When breastfeeding doesn’t feel good - Dysphoric Milk Ejection Reflex and other negative and unpleasant emotions while breastfeeding
-May 2026
The following article shares the experiences of two mothers and provides information on an uncommon experience of severely unpleasant sensations while breastfeeding.
You hear other moms chatting and texting about the amazing bond that comes with breastfeeding, but you simply don’t enjoy it. Worse still, breastfeeding sometimes makes you feel awful. You may be wondering if you’re doing something wrong and what could be going on.
It’s unlikely that any mother will enjoy every single moment of her breastfeeding journey. While there are common challenging periods around the early weeks of your baby still learning to latch comfortably, or the 3-5 months easily distractible period, or feeling frustrated with your toddler who pinches or bites down at feeds, or your little one having an extra fussy day, or you’re just feeling touched-out and drained; these are phases that will pass. Essentially, all of these feelings are very normal and are commonly shared and discussed at La Leche League support meetings.
Some mothers find they experience feelings of aversion (an overwhelming feeling of wanting to stop the feed) during breastfeeding due to hormonal changes around ovulation time or during their period. For other mothers, a breastfeeding aversion may be the first sign of pregnancy, or the start of the slow letting go process during weaning.
Very rarely, some mothers experience more pronounced symptoms. The following article shares the experiences of two mothers and provides information on an uncommon experience of severely unpleasant sensations while breastfeeding.
DYSPHORIC MILK EJECTION REFLEX
Dysphoric Milk Ejection Reflex or D-MER is most often described as experiencing:
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waves of nausea,
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feelings of doom,
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feeling like crying, or
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overwhelming anxiety that happens near the start of a breastfeed as breastmilk starts to flow when having a milk letdown. These unpleasant negative emotions can last for a few seconds or a few minutes.
By the time the milk wave releases and the baby starts gulping and swallowing, the feelings usually dissipate, occasionally returning just before another milk ejection reflex (MER). These feelings seem to be strongest in the early weeks of breastfeeding and very often disappear after a few weeks.
WHEN NEGATIVE AND UNPLEASANT FEELINGS PERSIST
Some mothers experience persistence of these negative feelings. They describe:
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wanting to escape touch
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anxiety
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annoyance
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dread and apprehension
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feelings of emptiness
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agitation
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rage
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aversion
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overwhelming urges to unlatch the baby
It is not clear whether breastfeeding aversion and agitation (BAA) and breastfeeding rage is a severe spectrum of D-MER or a separate issue entirely. They describe that the feelings of aversion will not abate until the infant has stopped suckling.
Mothers feel confused, ashamed and guilty about having these negative feelings and intrusive thoughts while they are breastfeeding. Many don’t tell anyone, and struggle with an internal conflict of wanting to breastfeed but experiencing aversion toward it. This can also cause feelings of guilt over weaning before a mother or infant was ready.
Mom A describes: “The thought and feeling of breastfeeding makes me full of rage. It's been like this since she (her baby) was a few weeks old but it's getting very bad. I'm ready to throw in the towel. I feel intensely guilty about this because I know it's the best thing for her; I'm at my wits end. Sometimes I have to unlatch to calm down, and she gets incredibly upset and then refuses to try again after. It's horrible!”
Mom B describes: “With milk letdowns I would often experience a feeling of deep nostalgia and emptiness, or, more severely, feelings of wanting to run away, abandon my family, jump from a high place or physically hurt myself with kitchen utensils.
Along with these symptoms I would also sometimes feel extremely dizzy and disoriented when I had a letdown, as if all the blood was being sucked out of my body at once. I would stay severely lightheaded through the whole feed and after nursing it would take me a while to feel steady again. Having this multiple times a day was exhausting.”
Occasionally moms can also experience these symptoms in between letdowns. In rare instances, women describe symptoms of significant pain.
Mom B describes: “With my firstborn, within the first two weeks, I started experiencing an intense itching/throbbing/pain sensation at the base of my spine while breastfeeding. It was as if my spine was trying to bend itself in two, getting tighter and tighter and more painful.
It felt like a muscle spasm or pinched nerve that also itched and throbbed and would resolve immediately when I unlatched my baby. I tried sitting more upright, and laying back more, but no matter what position, even with side-lying, the sensation would persist.
This was most prevalent at night or in the early mornings, and as I got through the first 2- to 3-week growth spurts and started adapting to motherhood, the feeling stopped. At the time, I didn't tell anyone, because I thought people might think I'm losing my mind!
The physical pains and discomfort were insane, but luckily, I read about D-MER on the La Leche League and Kellymom websites, and would try the distraction techniques mentioned there. I found that curling and uncurling my toes seemed to help. Reading that this horrible sensation had a name, already made me feel less like I had gone absolutely crazy.”
DOES THIS MEAN THE END OF MY BREASTFEEDING JOURNEY?
Most mothers report that their D-MER symptoms get better after the early months of breastfeeding, and others report that they get better when their babies aren’t exclusively breastfeeding anymore, and their milk supply has decreased.
The d-mer.org website states that many breastfeeding mothers are able to breastfeed long-term, but for a very small minority, weaning is the only way to eliminate all symptoms of D-MER.
[Mom A managed to breastfeed for 17 months and provided expressed breastmilk for another month.
Mom B breastfed her first child through the 2nd pregnancy, and continues to breastfeed her 2nd child who is now 16 months old (April 2026)]
WHAT CAN BE DONE ABOUT IT?
Here are some general suggestions:
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Meditation and mindfulness techniques. With mindfulness, mothers focus on their breathing, are in the present moment, and treat themselves with compassion. They remind themselves that the negative thoughts they are experiencing are thoughts, not facts.
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Not waiting too long to breastfeed so that your baby is not too upset and overly hungry.
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Deep breathing and positive visualisation.
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Distraction.
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Putting general measures in place to manage stress (e.g., getting others to help with household chores, meals, taking care of older children, etc.).
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At times a phone break and social media break is needed. Social media advice often increases anxiety and may cause unnecessary panic.
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Talking with another mother who has experienced D-MER.
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Protecting yourself from negative comments and building your support system (attend La Leche League support meetings).
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Stopping pumping and focusing instead on direct breastfeeding, although in rare cases pumping does not seem to trigger the same symptoms. Mom A shared: “Pumping triggers nothing. A little physical discomfort but nothing emotional at all. I can even pump while doing housework.”
SUGGESTIONS TO OPTIMISE THE FEEL-GOOD EFFECTS OF OXYTOCIN HORMONE
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Skin-to-skin care with your baby to optimize oxytocin hormone (although this may trigger a small percentage of mothers).
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Placing a warm pack on your shoulders.
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Soaking your feet in warm water.
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Having a partner or friend give you a neck/back/body massage.
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Listening to relaxing music while breastfeeding.
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Eating chocolate (shared in one case report; Heise, 2011)
NUTRITIONAL SUGGESTIONS
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Increasing protein in the diet. A possible explanation for why this helps is that suckling and breastfeeding increase insulin release, which lowers blood sugar levels. This can be modulated with dietary measures reducing the intake of carbohydrates and increasing protein levels. A very low carbohydrate diet may worsen D-MER symptoms.
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Staying hydrated (there are several reports from women who experience D-MER that their symptoms are helped by drinking cold water).
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Vit. D, Vit. B complex, Magnesium, Iron (it would be prudent to consult your medical doctor about these and have blood levels checked and treated accordingly).
OTHER POTENTIAL MEDICATION TREATMENT OPTIONS
1. Stopping the use of prolactin-increasing galactagogues like Domperidone and Metoclopramide if these are being used.
2. Dr Katrina Mitchell, a breastfeeding medicine specialist and member of the LLL International medical advisory board, shares that, “While they are not technically considered PMADs (perinatal mood and anxiety disorders), both D-MER and nursing aversion (improve or) resolve with the SSRI (selective serotonin re-uptake inhibitors) class of drugs, so it is important to seek treatment rather than stop breastfeeding because of these feelings.”
3. Medications that act as dopamine antagonists, such as Wellbutrin (Bupropion), have helped some mothers with their symptoms.
Mom A shared the remedies that she had tried: “Distraction, cold water, deep breathing ... I hate admitting this; I feel crazy, but pinching myself as hard as I can, slapping myself hard and biting a finger is sometimes the only way to cope; the physical pain distracts me. I have left scars on my breast and chest by pinching just to get through it. I'm very embarrassed about it but she needs to drink.”
[LLLSA disclaimer: we are sharing this experience to demonstrate the severity of symptoms, not as an endorsement of a coping mechanism.]
Mom B shared: “I sometimes had to unlatch multiple times during a feed to let the sensation pass and give myself a break and then start again. It did not stop there though, and my symptoms returned intermittently when my baby was four months old and again at nine months. I was not getting adequate sleep at those times. I realised that severe lack of rest is a massive trigger for the more intense symptoms. The body says, “stop this, I'm not coping! Prioritise ME, please!
The first year having D-MER on and off was a difficult time in my life. Motherhood in general and adapting to my new role was hard, but instead of running away from breastfeeding, I let it become my purpose and joy and felt happy that in spite of my difficulties with the D-MER I could push through and make my son so happy. I could be strong for him so he can be strong. Even though I never told anyone I experienced these feelings, this thought became my hidden source of strength.
Every letdown, I would deal with these invasive feelings by reminding myself that they are not thoughts I am having voluntarily, and like dreaming at night, I have no control over the imagery and can just let them pass me by. I would listen to music, play on my phone or curl my toes until the feelings passed, but often they would persist through the entire feed.
I was concerned about these more physical symptoms and absolutely wanted to try anything to support my body a little better and decided to try some dietary changes. I started having glasses of a DIY mix of a potassium source, a Vit. C source and a sodium source, and within 2 weeks I experienced a cessation of most of my more intense symptoms like the dizziness and severe intrusive thoughts. I tried to eat more regularly and prioritised having meat and fish often for extra protein. [LLLSA comment: We recommend that mothers consult with a registered dietitian/nutritionist for a dietary intake needs assessment, as the use of DIY adrenal and mineral cocktails are not supported by evidence.]
Our bodies need good fuel. No physical or mental system can work well if not cared for properly. And care looks like taking the time to eat nourishing meals and supplementing with the right things if needed.
At 6 months, with my mineral cocktails and a new dedication to taking care of my body, it all got a lot better and was mostly gone. I had a little bit of the empty feeling with letdowns at 9 months and 15 months (more sleep troubles!), but the pain and spine tingling only returned when I was pregnant and still breastfeeding through 80% of my pregnancy.
The sensations got very severe and breastfeeding, especially at night, came with instant feelings of intense nausea, itchiness and a need to run away from my family. I also had violent thoughts of unlatching during the day, and I would become full of anger, and I didn't like having these thoughts about my sweet boy. I couldn't cope with this on top of the pregnancy hormones, and after a lot of crying, I realised that to prioritise my sleep and wellbeing for the new baby, I would night-wean my toddler, and continue breastfeeding only in the daytime. He was about 20 or 21 months old at the time. I used a very gentle approach, and he accepted no more boobies at night quite easily within a week. My strength returned, I didn't find myself feeling so angry all the time, and I could enjoy nursing him in the daytime more until he gradually weaned fully. He was not a fan of the colostrum taste when the new baby arrived!
After the birth of my daughter, I started experiencing the dizziness with letdowns again at about 2 weeks postpartum, but luckily much fewer intrusive or negative thoughts. I believe, as I had a wonderful, calm birth with her, my mind was more at ease. But once again I had a new symptom. Past the initial engorgement, my letdowns were EXTREMELY painful for the first 2 months. Burning sensations would flood my whole breast. If I had a bad night, it would be extra intense the next few days. I would sometimes gasp at the pain multiple times a day. I immediately remembered that better nutrition helped me last time.
It seemed to me that the better and healthier I ate and supplemented, the more strength my body had to fight the bad feelings and sensations.”
WHY IS THIS HAPPENING?
Why would breastfeeding on a physiological level induce negative emotions; there seems to be some theories but no clear answers.
Here are some of the possible explanations:
1. THE DOPAMINE THEORY
Suckling at the breast releases oxytocin hormone, causing the milk ejection reflex or letdown. But suckling also affects the hormone, dopamine. Dopamine inhibits prolactin, the main milk-making hormone, therefore dopamine levels need to drop for prolactin levels to rise. This normal drop of dopamine occurs without breastfeeding mothers being aware that it even happened. With mothers who experience D-MER however, it is theorised that there is an inappropriate and abnormal drop of dopamine, which causes an instant and brief wave of dysphoria, a negative emotional reaction that lasts until the dopamine levels restabilise after prolactin has begun its rise.
The above explanation of dopamine’s role is not accepted by everyone. A further explanation is offered regarding oxytocin.
2. THE OXYTOCIN THEORY
Oxytocin hormone commonly known as the love hormone, has multiple effects. While it helps mothers feed, warm, and bond with their babies, it has another side which helps mothers protect their babies. Think for example of how mothers react to protect their children from danger; this is also an oxytocin hormone driven response. Oxytocin’s protective action can trigger “negative” or defensive emotions like fear, anger and aggression and the fight-or-flight response in mothers.
However, when mothers are experiencing D-MER, these symptoms are happening in the absence of any real danger. The symptoms of D-MER are like brief intense episodes of maternal aggression or the fight-or-flight response.
Some have described it as chronic hyperarousal symptoms similar to post-traumatic stress disorder (PTSD) where the stress system is chronically hyperalert, on the lookout for possible danger.
IS D-MER RELATED TO MENTAL HEALTH CONDITIONS?
The website https://d-mer.org/understanding-d-mer states that:
“A mother's medical or personal history does not dictate D-MER. Mothers do not get D-MER because they were sexually abused or because of a traumatic birthing experience."
However, more recent research suggests that there are several overlapping mental health considerations:
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It is important to note that D-MER is very different from Postnatal Depression (PND) or an anxiety disorder. However, postpartum depression, postnatal anxiety, and breastfeeding aversion are conditions often mistaken for D-MER because they share similar signs and symptoms (Deif, 2021).
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Mothers with pre-existing mental health and mood disorders and those with a history of postpartum depression or baby blues seem to be more likely to experience D-MER. (Kacir, 2024; Zychlinsky, 2024)
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Women with D-MER also have significantly higher depression, anxiety, and stress compared to women without D-MER and report having thoughts about hurting themselves significantly more frequently than women without D-MER (Žutić, 2024).
Mothers who experience mental health symptoms, should consult their healthcare provider for guidance.
WHAT SEEMS TO WORSEN THE SYMPTOMS?
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There seems to be a hormonal influence as many mothers report an increase in symptom severity around ovulation or menstruation time. With mom A, symptoms were worsened by the use of an oral contraceptive and around ovulation time but not around menstruation time. A systematic review considering contraception and mental health challenges has found mixed results (Jahanfar, 2024). There are also challenges related to unplanned pregnancies to be considered.
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Sleep deprivation, insufficient maternal hydration, lack of self-care and stress are all factors that have been identified by mothers for worsening symptoms.
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The d-mer.org website mentions that waiting too long to feed may worsen symptoms, whereas mom A found that when her breasts felt engorged, her symptoms were reduced.
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For some mothers, caffeine use seems to make things worse.
Mom B shares some motivation for other moms:
“I felt proud that I had not despaired but tackled the problem head-on and not let it consume me. Sometimes also, when things get hard, we can draw on our inner strength and push through when we are busy with important work; and breastfeeding my babies had become the most important work I have ever done!
I've never approached D-MER as something emotional - it has helped me to view it like any other bodily symptom that can be supported with the diet, sleep and exercise that most mental health problems benefit from! I don't give those empty feelings the time of day. They're not me, they're not a part of me, they're just a symptom I get when my body needs extra support. As much as someone else can counsel me or listen to how bad it is, I can support myself by taking care of myself.
With D-MER and especially through multiple ages and phases with multiple babies having a running and ever-adapting plan is needed. Know it may pass. Know it may not. Know you're not doing anything “wrong”. Know the more supported your body is physically, and you yourself emotionally, the better you can weather the letdown challenges.
Know whatever you’re feeling while nursing, your baby is only feeling the warmth and great love and joy that you nursing them brings.”
IN CONCLUSION:
D-MER and experiencing waves of negative emotions during breastfeeding is uncommon. Mothers do not need to remain silent. It’s important to know you aren’t alone. These sensations are a physiological response, not a reflection of your feelings as a mother. You don't have to carry this in silence, guilt, or embarrassment. Reach out for the support you deserve—La Leche League is an excellent place to start finding community and care.
WEBSITES, REFERENCES AND ARTICLES FOR FURTHER READING
https://physicianguidetobreastfeeding.org/dmers/
https://www.breastfeeding.asn.au/resources/d-mer
https://llli.org/news/what-is-d-mer/
https://laleche.org.uk/dont-enjoy-breastfeeding/
https://kellymom.com/bf/concerns/mother/breastfeeding-nursing-aversion-agitation-baa/
https://www.breastfeedingaversion.com/
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