The Complex Intersection of Mental Health and Breastfeeding: Understanding D-MER, Trauma, and Emotional Transitions
As a mental health counselor who specializes in supporting women on their perinatal journey, breastfeeding is a topic that often comes up in sessions. As I’ve gotten deeper into this field, I have found that there’s a lack of education for new mothers about breastfeeding. Even as I embarked on my personal journey of motherhood, I found the main narratives were, “breastfeeding comes naturally to mom and baby,” or, “you just need to get through the beginning which is really painful, and then you’ll be okay,” or “if it doesn’t work well, there’s always formula.” While there’s truth to each of these narratives, they fail to highlight the full picture of what breastfeeding entails.
Sure, breastfeeding is a natural process, but it’s not something that always comes naturally to mom or baby. There can be many challenges that impede on this process, making it feel anything but natural. We will explore some of these challenges in this article. But the most important thing for women to remember is that proper education and support is paramount to a successful breastfeeding journey, and there are so many professionals out there who would be excited to help you find success.
The breastfeeding journey represents a profound physical and emotional experience for many mothers, encompassing both challenges and rewards. Together, we will explore the intricate relationship between mental health and breastfeeding, with particular focus on specific conditions and experiences that can impact this journey.
Understanding Dysphoric Milk Ejection Reflex (D-MER)
Imagine you are a new mom and the moment you go to nourish your baby with your body, you experience a wave of sadness or anxiety. This would be enough to discourage almost anyone from breastfeeding. Especially if you don’t know what is happening.
Dysphoric Milk Ejection Reflex (D-MER) is a distinct physiological and emotional phenomenon that affects approximately 14.2% of lactating parents (Cappenberg, 2025). This condition is characterized by an abrupt wave of negative emotions that occurs just before milk release and typically lasts for several minutes. Unlike postpartum depression, D-MER is a specific physiological response related to hormonal fluctuations during milk letdown.
Key characteristics of D-MER include:
Sudden onset of negative emotions coinciding with milk letdown
Feelings of anxiety, sadness, or irritability
Brief duration, typically lasting only minutes
Distinct from postpartum depression or general anxiety
Ways to work through the effects of D-MER:
Knowing what’s coming and engaging in logical self-talk about it
Deep breathing techniques during breastfeeding
Having a positive mental mantra to anchor yourself to when breastfeeding
Learning into the uncomfortable emotions while telling yourself they have an expiration
The Impact of Sexual Trauma on Breastfeeding
The mind-body connection is a very strong one, and is consistently making itself known throughout the perinatal journey, into motherhood. Traumatic experiences can be stored as physical memories in our body. Since pregnancy, birth, breastfeeding, and motherhood are all very physically engaging experiences, if someone experienced a past trauma that included a physical component, such as sexual trauma, they can be easily triggered during this period of their life.
Sexual trauma can significantly impact the breastfeeding experience, creating unique challenges for survivors. Research indicates that past trauma can affect:
Body autonomy and control issues during feeding
Emotional responses to physical touch and intimacy
Anxiety around exposure and vulnerability
Triggering of past traumatic memories
If you are pregnant and know you are interested in breastfeeding, but have fears that your past experiences may interfere with this goal, it could be worthwhile to engage in mental health therapy to process the trauma before breastfeeding begins, and while you engage in breastfeeding to work through any difficult feelings that arise as a result. It can also be supportive to have a lactation consultant on your team in case you experience some lactation setbacks and need additional tools to find success.
The Weaning Process: A Significant Transition
Even through the most beautiful of breastfeeding journeys, women may experience a rush of emotions when the process nears its end. I am personally on the tail-end of my first breastfeeding journey and as I move closer to this eventuality, there are many thoughts and emotions that come up for me. Sadness and grief for the ending of something that I hold so dear. Excitement to regain some more control over my time and body. Gratitude for having been able to nourish my baby for over a year. Fear that our bond will change as breastfeeding ends.
The end of the breastfeeding journey often brings complex emotions. Some common experiences are the following:
Hormonal changes affecting mood
Sense of loss and transition
Relief mixed with sadness
Adjustment to changing physical and emotional bonds
Identity shifts as feeding relationships evolve
Wherever you are on your journey, if breastfeeding is something you are interested in for yourself and your baby, take the time to lean into learning about it. Take the opportunities to talk to fellow moms who have been there and to professionals that can support you. While it’s certainly not a requirement as you become a mother, breastfeeding can provide one of the closest physical and emotional bonds you can have with your child, beyond the time they spend in your womb.
Maria Clemente Morresi, LPC, PMH-C
