We are seven weeks into this whole mothering thing, and things are going well for this family of three. I figured I’d eventually write about my labor and delivery experience, but that’s not what happened when I sat down at my computer today.
Throughout my pregnancy, all I heard were stories about traumatic birth experiences from my friends and random women in restaurants and cashiers at the grocery store… For reasons I don’t understand, women everywhere are dying to tell you about their 92 hour labor and their emergency c-section. Plus, I had dozens of labor scenes from movies and TV shows playing in my head, each one featuring some actress in absolute agony, begging for someone to put her out of her misery. I was incredibly anxious about giving birth, but to my surprise, the entire experience was straightforward and I had very little real pain. Before you egg my house, let me say that I know I’m incredibly lucky to have had this experience. I know it’s not the norm, especially for a first baby. I had a relatively short labor, which started at around 3 AM when I woke up and noticed my water was breaking, and ended with me holding baby Carrie at 5:21 PM the exact same day. I had good drugs, and family support, and an awesome nurse, and… well, I really just don’t have much else to say about my labor and delivery. It was seamless.
But I do have a lot to say about what happened when we got home. I regret to inform all of you that most of this post won’t be terribly funny, which, let’s face it, is no way to live. I’ll get back to my usual brand of blogging soon. It’s just important that I share this incredibly bizarre and trying experience, on the off chance that it helps someone else.
Let me start by saying that I knew coming home with a newborn was going to be a real challenge. In addition to the labor horror stories from friends and cashiers everywhere, I’d also hear a lot about how the real work begins when you get home. How you don’t get any sleep and your hormones are out of whack. How breastfeeding can be a challenge. How all of the obstacles are completely worth it, though, because you can also stare down at the incredible life you created and take comfort in her perfection, blah blah blah. I’d heard it all, and I thought I was prepared. I’d been tired before. I’d had challenges and overcome them before. I’d definitely dealt with hormones before. I was ready to get on with it.
The day after that gorgeous textbook delivery of mine, and the entire first week of Carrie’s life, I marveled at now normal I felt. I was tired from being up all night with my baby, but I was still me. Although Carrie wasn’t latching when I tried to feed her, I was producing a lot of milk, and I was happy that I was able to pump and feed her breastmilk with plenty extra to freeze for later. I was also a little relieved, because I had been certain I’d be a hormonal mess after having a baby. But what I didn’t realize was that there can be a bit of a waiting period between having a baby and starting to feel “off.”
Exactly one week after Carrie was born, I started to feel more anxious than usual, and I felt a fog of depression settle over me. I started to cry easily, and more often. I was pumping every three hours, and spent up to four hours of each day attached to a machine, or cleaning its parts for the next use, or labeling and storing extra milk, or checking to see if Carrie was ready to latch yet (she never was, so it was a frustrating exercise each time). Every day was a groggy cycle of feeding, pumping, cleaning, changing diapers, snatching two hour stretches of sleep whenever possible, tidying up the house, and trying my best to entertain the scores of well-wishers who kept coming over. I needed to use every bit of energy I had to put on my best face until they left. I didn’t feel like I was bonding with my baby much at all. I asked my OBGYN to up my dosage of antidepressants, and hoped that it wouldn’t last more than a few weeks.
One day, through my fog, I somehow managed to notice a pattern. I suddenly realized that I felt the worst when I was pumping. I figured the negative association with pumping was probably due to the tedium of being so reliant upon a machine, so many times every day, unable to leave the house for more than a couple hours without being uncomfortable, but when I really thought about it, I realized I was feeling an actual emotional shift when I was pumping. With one Google search of “depression while pumping,” I found out about D-MER (Dysphoric Milk Ejection Reflex).
I learned that in nursing mothers, a hormone called prolactin is responsible for continued milk production, and it peaks at the beginning of a feeding. I learned that dopamine can inhibit the release of prolactin, so the body is smart enough to naturally suppress dopamine a little during nursing or pumping. Occasionally, though, this doesn’t work as intended and a woman’s dopamine levels plummet each time her body releases milk (lets down). This rare physiological glitch in brain chemistry causes the woman to feel a wave of negative emotion every time her milk lets down, which can be several times in one feeding or pumping session. I started to pay more attention to my emotions when I pumped, and realized I was indeed getting an obvious wave of gloom and doom, just before producing milk. I had been so exhausted and overwhelmed that it took me a few days to figure out that what I thought was prolonged baby blues was actually D-MER.
What do these “negative emotions” feel like, you might be wondering. The experience can be quite intense for some women, and a very mild discomfort for others. For me, each time I pumped, I felt like I had just learned that my house had burned down, with all of my loved ones inside, and it was all my fault. The worst despairing, self-loathing, homesick feeling I have ever felt. (Yikes. See? Told you this wouldn’t be a very funny one. Maybe I can tell a joke at the end to make up for it.) This feeling would last maybe 30 seconds, fade away as quickly as it came, and then with each let down I would have similar, less intense waves of bad feelings until I was finished pumping. Sometimes I would be feeling generally optimistic, but as soon as I’d get hooked up to my pump I would suddenly be unable to stop crying until I was finished. (Okay, definitely going to have to tell a joke at the end).
I saw a psychologist who specializes in perinatal mood disorders, and she agreed that what I was probably experiencing was D-MER. I was relieved that what was happening had a name, and I started reading articles and blog posts on D-MER to try to find out how I could manage it. I learned that there’s really not much you can do, if this happens to you. Excellent news, right? Some women report that it becomes less horrible as time goes on, but no one is sure why this is the case for some women and not others. Mostly, you’re just screwed. I read dozens of blogs and forums discussing D-MER and I saw again and again that women just “toughed it out” until their children were weaned at 6, 9, or 12 months old. I seriously couldn’t find any instances of a woman admitting that she was miserable, giving up breastfeeding, and feeling better. Not one. I felt like I couldn’t give up, either… after all, I continued to produce milk like a champ. I couldn’t bear the thought of putting my daughter on formula when I was making plenty of food for her, even if I felt bad a few times each day. My psychologist and I agreed I would continue to pump for one more week, monitoring my symptoms, and make a decision about whether to continue.
It was a nice thought. I lasted three more days, and then called it quits.
Flash forward to today: Carrie has been on formula since four weeks old and she is doing great. I am no longer pumping, and thanks to about ten different old wives’ tale remedies (sage tea, peppermint, cabbage leaves, ritualistic chanting, burnt offerings) I successfully went through the painful process of drying up my milk supply. Once I was able to stop pumping completely, I felt instantly better. I felt like myself again. I started to enjoy Carrie so much more. The moral of this story is that I was a better mother and partner because I chose to take care of myself.
I have found that D-MER is not something that many people know about, even doctors or therapists or lactation consultants, because it’s not a common problem. I was prepared for the usual breastfeeding problems, like milk production troubles, latching issues, forceful letdowns, the inability to monitor milk intake, and so on, but I had never known such a thing as D-MER was possible. When I’d done research and read that so many women soldiered on and continued to breastfeed through their D-MER discomfort, I had felt immense pressure to do the same. I regret that I allowed myself to feel that pressure, and I regret the guilt I felt when I realized I couldn’t bear to continue pumping. So, let me be one of the first to say it: It’s okay to attend to your own mental health by giving up breastfeeding. Your baby will be just fine. Better, probably, because she has a healthy and happy parent caring for her.
And now, here is a joke:
A baby’s laugh is one of the most beautiful things you will ever hear.
Unless it is 3 a.m., you’re home alone, and you don’t have a baby.
And one to grow on:
What did the buffalo say to his baby boy when paternity leave was over?