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

April 18, 2012. Posted in: BF Concerns: Mother

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.


Guest April 19, 2012 at 8:08 am

Wow, I had never heard of this… but I’m sure I’ve had it!  Not every time, for sure. But not infrequently, especially if my LO was really crying hard. I would put him on to feed, he’d start suckling, and I’d feel an intense resentment of him. Almost angry at him. Then once he started really feeding (after let down), I’d feel SOOO guilty that I could have thought that way. I felt like a terrible mother, a terrible person for feeling that way. I would whisper “I’m so sorry” over and over to him. Usually after a few minutes I felt totally fine again. I never, ever linked it to the letdown until now. Thank you!

Guest1031 January 23, 2013 at 10:47 pm

Strange and releaving to know that someone else did the same and said the same things as me.

Katie Mattson84 April 19, 2012 at 1:11 pm

I have this problem. I’ve been trying to figure out how to explain the feeling when I breastfeed and this is it. It usually only last for 45 seconds to a min when I breastfeed or pump. It’s a horrible feeling and makes me not want to breastfeed but because I know it’ll only last a short time I’m ok with this. I wish I was one of those Moms that enjoyed  breastfeeding.

Runningmom April 19, 2012 at 3:24 pm

This happened to me with my twins! I would have panic attacks before I fed them. I have a 5 month old now that I’ve been breastfeeding and I had it sometimes with her but decided to work through it and I don’t get it anymore. I enjoy breastfeeding now and have more so since she was 3.5 months, so don’t give up! It does help to know you are not alone in feeling this way doesn’t it? The fact that there is a term for it and everything makes it easier to handle and not just like feeling you are a bad mother. And you’re not a bad mother! You cannot help what your hormones make you feel. Just remember it will get better before you know it. Keep up the good work! :)

Attalieanna April 25, 2012 at 11:20 am

As your baby gets older this totally goes away and nursing is more enjoyable. I always try to remember that I KNOW I’m doing the best for LO and this is what my breasts were made to do for him and I can see it in him everyday that he gets older how much he Really LOVES the boob!!! It’s the ultimate comfort, any ailment they have, boob fixes powerful tool

Heather April 19, 2012 at 9:00 pm

OMG…ive never heard of this but it totally fits what I’ve been experiencIng! In fact, tomorrow is my first appt with a therapist who specializes in post partum issues because I’ve been worried about ppd, even though my “episodes” seem brief and isolated and not like what I’ve read about ppd. Thank you, thank you! I will investigate this further. It’s nice to know I’m not “crazy!”

Susan April 20, 2012 at 4:20 pm

In the hodge-podge of feelings I’m experiencing just 3.5 weeks post-partum, I don’t kmow if I’m experiencing this specifically.  But one thing I invariably experience when my milk lets down is what I call “cold flashes.”  I get so cold and it feels like it emanates from within.  I wonder if there is any connection.

Lambriek April 22, 2012 at 8:54 pm

Wow! It’s a real thing!  I was wondering why I felt like crying when my milk lets down.  I knew it must have been a weird hormonal thing, but I’m glad to read I’m not the only “crazy” one :)

Lpuchir April 24, 2012 at 5:25 pm

Omg i think i get this! I get a home sick type feeling right at the beginning of feeding. Glad its normal.
I was getting this feeling a lot at the end of my pregnancy too.

Attalieanna April 25, 2012 at 2:55 am

My very close Friend and I both experienced this. I described it as feeling sad and almost a homesick type of feeling and she almost called it the depression flash. It does go away!!!! By the time our babies were 6 months the feelings had subsided quite a bit and gradually it fades to just a memory. This is the first I’ve read about it actually being real so this is great news for us as we thought it was really awkward and never knew if it was normal.

Shey April 26, 2012 at 8:53 pm

I have this too!  I usually notice it most in the middle of the night when I am pumping.  I get this really empty weird feeling.  I hate it.  I’m glad to know it’s normal. 

Tracie P April 29, 2012 at 4:09 pm

I had ppd that mercifully ended 2 weeks after my daughter was born. But every time I put her to the breast, I get a miniature dose of ppd–only lasts maybe a minute then goes away! Thx for talking about this. Looks like it may not be so uncommon.

Valerieanne9015 May 2, 2012 at 2:17 pm

Oh wow this is me!!!  I thought it was all just in my head, but I would say about 50% of the time I feel this way right before Let down.  I thought I was just starting to have negative feelings about pumping so much at work, ans stressing trying to keep up with it while working.  It’s nice to hear I’m not the only one, and that it’s a reflex and not something wrong!

Patty May 15, 2012 at 9:52 pm

Ohh, that’s what it’s called. I had that and couldn’t understand why I would feel so sad. But it’s true, right after a couple of minutes it would go away.

KP May 30, 2012 at 10:34 am

Wow. I’ve been telling my husband for months that I feel random bouts of anxiety. It wasn’t until a week ago that I realized it was right before my milk lets down. Now I know why!

Christine December 10, 2012 at 2:18 pm

I am nursing my seventh child and have always had this feeling with let down. I described it to my husband as a moment of “intense longing”. It reminds me of the feeling I had when I turned 13 and would cry the drop of a hat and felt romantic and lonely with the “growing pains” of becoming a woman. It goes away quickly.

Kate March 29, 2013 at 3:05 pm

Thank goodness, I thought I was losing my mind…

Michelle June 8, 2013 at 8:35 pm

Wow. I didn’t realize this was a thing. I’m glad to know it’s a hormonal thing and that I’m not the only one that experiences it.

Kate September 3, 2013 at 2:56 am

I always told my husband that whenever i started nursing the baby I felt like I did when I was a small child and I was without my mom (at grandma’s or school) or when I was scared at night…just a horrible feeling of fear and being lost and alone….I always felt guilty for not enjoying breastfeeding.but this makes sense