An un-apology: a physician's breastfeeding isolation

This article was written before COVID-19 social distancing recommendations.

I want to start off by saying that I fully know my breastfeeding journey is a success story. There are so many women who struggle with medical illness, latch issues, an unsupportive workplace, milk production, and more. I had initial struggles; but, largely, these were not my issues. In that way, I was fortunate. Mine is the story of learning to become unapologetic.

I am a physician at an academic internal medicine program, practicing primarily in the outpatient setting. During my first year as a new faculty member, I gave birth to a beautiful, healthy baby girl. I knew I wanted to breastfeed, and I knew it would be hard. I attended prenatal breastfeeding classes, met with lactation consultants shortly after my daughter’s birth, and was lucky enough to have a friend who had gone through this a year before me who allowed me to text her my random breastfeeding questions at all hours of the day.

From the start, my employer was supportive. They asked me if I was planning to breastfeed so they could block time between patients when I returned from maternity leave—and they did it, without me having to repeatedly ask. With all these things going for me I thought it would be a breeze to breastfeed for a year.

When I first returned to work I was so focused on reacclimating, taking good care of patients, figuring out how to do daycare drop-offs, doctors’ visits, and pumping in between patients that I didn’t initially notice what would become my biggest struggle—the isolation.

At home, I experienced the isolation early on. When your baby eats every 90 minutes and takes 40 minutes to eat, you could spend all day alone in a room without talking to anyone else. If you’re afraid to nurse in front of others, you could go two months without any adult interaction. Having noticed that, I told myself I would be “brave” and nurse in public. Over the first six months of my daughter’s life, I breastfed in front of my dad, my father-in-law, my grandfather, friends, and strangers of all genders. Despite the too-frequent looks from strangers, I was “bold.” I nursed on airplanes, in airports, in restaurants, outside at a street fair, sitting down on a curb, and standing up in a public bathroom at a conference. I’ve pumped in a packed mountain lodge cafeteria on a ski slope, while calling patients and insurance companies on the phone, over every lunch break, and while driving. One personal milestone was when I realized I had the ability to successfully nurse my daughter in a restaurant while eating a salad, with chopsticks.

This was a process. Initially, when I tried to use a cover, my daughter hated it, pulled it off, unlatched, and I felt more exposed than I would have been otherwise. When I built up the courage to start nursing in public, I got some well-meaning comments like “Oh, you’re just whipping them out, huh?” or “Wow, you’re really comfortable with this …” which didn’t help.

While I was able to manage my home and social isolation with my newfound “breastfeeding bravery,” the same rules didn’t seem to apply at work. I couldn’t pump and see patients at the same time; there was no way around that.

My practice has a focus on team-based care, so I usually work out of the communal workroom. However, now between patients, I was running back and forth to my office to pump while I dictated. As a medical educator, I am involved in educational research and administrative committees. However, I needed to pump over the noon hour, so I was constantly missing meetings, leaving early, or showing up late—if at all. I constantly worried my colleagues would think I was lazy or disengaged from my work.

I used to keep my office door open, so colleagues would stop by, poke their head in, talk about a patient case, or a research idea. When pumping my door is closed. No more visitors—for nearly a year. I quickly found that the world around me didn’t stop and wait while I was pumping.

I still don’t feel like I really figured it all out. Overall, people were supportive, but occasionally the “how long are you going to keep breastfeeding?” and the “aren’t you going to use a cover” crept in and made me want to throw daggers from my eyes. I still couldn’t pump and see patients simultaneously, so I relegate myself to solitude multiple times a day. However, I no longer shy away from telling people why I have to slip out from a meeting, and I do not apologize for needing time to pump or nurse anytime, anywhere.

Motherhood and medicine each can be isolating enough without adding additional reasons to isolate yourself. So if you find yourself in this position, I challenge you:

Be bold: Nurse your baby in front of your spouse’s grandfather.
Be brave: Pump in the open, in a mountain lodge, while skiing.
Be unapologetic: Whether two months or two years, in public or private, with or without a cover, each breastfeeding journey is different, and no one gets to decide what it should look like for you.
Be proud.

Breastfeeding for a year is one of the hardest things I’ve ever done. As a busy, working mom, it made me feel like I was providing my daughter with nutrition, love, and comfort even though she is at daycare while I work. With all that said, I am really ready to stop washing pump parts and rejoin some lunch meetings.