As Renee Scott's newborn daughter was put on her breast for her first feed, Renee felt an overwhelming anxiety and a deep, intense sadness. Putting it down to exhaustion, being a new mum and a long labour, she dismissed it.
Months later, the feeling remained.
"I experienced these symptoms for a long time before actually identifying the cause-and-effect relationship between feeding and feeling an influx of negative emotions," she says.
"I thought I was going crazy when I suspected there might be a relationship between the two, but when I googled 'Why do I feel sad when I breastfeed? I was met with several forums where other feeding mothers had asked the same question. That's how I came to learn about D-MER."
D-Mer (dysphoria – milk ejection reflex) is defined as a state of dissatisfaction, anxiety, restlessness or fidgeting that occurs seconds before a mother's milk ejection reflex.
D-MER is very different from Postnatal Depression (PND) or an anxiety disorder as it's only associated with the negative emotions that occur with milk ejection.
According to the Australian Breastfeeding Association, research is currently underway to determine what causes D-MER. The current theory is that inappropriate activity of the feel-good hormone, dopamine, is the cause.
Symptoms of D-MER may decrease by three months postpartum or they may continue throughout the breastfeeding period.
Since the birth of her triplets in December 2018, Renee has suffered D-MER again. While the negative emotions are still as strong as with her daughter, she has found that education has helped her.
"Putting a name and explanation to what I was experiencing and understanding that it's a physiological reflex to breastfeeding, rather than a psychological response, has helped with my D-MER journey," she says.
However, Renee believes that more education and awareness is necessary.
"I've spoken to several medical professionals about it but have only found one nurse who'd heard of it," she says.
"I still get funny looks when I try to educate people about D-MER, but I think it's so important to bring awareness to something that's affecting mothers everywhere. Educating a mother who's suffering from D-MER can positively impact on her experience and assist in prolonging her breastfeeding journey."
Angela Shone, a registered nurse, agrees. She's suffered D-Mer with all three of her babies for the duration of the breastfeeding journey. She's currently breastfeeding her third baby who's now 14 months old.
"Many women don't associate the feelings with let-down, are unable to describe the symptoms adequately or unwilling to mention it for fear of judgement by others," says Angela.
"If they do talk to a health professional, they're often misdiagnosed with post natal depression and therefore miss out on the opportunity to have appropriate support and education which may have been all they needed to cope with the symptoms."
Angela believes that the more the word is spread about this being a real problem for women, the more can be done to help. Like Renee, she believes that this will also result in mothers breastfeeding their babies for longer.
"I think D-MER is highly underreported by women and I can easily see how many would view symptoms as unmanageable," says Angela.
"More research is needed, and more doctors, midwives and obstetricians need to be aware that this exists so they can help educate women."
If you or someone you know is suffering with these symptoms, contact a health professional to seek advice. Also visit the D-Mer organisation for more information and support forums.