Just Feeding My Baby

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Breastfeeding my second child has been significantly easier than the first.  She latched immediately and has been adept from the beginning.  The lactation consultant who saw us in the postpartum unit said, “well she read the book on breastfeeding… no wait, she WROTE the book.”  After struggling with my first premature child and needing to pump after each feeding and use a nipple shield, the ease of breastfeeding my daughter has been a welcome relief to the chaos of being a mother of two.  When it is going well, breastfeeding is amazing.  I appreciate that this isn’t everyone’s story though.

The second time around, I also feel much less inhibited and as a result, breastfeeding in public has not been an issue.  Here are some of the places that I have breastfed G so far:

- a tea party

- the zoo

- a swanky restaurant, and a few not-so-swanky restaurants

- a public park, or a few public parks

- my office

- a hotel lobby

- a friend’s house

- a holiday party

When G was only 5 weeks old, I took her to the annual conference of the Academy of Breastfeeding Medicine.  Wearing her in my Ergo and breastfeeding on demand, we attended full days of breastfeeding lectures, practicing what we were learning.  It felt empowering to be living what I preach to patients, while learning more skills to apply and pass along.

When I see new moms breastfeeding in the office, I give them support but not necessarily privacy.  I often start with the apology/disclaimer that “I’m going to get very close to you to examine the baby and make sure that breastfeeding is going well.”  I can then learn a wealth of information about the breastfeeding dynamic.  Whenever residents tell me that they aren’t seeing a patient because the mom was breastfeeding and they told her they would return when she is finished, I inform them that this is a missed opportunity for both the mom and resident to learn.  It also sends the message to the mom that breastfeeding is something that is only done in private.  If your doctor isn’t comfortable watching you breastfeed, then what does the general public think?  Now certainly if a mother ASKED me for privacy, I would give it to her!  But she should know that what she is doing is normal and that her doctor can often help (because it isn’t always easy!).

Although things were more challenging with N, we still persevered and I remember pulling out my nursing cover in a number of public venues, wrestling with it and him uncomfortably but ultimately accomplishing our goals.  N breastfed at my pediatric board exam and my residency graduation banquet.  I had advocated for myself and other moms that breastfed babies deserve to be with their mothers at all times, even at formal occasions.  So if I was to attend, so was he.  It works the same with G currently, hence why she has such an eclectic variety of breastfeeding environments.

There have been times when I have been told to breastfed in a public restroom, or that no place was available to sit to feed my children, but I have disregarded these ignorant comments and advocated for my breastfeeding rights.  If you don’t know what your rights are, make sure you find out:

Breastfeeding Law: Pennsylvania

Federal Health Reform and Nursing Mothers

Surgeon General’s Call to Action to Support Breastfeeding

One of the top reasons that women stop breastfeeding their baby is being uncomfortable doing so in public.  This is one of the main reasons that I am so passionate about doing so publicly, because we need to shift our cultural perception that breastfeeding is sexual or taboo and needs to be covered, hidden, or avoided.  Breastfeeding is normal.  So if you are a breastfeeding mom, join me when you see me… at the park, at a party, or at the zoo.  And if I see you in my office, get ready to get intimate as I watch your baby latch, auscultate his/her swallow, and adjust your positioning.  While it may seem uncomfortable at first, you will soon realize, it’s just feeding a baby.

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Working Mom Friends

Finding working mom friends has been crucial to my success as one myself.  I met one in particular before we were both moms, but one of our first conversations was about becoming moms.  We had just started our pediatric residency and as our careers intensified, we took time over tea to dream about our future families.  Hers started before mine, so she has been my road map for this journey.

Without my own children, it was hard for me to understand how difficult being a working mom was, but once I had my own I was amazed at how gracefully she had made the transition.  My own entry into motherhood was more messy.  It started when my water broke while 34 weeks pregnant, at 2:30 AM, while my husband was out-of-town.  So, I called this friend and in the middle of my sobbing I said, “I need to go to the hospital,” to which she replied, “I’ll be right there.”  She didn’t hesitate and didn’t even know why we were going to the hospital until she arrived at my door and I said, “I’m having a baby.”  She was with me until her shift at the hospital started that morning, and has really been with me ever since.

Every working mom needs someone to help guide them through this crazy adventure.  A few months after returning to work from my first maternity leave, I formed a group at our hospital for residents, fellows, and attendings who were “new” moms.  While the irony was that most of us were too busy to make it to actual meetings, it was still quite popular among its members.  It seemed that one thing was universal: we all struggle and we need to talk about it.  Some days it is with our careers, other days with our families, and usually with ourselves.  Hearing that you aren’t alone helps.  Recently, one of my college friends joined the working mom ranks and feeling a need for a physician working mom community, started a private Facebook group for this purpose.  What initially started out as a handful of her working mom friends exploded into a group of a hundred moms within a few days.  Again, working moms were eager to share their struggles with others experiencing the same.  My Facebook feed filled with discussions of sleep training while working, sick days, maternity leave, and gender roles in our marriages.  Together, we try to make this journey less challenging for each other by sharing our workarounds, shortcuts, and shorthand.

One of the best features of my current work environment is the number of colleagues who are moms.  Having other moms around helps to normalize my anxieties as a working mom (“oh you went through this too?”) and support my work-life integration (“of course you need to be at that school event!”).  After all the mentoring my friends have provided me, it is now time for me to pay-it-forward and I am enjoying all the new moms around me and hope that I offer them the same comfort that was given to me.

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Dedicated to my first working physician mommy friend… Happy Birthday, TW.  You are a role model to all who know you and I am thankful to have you in my life, whether near or far.

 

 

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Childcare Errors and Working Mom Guilt

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Childcare is one of the biggest stresses in a working mom’s life.  I have been fortunate to have a daycare that I love for N, and now G, but that doesn’t mean that it has been easy.  Anytime that something happens to one of my children in childcare, it hits the Achilles heal of any working mom: this happened because you weren’t here.

The first time N was hurt at daycare, he had only been there for one month and fell while pushing a truck on the playground.  He ended up with a cut on his face that warranted a trip to the Emergency Room for stitches.  I had no concerns about the daycare’s role in this injury, as I was actually amazed that nothing like this had already happened while in my care given how active N was/is.  Rather, my guilt came from feeling so far from him at a time when he was hurt.  Even though his teachers provided him with all the comfort he needed and he was already happy by the time they called me, I still felt sad that I wasn’t the one to give him a hug and bandage his wound.

While N’s injury felt like one that couldn’t have been prevented regardless of whose care he was in, G’s first daycare issue was a hazard that she could not have been exposed to had she been home with me.  It brought all of my working mom guilt to the surface.  Was I actually causing harm to my children?  Is working selfish?  In the end, I calmed myself down and realized that what I needed to do was problem solve how to minimize errors.  We do this in medicine all the time.  A mistake happens and we form a working group and perform a root cause analysis to address the problem and brainstorm solutions to prevent recurrence.  So, I did this in an abbreviated form with my daughter’s daycare and this allowed me to feel more comfortable moving forward.

There will always be a little bit of the would they be better off with me question in my mind.  Whether in the care of parents, grandparents, nannies, or daycare, none of us are infallible, which I often need to remind myself when my working mom guilt flares.  Then, N will come home counting in French and Spanish or I will pick up G in the middle of her class puppet theatre and I am appreciative for the enrichment that high-quality childcare can provide in children’s lives.

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Mommy’s Approval Rating

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A patient’s mother stood at the front desk at my office and said, “She has two kids AND she’s a doctor.  I don’t know how she does it!”  Compliments in general make me blush, but this particular one embarrasses me because it implies that I do “it” well.  I’m not sure what she meant by “it” because I probably don’t wear as many hats as she imagines.  While I think (and hope) that I am doing my job well, I am not sure I am always as successful at home.  No one has polled my husband, children, family, or friends and calculated my approval rating.  At any given time, I know I am failing in at least one of these categories.  On a good day, I’m failing in only one.

The compliment from my patient’s mother though made me wonder: what’s my approval rating of myself?  While she apparently thought I was juggling all the working mom tasks well, how would I assess my own performance?  Well, the day I forgot my breast pump at home and had to sacrifice my lunch break for a $20 taxi ride I would have given myself a D.  Another day I managed to work from home, attend mommy-baby yoga, take my kids to the playground, and cook dinner, I gave myself an A- (points off for making boxed mac and cheese).  If I can go to work, spend quality time with my kids, and accomplish one household chore, I’m doing pretty well.  However, when I see the pile of laundry in my room, the dishes in the sink, and the emptiness of my refrigerator, I am reminded of all the things I am failing at.  And there are always other moms around me excelling in these areas to remind me of my weaknesses.  If I’m feeling particularly critical of myself, I need to avoid Pinterest altogether, as this seems to be the place for moms to showcase their best mom achievements.

While feminism taught me that I can “have it all,” and sometimes I feel as if I do, it also creates guilt that I should be able to do it all, and all the time.  So while I can be a mother and doctor, raising two kids and working full-time, I can’t be everywhere and do everything needed for these roles simultaneously.  I find the domestic responsibilities the most challenging, as they have never been my forte, and a bigger family and busier job did not help.  So, I survive by outsourcing some of these and neglecting the rest.  My home is lived in, not ready for an HGTV photo shoot.  Because whenever given the choice, as I am almost every day, of playing trucks with N and smooching G or cleaning my kitchen, the kids win every time.  My job keeps me away from my kids enough, so I have to make the most of the waking hours I have with them each evening.  And if I’m going to grade myself on living in the moment and loving my kids, I am definitely on the Honor Roll.

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The Lies We Tell Patients, and Ourselves

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Throughout my medical training I have witnessed and participated in many white lies that we as medical professionals tell patients.  “This will only hurt a little” or “I’ll be right with you” are two that I hear often.  Around my office, these white lies come out when talking about immunizations (“it’s just a little pinch“) or performing an uncomfortable procedure (“almost done“).  We say what we think a patient or parents wants to hear, because we don’t want to cause pain and we don’t want anyone to be unhappy with us.  In fact, we vowed to first do no harm, so when our practice causes discomfort, it is natural to want to reassure and provide relief, if only verbal.  I didn’t know how much these little white lies contributed to my own distrust of the medical establishment until I was in labor.

After 40 weeks and 2 days of pregnancy and days of contractions, when it was finally time to head to the hospital, things started to progress quickly.  As my pain escalated, I started pleading for my epidural.  The nurse reassured me that she had let the anesthesiologist know about me and that he would “be coming soon.”  When he had yet to arrive a few minutes later, I asked again and was told that he would be with me in a few minutes, right after he did a C-section.  “A C-section?!,” I screamed in disbelief, “I know how long those take!”  I was reassured that he was only going to be there for the start of the C-section and then would be right with me.  I was skeptical.  As more time passed and I was again pacified, I started yelling between contractions, “Don’t lie to me.”  Surprised, my nurse said, “Katie, I wouldn’t lie to you.”  I responded that “I know what we say to people to make them feel better.  Don’t lie to me.”  I said “we” with disdain.  We, those people who lie to patients, as in doctors and nurses.  Apparently, those white lies weren’t so harmless as they had tainted my view of how we communicate with patients.

In the end, the anesthesiologist placed my epidural just minutes later as the nurse had said, and as my pain subsided I apologized for my accusations and (out of character) yelling and my nurse and I became friendly again.  This experience has made me reassess the white lies that I occasionally find myself wanting to say, the things that I think will make the patient feel better but more likely serve to make myself feel better about what I am doing.  I caught myself saying “it won’t hurt” recently and it was when my 4 month old was about to get her shots.  She can’t even understand me and  I am already lying to her.  So I won’t lie to you: shots hurt, doctors run late, and uncomfortable procedures always last longer than you want.

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