FFF Friday: “If someone wants to judge me…that’s their choice.”

Welcome to Fearless Formula Feeder Fridays, a weekly guest post feature that strives to build a supportive community of parents united through our common experiences, open minds, and frustration with the breast-vs-bottle bullying and bullcrap.

Please note, these stories are for the most part unedited, and do not necessarily represent the FFF’s opinions. They also are not political statements – this is an arena for people to share their thoughts, and I hope we can all give them the space to do so.

D-MER, or Dysphoric Milk Ejection Reflex, is a problem that is seldom discussed in breastfeeding literature. It’s a tricky condition to diagnose, because other things can make breastfeeding a negative experience – postpartum depression, psychological responses to physical pain or sensations, associations with past abuse, body image issues…  D-MER, however, causes a “dysphoric” response (depression, anxiety, anger, negativity) with milk let-down, and it typically subsides as soon as that physiological process ends. In my opinion, this is a vastly under-diagnosed condition due to the perception that these feelings are shameful or “abnormal”, because we are told that breastfeeding should be a lovely, enjoyable bonding experience. Further, the vast majority of D-MER resources operate under the assumption that weaning is not an option, and that it can be resolved through medication. For those who want to continue breastfeeding, this is wonderful – but for those who do not feel comfortable taking certain medications while nursing, or at all, this advice may cause more frustration than comfort. 

FFF Andrea’s story, which unfolds below, demonstrates the conflicted feelings of a woman who wants to breastfeed, but also wants the happy, emotionally-attuned family life she so deserves. I hope that her willingness to share her journey will encourage other women living with D-MER to come out of the closet regarding their true feelings and experiences. This is a real problem, affecting real women, and it’s time we had some real, honest discussions about it – because in many ways, it is the most literal “booby trap” of them all.

Happy Friday, fearless ones….


Andrea’s Story
I formula fed my first and for the most part didn’t mind.  I knew he was turning out healthy and he was advanced for his age too.  I had no doubt that formula was a good alternative for those that didn’t want to or couldn’t breastfeed.  However a part of me always sort of wished breastfeeding worked out for me.  However I had depression only during breastfeeding and it just got worse as the days went on.  After a bit of research sometime later I found out that it was D-MER and was a bit relieved that I wasn’t abnormal and others experienced it too.
Fast forward a couple years and we had our second on the way.  I hoped that breastfeeding would work out and was determined off and on to exclusively breastfeed.  I researched D-MER and found out that if you had it before you would likely get it again.  That thought scared me quite a bit because I remembered how miserable I felt and the dread I felt before he latched on.  I found out that Wellbutrin had some good results with D-MER though and started researching the use of Wellbutrin while breastfeeding.  I took it for ADD already with great results, but had stopped before I got pregnant.  However, I just couldn’t find enough research to make me feel comfortable with that.  I knew only a little transferred through the milk, but I couldn’t help but wonder how much it affected a baby’s brain since they were so tiny and still developing quite a bit.  My education background made me wary as well.  To me, formula honestly seems to be a much safer alternative because it doesn’t have a drug in it that affects the dopamine levels in her brain.
Fast forward again and my daughter was born at a very healthy 7.11 pounds and 20.5 inches.  She had (still does have) the cutest chubby cheeks!  I decided to go ahead and let her latch on and she did, very fast and pretty good, too.  I remember telling the doula that we would take it one day at a time and wistfully stating that I hoped it would work out.  It was an experience I wanted to have.  I knew I’d bond with her just as well with formula; in fact it would be better than breastfeeding if the depression came.  We were in the hospital for 2 days and she breastfed really well; in fact I’d say she had a voracious appetite.  She had a wonderful latch, but she went at each feed so thoroughly that I got peeling and cracked nipples.  It only hurt when she latched on fortunately and sometimes that was because she’d just inhale the nipple.  On the third day I was pretty much couch- bound with a baby that was feeding pretty often for short cluster feeds.  If she wasn’t feeding she was using me as a paci or insisted on sleeping with her head right next to the nipple.  I could get up to maybe use the bathroom, but that was it.  My milk had started coming in and I began to feel those same depressing thoughts and I had some random bouts of anxiety as well.  Faint as they were at that moment, it was still undesirable.  I also found myself really hating the couch-bound aspect.  I couldn’t find a position that didn’t hurt since I had a couple stitches.  I also had a son that needed me.  My husband was helping out a ton, but my son insisted on having me help him go to bed at night and to pat him back to sleep if he woke up.  I wanted to be with him at bedtime and more as well, but with the way my daughter was feeding, it was very hard.  So midway into the third day we switched to formula.  Admittedly I felt relieved.  I wasn’t tied to the couch and my mood started improving with the slowly diminishing letdowns.  The more my milk dried up the better I felt.
A few days later though it was clear the formula wasn’t agreeing with her.  She was comfort feeding so much that she would drink about 6 ounces over a couple hours between fussing.  Then she’d cry and fuss herself to sleep.  We tried paci’s and all, but she wouldn’t take them.  I also noticed that she had silent reflux.  I decided to try Similac Sensitive since that was what my son was on.  I remembered that he didn’t do well on Enfamil Gentlease so maybe it would be the same with our daughter.  It seemed like she improved briefly, but she actually got worse.  So as a last option I bought a can of Alimentum and gave that a shot.  She started doing so much better.  It was an amazing improvement.  I fell in love with the formula, she is such a happy and calm baby now.  She does just as well on Nutramigen as well, which is a bit more affordable.
Part of me felt bad though.  I occasionally wonder if she’d have had this problem if she were breastfed.  I also wished a bit that breastfeeding had worked out.  I wanted that experience and the convenience as well.  I felt a bit guilty that I enjoyed holding my daughter more now that she wasn’t attached to me and voraciously feeding almost all the time as well.  She had such a high demand and was always tugging and pulling at me as well as feeding quite hard at times. 
I can’t help wonder if some of the guilt I feel is because all my friends breastfeed.  The only person I could talk to about the whole breast or formula dilemma while pregnant was with my mom, who had done both with my brother and me.  I tried talking to a friend, but she wasn’t very helpful.  I got some clear anti formula comments from another friend as well.  I laughed it off, but it did hurt a bit.  I know part of me feels envious because I did hope it would have worked out.  It’s just an experience I wanted to have that wasn’t tainted with depression or random bouts of abnormal anxiety.  At this current moment I’m trying hard to not get down that it didn’t work out.  It is so nice that my husband can help with feedings.  It’s nice that I don’t have a baby attached to me almost all day as well. It’s especially nice that my mood isn’t going downhill and that I won’t wonder someday if the Wellbutrin changed her brain at all.  I can help out more with our son too.  I do enjoy feeding her much more now.  It’s a wonderful bonding experience and as I say, since you need two hands for feeding with a bottle you can’t read a book or surf the web like you can while breastfeeding.  Sure you can watch TV, but I rarely pay attention to that, I love watching her and it helps keep me aware of her cues on when she needs to burp or is done. 
Overall, I know that this is better for me emotionally.  While most don’t understand DMER or why I won’t breastfeed while taking Wellbutrin, I know the truth.  If someone wants to judge me on my reason for not breastfeeding, that’s their choice.  I hope that someday moms won’t feel this huge push for breastfeeding and have more support for formula feeding.  We have enough to deal with as moms, how one chooses to feed their baby shouldn’t be one of those nerve-wracking issues that can be laced with guilt if the choice isn’t breastfeeding.
Share your own experience for an upcoming FFF Friday. Email me at: formulafeeders@gmail.com.

Suzanne Barston is a blogger and author of BOTTLED UP. Fearless Formula Feeder is a blog – and community – dedicated to infant feeding choice, and committed to providing non-judgmental support for all new parents. It exists to protect women from misleading or misrepresented “facts”; essentialist ideals about what mothers should think, feel, or do; government and health authorities who form policy statements based on ambivalent research; and the insidious beast known as Internetus Trolliamus, Mommy Blog Varietal.

Suzanne Barston – who has written posts on Fearless Formula Feeder.

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14 thoughts on “FFF Friday: “If someone wants to judge me…that’s their choice.”

  1. While I can understand the urge to continue breastfeeding that some may have, I can't comprehend anyone else's interest in medicating an otherwise healthy woman experiencing this. You have a healthy woman who, upon assault of a biological process becomes unhealthy? You remove the process. You don't treat her with something that can result in significant side effects. This is CRAZY! As someone who has experienced significant mental health issues over the years and will be on medication for the rest of my life (if I'm lucky and people don't decide that I don't deserve to function) I just don't get it. If I could just stop doing something so simple and it would all magically disappear, I'd drop the drugs and do it in a heartbeat.

    Note that the same people who think you should most assuredly go on antidepressants to keep breastfeeding when you have D-MER are likely the same people who don't think you should use any medications during pregnancy or birth and should “just switch to something else” or quit for breastfeeding when you don't have D-MER.

  2. I completely understand where you are coming from! I have dealt with anxiety and depression the past 4 or so years (probably longer, if I am honest) for which I've been medicated. My OB felt it was safest and best for baby to discontinue meds during my pregnancy…which I did. My pregnancy was a terrible emotional experience for me and was very difficult without medication. When my son was born, we learned he had a craniofacial birth defect and would require surgery. I began taking Wellbutrin when he was less than 24 hours old. I honestly believe there isn't enough known about SSRIs and benzos to think they are safe to take during pregnancy OR breastfeeding. I wonder if my son's birth defect was caused by the SSRI I took before I got pregnant (and until I got a positive pregnancy test). I get so tired of hearing, “such-and-such is safe while breastfeeding.” The fact is, doctors really don't know because it's not like pregnant women and breastfeeding women are signing up in droves to take brain-affecting medications as part of a study. I get tired of defending my decision to FF, because it's as if a woman's emotional health means nothing if being emotionally healthy comes at the expense of breastfeeding. I am of the opinion that it really doesn't matter how a child is fed if its mother is too depressed to get out of bed and be a good mother…

  3. Oh. My. God. I have to read more about this. I read this blog every Friday and as my son approaches 14 months old, I have struggled with the guilt I felt because I hated breastfeeding so much. Supply was never an issue. Latch? Never an issue. Hotflashes? Ooh goodness all the time. But I would also have these surges of anger, and hate, when I breastfed. I thought something was wrong with my way of thinking because I'm very fortunate and I had a healthy childhood (no child molestation or anything like that). So, I kept questioning, why would I get these intense negative emotions when I breastfed when the “happy chemicals” were released? I was so confused. I must read more about this.

    What are some good sources? Please, anyone. I'd love to know more, especially if we decide to have another child in the future!

    Fearless Formula Feeder, you are revolutionary. Thanks for sharing these stories!

  4. Okay, so I knew about the connections between dopamine and milk production because the two meds that usually get recommended for supply issues (Reglan and domperidone) both reduce dopamine levels. Dopamine inhibits prolactin, which is necessary to make milk. Reduce the dopamine, you get more prolactin, you get more milk. Reglan at least has depression as a side effect and it's not recommended to stay on it more than a couple of weeks. Low levels of dopamine can also lead to depression. But this post plus learning a little about a friend's recent experience with breastfeeding (developed anxiety that promptly went away after switching to formula) made me wonder…. So I Googled “serotonin and milk production” and found out that serotonin is produced in the mammary glands and is what inhibits milk production as your breasts fill with milk. So yet another neurotransmitter that has ties to depression and anxiety that also has ties to milk production. Low levels of serotonin have also been linked to SIDS deaths in infants. More Googling finds connections between neurotransmitters that are involved in depression and anxiety and such wide-ranging bodily systems as the digestive system and the immune system, as well as the prominent role of insulin in production and uptake of serotonin.

    So what does this all mean? I have not a clue, since I'm not a scientist or medical professional. But it sure seems like there is a lot of interconnection between a lot of different systems that could explain the connections between breastfeeding or not breastfeeding and so many other things. Not that I think there is a single thing that is the master key for all of them, but that a disruption in any one area could affect multiple things, including breastfeeding.

  5. Wow, that's a lot to take in…although I'm sleep deprived at the moment. I'll have to read that again and again here when I'm more rested.

  6. Thanks everyone!
    I should up date just a bit. Since my daughter has Silent Reflux and we just got transferred to Tri West from Tri North (gotta love military insurance) we haven't been able to get her in to get medication. I have an appointment set up in 2.5 weeks with a pediatrician that specializes in gastroenterology though and he's a primary care too! Anyways, she loves to comfort feed and since she won't take a paci no matter all the ones we have tried, and trust me we have tried a ton (she will take a latex mam now and again though!) I let her comfort feed on me a bit. It keeps her from screaming bloody murder so I'm fine with it for the most part (I do get the negative effect now and again but not in a severe way). We are working on getting her to take the latex mam more though and I'm sincerely hoping that once she starts a medication we can cut comfort feeding out.

    Nutramigen costs an arm and a leg so I prefer to use something that's free versus something that's so expensive (I cry inside a little every time I spill a bit of the powder, she didn't do well with the concentrate version WIC provides). I don't make a lot of milk though thankfully. She has brought a bit more in though, just not a lot. I'm not too worried about the wellbutrin going through since she gets her main source through formula.

    On a side note, I love the Dr. Browns preemie flow nipples. She improved a lot more with those today. She didn't comfort feed as much in the evening because of that too.

  7. So glad you figured out what works! I'm not a doctor, but I have several friends whose babies had/have reflux, and my impression is that BFing or not BFing doesn't cause it. It's something the baby is born with, and luckily, can often be controlled with specialty formula, sometimes meds for the baby, specific positions for feeding and many kids outgrow it as they get older. ( Not everyone–my mother has GERD, and probably always has.) ANyway, I hope she outgrows the GERD.

  8. I have D-MER and I can certainly relate to the conflicting emotions. I have been able to overcome most of the anxiety with meditation/breathing exercise but it does vary from day to day. I certainly don't begrudge the women who choose to to bottle feed to regain some sanity. I have considered doing differently with this next bay only because the process was so overwhelming. It is a condition that is definitely not talked about enough and I wonder how many other women have dealt/are dealing with this as well. When I mentioned it to my psychotherapist she had never even heard of it or realized the impact it can have on a mother's psyche. I hope that talking more about it will encourage more research on it's causes and how to treat it appropriately.

  9. I don't know why anyone would judge you! You made the best decision for your family for a number of reasons, none of which sound remotely selfish to me! I don't think it's selfish to want to spend more time with your son, or not hate every single feeding.

    Well done you for being brave enough to do the right thing for your family!

  10. I had a really hard time finding much on this. There is a D-MER.org site (not sure of the link) so try looking for that one. It took a lot of work just finding a bit of info and a lot of just said to keep breastfeeding and then the moms who did really congratulated themselves for sticking with it.

  11. Every woman and mother is different and we have the absolute right to make an informed decision based on our own personal needs and circumstances. I hope things smooth out for you soon, mama, and just know that you are not alone. Katiespencerwhite.com

  12. Thank you for sharing your story! I absolutely hated breastfeeding my first baby. And I don't use the word hate lightly, especially when it comes to caring for my child. I continued for 4 months until I went back to work. And the relief I felt when I gave her a bottle is indescribable! I wasn't in pain, I no longer resented my baby, I could share the feeding with my husband, and I could finally enjoy feeding time. I never understood when people would say breastfeeding was supposed to make me 'feel good' and help me bond with my baby. I bonded so much more once I could give her a bottle. I was happy, she was happy. What more could I ask for?

    I am expecting my second baby in about 3 months and have considered trying to breastfeed again because I have been told each baby is different. But after reading this story I believe I have D-MER and I am not sure it matters what kind of nurser my baby is. It probably will be the same if I am the one with the issue. Thank you Andrea for sharing your story and thanks to the person who created this wonderful website!

  13. The same people who demonize formula companies are sometimes the ones who say breastfeeding is safe on any drug. They don't always seem to know that formula and those medications are produced by the same companies. Yet WE'RE the ones who are uninformed…

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