D-MER: The scary breastfeeding mental health disorder I'd never heard of

I’m Emma Marns - freelance journalist and mother of one, on a seemingly neverending journey through the Wild West of mental health. I’ve experienced the good, the bad and the frankly unheard of - as I discovered after the birth of my child in the heatwave of 2022.

Breastfeeding wasn’t widely discussed in my family and not many of my friends had children when I fell pregnant with my child in 2021. I’m not sure exactly where the passion for breastfeeding came from, but it was certainly there long before I got the obligatory ‘breast is best’ leaflet from the NHS midwife.

I was blessed with a healthy, textbook pregnancy at the tail end of the Covid-19 restrictions in the UK. I spent much of my time researching hypnotherapy, water birth, and how all these lovely things would springboard joyously into successful breastfeeding. I have a long history of mental health problems and was assigned a Mental Health Midwife for the duration of my pregnancy.

Photo by freestocks on Unsplash

Armed with knowledge about how to tackle and counteract the most common problems – low milk supply, exhaustion and experimenting with different feeding positions or ‘holds’ being the main ones – I went into a 36-week scan having been reassured multiple times that my baby was, as much as the term exists, staggeringly normal.

An hour later, my husband and I sat with a consultant hearing things like ‘gestational diabetes’, ‘repeat blood tests’, ‘98th centile’ and ‘intervention needed.’ My hitherto perfect pregnancy was thrown into disarray – I had no trace of gestational diabetes, as it turned out, and no palpating midwife could find evidence of an alleged mini-giant in my uterus. Nevertheless, it was decided I was much too high risk now to give birth in my lavender-mist bath, as planned, and after three days of standstill misery on an induction ward, I stubbornly walked myself into an operating theatre on a stifling Monday morning in August.

Our, as it turned out, perfectly average-sized daughter was delivered by a completely unnecessary c-section so physically flawless I didn’t even lose that much blood. In recovery, the midwives marvelled at my hungry little jellybean.

“Would you like to try giving her her first feed?” they asked politely.

Would I ever, and I wriggled out of my hospital gown with the speed of someone who’d been out of surgery ten minutes. It was a standardly chaotic first-time feed, with lots of falling on and off and not much actual digestion taking place, but I was sure it would all be fine once we were settled. Those first few moments gave me an odd prickling sensation, but as I was half-numb from the spinal and out of my mind with joy, I didn’t have much time to notice.

We had to stay on the postnatal ward for 48 hours monitoring and then, I had nothing but time to notice.

I received little to no breastfeeding support even though I practically begged on my numb knees for it – the staff were too busy in the next bay, trying to bully the young new mum recovering from infection into breastfeeding when she had no intention of doing so. I had a spiteful Healthcare Assistant come and glance at me, tell me my ‘nipples were insufficient’ and shove a bottle of formula into Melody’s mouth before I could say no.

I tried to persevere with harvesting colostrum for a syringe feed – even being milked like a cow by a nurse whilst I sobbed at one point – and trying to latch Melody on. Every time I did, I’d start to cry, feeling like a thousand bugs were crawling up my legs and feeling like all the lights had been turned off in the world.

By the time we got home, Melody was almost completely formula-fed and I was already devastated. Formula is perfectly safe, perfectly healthy and a very valid feeding choice for any parent - but it just wasn’t what I wanted. My friend, who had successfully breastfed her son for a year after a c-section and sepsis, rushed round with an electric breast pump and showed me how to use it. It was incredibly powerful, and so were the feelings – I felt dark, swallowed up by a depression so sudden and so wrathful that I couldn’t even speak.

While she was busy marvelling at how much milk I’d produced so quickly, I was mentally plotting out a route to the level crossing around the corner from our flat, and how I might get there without being missed until it was too late.

Once the pump was off, the feelings almost completely subsided, like it had never happened.

“Did you, um...” I asked, “ever feel... sad, when you were breastfeeding?” She can’t have heard me correctly because her answer didn’t quite tally.

“Oh, I cry over all sorts of things now, ever since I had him!” she chuckled. “Lots of people do.”

We continued like this until Melody’s five-day check. The midwife asked if I was breastfeeding.

“It... makes me feel strange,” I managed to say, barely articulate through exhaustion and sadness. I couldn’t explain how the moment anything – pump, or baby - attached, even so much as running water hitting my breasts in the shower, made me pray for swift and merciful death almost instantaneously.

“Not breastfeeding,” she scribbled down on my notes, “doesn’t like the feeling.”

Not totally inaccurate, I thought, but a staggering understatement, to say the very least. I tried to reach out for help, but I just couldn’t articulate properly how I felt, what it was like to be in my body at those moments.

My mental health midwife signed me off after two weeks of sobbing at home. The Health Visitor was appalled and had me re-evaluated. I was discharged again, as they said the feelings I was describing weren’t pregnancy or post-partum related, and must be “to do with things from the past” - although no one could specify what they might be.

One night when snatching an hour or two of sleep, I had a dream. A man in a white coat was embracing me – wait, no, not embracing suddenly. Holding me down.

“Where am I going?” I asked him. He looked at me, pitifully.

“You know where you’re going,” he said.

I had to stop. My husband’s family generously bought us a Prep Machine because their daughter had found it somewhat lifesaving in her own new motherhood. I cried as we unboxed it. I gave back the borrowed breast pump, remembering all the hopeful hours I’d spent in pregnancy researching everything to do with breastfeeding.

I’d looked into everything – everything, except this.

In the end, it was my husband who found it.

An article had been published online in the US about a condition called ‘D-MER’: Dysphoric Milk Ejection Reflex. In a nutshell, a condition in which at the point of milk letdown, negative emotions such as shame, depression and anxiety surge the mother instead of the euphoric and bonding oxytocin.

Once it had a name, it was easy to Google and see that, whilst rare, other women had reported feeling the same. There are some academic papers available, showing it was serious enough to warrant proper medical research.

The cause? No one knows. Critically under-researched and still very much not understood, like many women’s health issues, even my midwife friend had never heard of it. If I thought I’d been crying before, the wave of emotion hit me like a tonne of bricks when I realised: I wasn’t insane. I wasn’t a terrible mother or a bad person.

It was real, but why it chose me, I’ll never really understand.