05/28/2026
This is a great description of breastfeeding aversion etiologies. What many moms think is DMER I often find is BAR or sensory aversion during breastfeeding, and yes, all can overlap.
The key takeaway is that all three have a nervous system root. These moms are often in sympathetic dominance, "fight or flight", with adrenal burnout.
When we get the stress off the nervous system, many of these symptoms disappear, whichever of the three diagnosis you might have.
I have one mom who uses the angst, "touched out" feeling she used to get with tandem breastfeeding as a way to gage how frequently she needs adjusted. We started out at three times a week and as she started improving she wanted to drop down to two, which I supported. (You are the head of your care team!)
At twice a week she found that touched out feeling started coming back, so for now, she gets adjusted three times a week as we help her nervous system unwind.
She continues to make great progress and I anticipate she will quickly find that we can spread them out further and further as her nervous system adapts and heals.
There are lots of ways for me to assess stress on the nervous system which help me determine adjustment frequency. Mom's feedback is just as important.
If you feel sudden rage, agitation, panic, or the overwhelming urge to crawl out of your own skin while breastfeeding… you are not the only one experiencing this ❤️
And importantly: not all breastfeeding-related agitation is the same thing.
Here are three experiences that can look similar on the surface but have different causes:
✨ DMER (Dysphoric Milk Ejection Reflex)
DMER is a sudden emotional drop that happens RIGHT before or during letdown. It is believed to be related to a rapid dopamine shift when milk releases.
Mothers often describe:
• dread
• sadness
• panic
• hopelessness
• irritability or rage
• a “pit in the stomach” feeling
The key clue?
It is very brief and closely tied to milk letdown. Many mothers notice it lasts 30 seconds to a couple minutes and then disappears completely once milk is flowing.
It can happen while feeling emotionally well otherwise.
✨ BAA/BAR (Breastfeeding Aversion and Agitation Response)
BAA/BAR is more commonly described as intense agitation, anger, skin-crawling, resentment, or the urge to stop feeding immediately.
Unlike DMER, it is NOT necessarily tied to letdown itself.
It often happens:
• during long feeds
• comfort nursing
• frequent night waking
• pregnancy nursing
• tandem feeding
• feeling “touched out” or depleted
Parents often say:
“I want to throw something”
“I feel trapped”
“I cannot tolerate being touched anymore”
The feelings may continue the entire feed rather than disappearing after letdown.
✨ Sensory Aversion During Breastfeeding
Sometimes the issue is primarily sensory nervous system overload rather than a milk-ejection response.
This may feel like:
• intense irritation from the physical sensation of sucking
• distress with wetness, rubbing, breathing sounds, or repetitive touch
• overwhelm from being climbed on, touched, or needed all day
• worsening symptoms with stress, sleep deprivation, ADHD, autism, anxiety, or sensory sensitivity
Unlike DMER, this is usually not tightly linked to letdown timing.
Unlike classic BAA/BAR, the reaction may happen in many non-feeding touch situations too.
And honestly? Sometimes these overlap.
A mother can experience:
• DMER PLUS sensory overload
• BAA/BAR during pregnancy
• neurodivergent sensory sensitivity that becomes magnified by constant nursing
None of these experiences mean you are a bad parent or that you do not love your baby.
Sometimes the nervous system is simply saying:
“I am overloaded.”
