Depression or other negative emotions upon milk let-down (D-MER)

A small percentage of breastfeeding mothers experience feelings of depression (or anxiety, homesickness, agitation or anger) beginning immediately before their milk lets down. This is called Dysphoric Milk Ejection Reflex, or D-MER. According to, “Dysphoric Milk Ejection Reflex is a condition affecting lactating women that is characterized by an abrupt dysphoria, or negative emotions, that occur just before milk release and continuing not more than a few minutes.” This is a physiological response (not a psychological response) that appears to be tied to a sudden decrease in the brain chemical dopamine immediately before milk let-down.

Following are some resources for more information: is a website devoted to information about Dysphoric Milk Ejection Reflex

Dysphoric Milk Ejection Reflex (D-MER) from the Australian Breastfeeding Association

D-MER (Dysphoric Milk Ejection Reflex): What is it? by Alia Macrina Heise, from Breastfeeding Today, Issue 4 (November 2010), pp. 18-20.

When breastfeeding causes bad feelings: Dysphoric Milk Ejection Reflex. An interview with Alia Macrina Heise

Heise AM, Wiessinger D. Dysphoric milk ejection reflex: A case report. Int Breastfeed J. 2011 Jun 6;6(1):6.

Cox S. A case of dysphoric milk ejection reflex (D-MER). Breastfeed Rev. 2010 Mar;18(1):16-8.