastfeeding aversion
Again, while we have few studies about BAA, we can make some educated recommendations for what you can do to help decrease the symptoms. These include:
Ensuring a proper latch
Distraction during feeding
Get better sleep
Ensure adequate hydration and nutrition
Self care
Get checked for hormonal imbalances, especially when your cycle returns postpartum
Knowing your triggers, getting enough sleep/self-care/taking time for yourself, and potentially weaning if you’re ready can all help the symptoms of BAA.
Does nursing aversion go away?
It can certainly dissipate over time or with intentional attention to the list above for helping decrease the symptoms. It can come and go based on your hormones, or can increase while pregnant or tandem nursing. It’s not as linear as DMER tends to be.
You may have luck switching to pumping, combo feeding, or weaning an older child while tandem feeding to decrease the demand on your body/hormones, etc.
Breastfeedingaversion.com is a wonderful resource with a course if you’re currently experiencing this!
