Monday, December 1, 2014

Pumping at work...caution, some graphic details here

I discussed in a prior post about how difficult it was being a pregnant resident. So moving along chronologically, we should discuss post-partum life too. It was certainly no walk in the park. Women don't seem real open to talking about the difficulties with post-partum life, the technicalities of nursing and pumping and trying to return to work. How do we juggle babies with any job, much less a professional career? I hope to open up the discussion here.

Since I was in an educational setting, the standard FMLA 12 weeks required unpaid leave wasn't exactly the case. I was a hospital employee but was also undergoing a rigorous educational program at the same time. I did not insist on 12 weeks off, but took 8 weeks and still had to make up some time after graduation. I had a colleague in a similar position who took only 6 weeks off. Maybe it never feels like enough time? I had a mushy mommy brain (it's a real thing, guys) but had to resume work with the same physical/mental/emotional rigor that was standard before my new mommyhood.

Mommy brain

I think here begins my dissolution with medicine. There is no way to have a work-life balance in this state. My wonderful mother moved in with us for 6 months so my husband and I could both finish our difficult residency schedules and she was my daughter's main caretaker. I think I still wanted to be important and vital to my daughter so I chose to breastfeed. But I'm not sure where I found the strength to do this. I wanted to try it and experience that special bond between mom and baby. I didn't want my work to take away everything special about having a baby. Emily was my first child and fortunately I had a lot of support at home. I felt some obligation to try nursing, too, since I was in the medical profession and we always speak about the numerous benefits of breastfeeding to patients.

In retrospect, I probably should have been nicer to myself and just used formula. But after my maternity leave, I returned to work with the black Medela pumping bag around my shoulder. I was also armed with a ton of disposable breast pads and scribbled notes/encouragement from my lactation consultant in my pocket.

How do you keep nursing at home when you have a demanding job, over 40 hours per week? I had to pump at work during my 8-12 hour shifts. How do you do that when you have no scheduled breaks and typically feed your child every few hours at home? It just was not possible to take a pumping break every 2-3 hours. So...I remember a lot of pain, leaking, mastitis, and misery. Suffering in silence...while covering my wet scrubs and trying to talk to sick and distraught patients in the ER. I somehow managed to carve out one pumping break per shift. But as you know, the less you pump, the less your milk supply, and you inevitably don't provide enough milk to exclusively breastfeed. Overall, I felt that some breast milk was better than none, and did my best with breastfeeding and pumping for about 6 months.

There are other details here, like, where do you pump when you get a chance?
How long of a break do you get to pump?
Who covers your work while you are gone?
How do you deal with the stress of it all?

I ended up finding a small locked room in the ER, officially called the grieving room, where we would tell families about their sick or dead loved ones. Not a great ambiance there, but it was all I had.  I would sit on the floor and put the pump on a chair in order to reach an electrical outlet. I had quite the system down for doing things as efficiently as possible and it took 16-18 min or so. Setting out the equipment, applying the various hook-ups, trying to RELAX, pump, wrap up, put away. No one really did my work for me, but I let my (usually male) attending know I was on a pumping break (insert blank, red face, hushed voice reaction here) and would be back ASAP. You can't control who walks in the door of the ER, so sure, I missed some interesting patients and procedures while on break. But it never really bothered me. Did it bother my attendings? I guess I'll never know. And regarding stress, I'm sure I didn't deal with it very well, but I was in a very pressured setting and was literally just taking it a day at a time. It has taken 6 years to get motivated to finally talk about this, so I am probably working through some PTSD!

I personally and completely understand why some women don't breastfeed. But I was surprised with the statistics here on the CDCs 2014 breastfeeding report card. The majority of women try, but significantly fewer succeed past the 6 month mark. I view this to represent a general desire to breastfeed in many women. But there are a lot of barriers to success. Perhaps a good topic for next time. I am glad I tried and am in awe of my prior self finding the strength to stick with it. But it probably came with a cost-a growing disinterest in medicine because it took me away from my family and good mental health.

Do you have any embarrassing/good/bad pumping stories?

Do you remember when you first learned HOW to pump? (My husband and I had to watch a YouTube video, which was absolutely horrifying as a first timer...)

Thanks for reading!

Here's the picture I carried in my pump bag way back then:


  1. Ann! This is such a truthful blog. I had similar experiences, even in a much less physically demanding Allergy& Immunology Fellowship. Thanks for writing about this. We all want to do what is best for our babies, but we sometimes forget that our own sanity might be what is ACTUALLY best for them! I'm just as guilty as any other mom!

    1. Thanks Sharon! I agree with you- sanity is highly underrated. I'm sure it was difficult to get through your fellowship while being a mommy. Maybe you have some sad/funny/horrifying stories to tell?

  2. Hi Ann,

    I finally have a chance to re post my comment. I am now a mother of 3 children under the age of 5. My first child I had a difficult time latching on. After countless advise from lactation consultations; I pumped exclusively with him for 7 months. My second child I was able to breastfeed and pump for 7 months. My last I am currently having some difficulties with latching on. She is breastfeed and I pump. With my first 2 children I was able to take off from work for 12 weeks. That time was wonderful. With my last child since I became a nurse practitioner and just started my new job 2 months prior to delivery; I will be taking 8 weeks off :( The time is going by fast. I have just 1 more month left of bonding. When I returned to work with my first in the ED; I had to go to a private bathroom or locker room to pump. When I had my second..that is when the lactation rooms became available or I could use the back office for this. Now with the new redesign of the ED a lactation room with be in the department.

    My first encounter with pumping was shortly after my C-section. The nurse rolled the yellow medela pump into my room. I was to begin pumping when I was more awake and every 2-3 hours during my 4 day stay at Casa FMLH. This is because my oldest would not latch on and of course he was still sleepy following the C-section.

    The best pump story that I have was when I was working a night shift. I had 4 hours left and I decided to go pump. I was in charge and I went to the back office to pump. I hooked myself up and prayed that a trauma did not come in. After hooking myself up to the pump I turned on the switch and there was a strange noise. My dang blasted pump decided it wanted to stop working. I'm yelling at this point to my pump and to top it off the pager goes off for a trauma ahhhh!!! At the end of my shift I went home and attempted to rent a pump, but nothing was available. I soon found out that my insurance company would pay for a pump. I had to contact my OBGYN and he faxed something over to the medical supply store and I had my new pump that same day. Unfortunately my milk decreased during this time, but eventually came back after a week.

    1. Wow Laura! I so admire your breastfeeding/pumping efforts. I am also SO glad there will be a lactation room in the ER! Congrats on the NP job too :) I can see you rocking that kind of position.

      I don't know what I would have done if my pump stopped working while at work. How miserable and painful that would be!! And to be responsible for the whole ER at the same time. Yikes! Pumping takes a certain kind of persistence, that's for sure.

      Thanks so much for reading and commenting!!