Thursday, October 21, 2010

Guest post: New mom in an unsupportive environment

Today is day two for me. Day two, that is, of returning to work leaving behind my 5 week old infant daughter.  I am a 34 year old surgery intern, wife of a new work-at-home-dad and mom of one.  I was allowed to take my vacation weeks as "maternity leave" in order to avoid becoming behind in my program; however, a late baby and an unforeseen c-section caused me to have to take another 2 weeks off unpaid.  I knew this was going to be difficult. "How difficult" remains to be answered.  The all-male administration/faculty/senior residents of my program have barely acknowledged the situation aside from the program director's half-joking comment, "Don't you dare have any more."

Right now I'm on a lax 2-week radiology rotation consisting of half-day lectures but on November 1st, I return to the surgery department for 2 months of Q3 30 hour call.  Board exams are in January.  It's beyond daunting to even think of it right now.

After a struggle to establish successful breastfeeding with my baby, we have finally done it! But now I'm facing going back to work in an unsupportive environment. I questioned the possibility of pumping at work (very loosely suggested the topic to the head admin) and was told I could probably pump in the bathroom. I really don't think I'll be able to sneak off to do it anyway, but the fact that there is really no place to do it at this facility besides a dirty bathroom is even more frustrating.  I've been torn up over making the decision to try to pump some or to just switch to formula.

As I have not met anyone who has had a baby during intern year, let alone in surgery, I would love to meet anyone who has been in a similar position.  Even other moms in surgery practice.
Anyway, this has been a very emotionally draining and physically exhausting month "off".  My medical school debt load is so insanely large that I could never fathom taking time off or not pursuing the paths I have taken so far.  So, here I go...

34 comments:

  1. Let me first say that you're a hero for attempting this. I do know several interns who have had babies and even one ob/gyn intern who came into the program shortly after having twins, but I honestly don't know any surgery interns or even residents who are new moms. You have my sympathy.

    My advice is to try to do things the easy way as much as you can. Don't try to be supermom. If trying to pump is driving you to the brink of suicide, don't feel guilty about giving formula. Formula will not kill your baby!

    I know your career is important, but I'm sure you realize that your new baby is the most important thing in the world right now and she'll only be a baby once. If your program isn't allowing you to time to take care of that baby, maybe it's worth attempting to switch? I switched residencies and it isn't as awful as it sounds.... people do it all the time. Even if you lose a year, you can moonlight once you get a license and probably make more money than you get now. It's something to at least consider if you're really unhappy.

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  2. I'm not a mom (or even a resident), so please take my advice with the grain of salt. However, there are a couple of women at my institution who had babies during surgery residency. Our surgery clerkship director is an endocrine-onc surgeon, and has made it her mission in life to make surgery more woman friendly. She has 2 kids. There is a breast surgeon at my instituion with 2 kids, and a trauma surgeon with 2 kids. I know another trauma surgeon with two kids and a stay at home husband who works in Boston. And those are just the ones I have personally met and worked with. Of all the woman physicians I worked with during my third year rotations, I enjoyed working with these women the most, and I have a great deal of respect for them. It's not common, but it's definitely done. One of my favorite surgery residents had a son during residency. She was awesome.

    I guess I just want to say, you may feel alone, but you're not.

    Not that you should bring this to the attention of anyone.... but isn't it illegal not to have a non-bathroom place to pump? So frustrating. Fizzy is right: formula is not poison.

    However, I was a bit troubled by her advice to drop out. I mean, if you HATE what you're doing, consider it. But if you're doing something you love, remember things will get better. It sounds like you have a great support network at home.

    Good luck. I'm cheering for you!

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  3. Good luck, I admire you greatly. I would echo not trying to be supermom. Get a cleaner if you can, stock up on frozen meals and if the pumping is a problem, nurse when you are home and use formula otherwise. Remember that the best gift you can give your child is a healthy happy mom. If surgery is what makes you happy, do it.

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  4. I am a surgeon, but never managed to have any children. I too trained (mostly) in all male departments. Best to you. He was probably not joking about wanting you to have no more children during your residency. They'll deal with it if you do, but won't like it.

    Check with the Ob-Gyn department and see if they have a cleaner area you might use for pumping. Perhaps even there or in another surgery department you might find a "mentor" of sorts to give you some help. Is there a female ENT or Ortho attending/resident with children who might help?

    It'll be tough, but hang in there. Take help where you can find it. :)

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  5. Formerly in medicine, now an academic - Formula is NOT a bad thing. When I delivered 20 years ago my doctor had me bring medication that I had to give up during pregnancy with me to the hospital with instructions to take it as soon as I delivered. My baby boy never breast fed...couldn't because of my meds. Today he is a healthy college student. Formula did not hurt him at all.
    By all means, don't beat yourself up over this. Supplement with formula!

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  6. Hang in there, and good for you!! I definitely know surgery residents and attendings who have had babies and they all survive, you will as well. You have a stay at home husband!!! that is totally awesome and he will do a fantastic job, it may be hard to have him doing stuff that you would rather be doing, or feel like you should be doing, but he will be great and your daughter is going to grow up with two amazing role models for parents. I think she is extremely lucky and you should keep that first and foremost in your head.

    Here's an odd thing that I tell my patients sometimes: the baby days are great and all, but not everyone adores them, and honestly I kind of enjoy the older months & years better. To me it doesn't sound like the end of the world to have some really busy stuff coming up, get those exams out of the way, and then maybe??? be able to have some more time down the road once she is older. Do not beat yourself up over missing some days at this point. She is with her dad! it's going to be fine.

    I don't have a strong opinion on pumping or not. Pump while you can --try the NICU while you're in hospital -- but if it becomes more stress that it's worth, let it go. You can do a mix too -- I often still pump once or twice a day, feed "live" when I can, give formula the rest of the time. Babies are ridiculously adaptable.

    You're doing great!!

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  7. Just wanted to say good luck! Also if you want to try pumping, try the NICU, Peds floor, or OB. They always have pumps.

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  8. I have done both - breast feeding and bottle feeding. I love my children equally and they love me equally. There is no difference in bonding if you do not make it different.

    As Sarah said, there are plenty of times in your child's life that are great. I enjoyed bonding with my bottle fed son when he was three and he could sit on my lap for hours while I read him books or told him stories (Disclaimer: Not every three year old will sit that long, none of my others did!)

    I just began a new bonding event with my five year old daughter (who was breast fed) that we nail polish each other's toes.

    You will have bonding opportunities. As a mother in medicine, keep your eyes open for creative, special things to do. Quality over quantity. :)

    PS: Anecdotal research N=4. Two breast fed kids and two bottle fed kids (randomly selected by a Higher Power?). One boy and one girl in each category.

    100% of breast fed kids had chronic ear or sinus infections during their first year of life.

    100% of bottle fed kids had no ear or sinus infections during first year of life.
    (Note: Bottle fed boy, child #1 was hospitalized at 3 weeks old d/t pneumonia, but he was being breast fed at that time and was failing to thrive d/t his mother's low milk supply, hence the switch to bottle.)

    Bottle fed boy, at 8 years old, finished reading the entire Harry Potter series and Percy Jackson series in less than two months.

    Breast fed boy, 7 years old, has never had to take a second grade spelling test because he spells all the words right during the pretest assessment.

    Conclusion: Breast or Bottle? Not clear that one or the other is better according to my study. :)

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  9. Note: I should have clarified that bottle feeding = formula feeding. I consider bottle feeding with breast milk as breast feeding.

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  10. Had twins in medicine residency. Pumping was impossible--formula saved my sanity.

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  11. Congratulations on your baby, what a wonderful gift to have a healthy newborn. I'm sorry to hear that you're not receiving adequate support from your program. I am a surgeon. During seven years of residency a female resident in my program was pregnant every year except one. I was pregnant my chief year, as was the other female chief. It sounds like it has fallen to you to break ground at your own institution. I did pump at work in part because formula is so expensive! However, I had a desk with a computer and a phone. It was relatively easy to pump for 20 minutes at a time while looking up labs, writing notes, signing dictations, answering pages, etc. It helps if you are able to pump "hands-free" with the nursing bra that hooks to your pump. You need access to a refrigerator to store 30+ hours worth of milk for call days, unless your husband can pick them up. Also, you need to have a stockpile of milk at home for the baby to have while you're at work. I wish you the best of luck. There are many many mothers in surgery. I love what I do and cannot think of a better field.

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  12. Please do not beat yourself up if your baby drinks formula instead of breastmilk. Your life is stressful enough without feeling guilty about this. Yes, it is wonderful if you can breastfeed after your maternity leave, but for us working moms and especially residents, this can be a near impossibility and a big cause of stress.

    I was a 3rd year resident in an IM program, and had to quit in 5th month when pumping became impossible during an ICU rotation. For my 2nd, I was a hospitalist and had a much easier schedule--was able to make it until 11 months, though it wasn't easy.

    What's better for your baby is to have a mommy that's not quite so stressed out! If you think you'll be more stressed by not giving your kid breastmilk, then of course, go through the effort.

    Unfortunately, some of us don't work in supportive environments. You have the legal right to demand a clean and private space to pump and to store milk. You have to decide if the fight is worth it for you.

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  13. I agree with Sarah and Anony. - you can have the best of both worlds with formula when you need it and breast feeding when you don't. Pumping is overrated and additional work - lugging the machine, cleaning the parts, finding electricity and privacy to use the machine - I did it for a bit with #2 - but got to the point of diminishing returns when all I got was 2 ounces mid-day between patients. BF am/pm (when you can in the q3 30 hour stretches)and fill in the gaps with formula.

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  15. I'm also not a physician, but I did go back to work as an EKG tech soon after I had my baby.

    I agree with everyone else -- definitely investigate possibilities at the maternity unit in your hospital. Mine had a dedicated private pumping area that was open to employees (and had a fridge just for labeled breast milk), and some extra pumps that you could drag into empty patient rooms to pump if need be. I usually took my beeper with me and sometimes I had to stop thirty seconds into things, but it was doable.

    I also supplemented with formula, and in a lot of ways, that was great, because it allowed my husband to help and me to get a break to sleep once in a while. There's a lot of stuff on the market now that is comparatively less processed (no high fructose corn syrup, etc).

    In retrospect, I think that that period of parenting was the toughest for me. Hang in there. It will get easier.

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  16. The place I was "supposed to" pump when I went back to residency, on the maternity floor, had old milk stains all over the chairs and floors. And it was far away and inconvenient. I befriended the residency coordinator (also a mom) who let me use her office. Also found an attending that would let me use empty apheresis rooms. That saved my pumping effort for a little while - but I too had to supplement with formula for my second kid when things got too crazy. So do what works for you. And be proud of yourself no matter what you decide. You've already made it this far, which is great!

    Good luck! Sounds like you have great support at home - use it!

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  17. Congratulations on your new baby, and on working it out to avoid an extra year of residency!

    I had my son during the most difficult year of my neurosurgery residency, PGY-3. I also had a late baby and a C-section. I completely understand what you are going through. It will not be easy going forward from here, but you can do it!

    My advice to you will be strictly practical.

    1. Forget breastfeeding altogether, ASAP. Get started with formula and DO NOT let anyone make you feel an ounce of guilt about doing this. You will never be able to establish a pumping regimen, and you will send your already high stress level through the roof by trying.

    2. When you go back to the q3 schedule, it will be hard at first, but you will soon get back into the routine. Don't even worry if you don't pass boards the first time - if it's like neurosurgery written boards, you'll have other chances to take them again.

    3. Do not let comments by your attendings and fellow residents affect your plans to have another baby down the road. As has already been said, they may not be happy about it, but they can't stop you and they can't fire you for getting pregnant. And your reproductive life is NONE OF THEIR BUSINESS.

    4. Do not expect any support from your residency colleagues. They may well, in fact, try to make your life miserable. If they do, don't take it personally. Just do your job well and make sure your attendings know you are doing your job well. This is not fair, but it is the current reality in some surgical training programs.

    5. Realize that this unsupportive environment is TEMPORARY. Do not be tempted to quit if you truly love surgery. I seriously considered quitting more than once in a similar situation, but it was well worth hanging in there - and now, looking back from a vantage point of 9 years in practice, quitting would have been the WORST thing I could have done. It gets so much better.

    6. Do not let frustrations at work poison the time you have with your husband and family. Make it quality time. Appreciate the advantages of your situation, such as having a healthy baby, having a supportive spouse who can work at home, and having a stimulating, challenging career. Stop to count your blessings as often as you can.

    You can do this! And you will one day inspire your daughter with stories of what you did and what she, too, can do as a strong, intelligent woman.

    As more women go into surgical careers, the old school culture will inevitably soften and become friendlier to families. We lead the way. You are not alone.

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  18. Congratulations! I'm a 4th year anesthesia resident and had a baby during my 2nd year. I did the pumping thing for a few months...but it was SOOOOO STRESSFUL! Literally, every free moment I had was spent with my pump and trying to get it done within the short amount of time that I had. I felt like a failure when I started supplementing with formula at 4 months and made the switch entirely at 6 months. However, about 1 week after the pumping had ended, it was like a weight had been lifted from me at work. Finally...I could use my breaks as true "breaks" and actually eat lunch, converse with colleagues, check email, etc. Switching to formula was definitely the best thing for me at that point...and my baby has not had any ill-affects that I've noticed. She's nearly 2 years old now, goes to daycare, and has been very healthy overall. My husband & I are planning for our 2nd soon, and I am fairly confident that when I go back to work after that maternity leave, I will just go to formula (and maybe try to breast feed before work in the morning or when I get home at night)...not planning to pump, though!

    I have to say, too, as much of a big deal as this issue seems to you at this moment, a year from now, it won't even matter when your daughter is eating her own birthday cake (and everything else off your table)!

    Also, I totally agree with Sarah's comment about some moms bonding better when the kids are out of the baby stage-that's definitely me. Don't get me wrong-the baby stage was special in its own right and I loved my daughter back then, but now, oh my goodness- I love her so much more! So look forward to the years ahead when you won't be an intern anymore- your daughter will still love you and by then she'll actually be able to TELL YOU that too! It's awesome!
    Hang in there and remember, you are not alone.

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  19. Hi, I'm a longtime lurker here, but your post prompted me to write. I'm a non-trad pre-med, but I work in a male dominated field with crazy hours and long days. I was committed to breastfeeding, too. One of the best things I did was look for a pump that was small and could be used cordless. I didn't check all the companies, but I bought the one Medela makes and it's been great. You don't have to worry about having an outlet in the bathroom, and it's small enough to fit in a small bag (I've even carried it around in my flight suit pocket). I'd also recommend ordering several sets of pumping parts so you don't have to spend time cleaning after each session.

    I returned to work determined not to apologize for breastfeeding my child. Yes, I disappeared for 10 minutes or so at a time, but dudes talk about football for longer, so they'll get over it.

    I'm at 8 months and have to supplement with formula every once in awhile. As others have said here, formula isn't the end of the world. But, I do like pumping at work because it helps me feel close to my baby even when I'm not there.

    Is there an HR office at the hospital that you can ask where the pump room is? I had to ask someone in another department at work to figure out where it was, because none of the men I worked with had a clue.

    Long post, but hang in there, I've found breastfeeding to be worth all the hassle. Best of luck!

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  20. As a fellow doc mom I have to admit that I find the advice to, "just give the baby formula" utter crap! Sure you have to do what works for you but don't give in! If no one speaks up, nothing will change for female residents. You have rights (one of which is NOT to have to pump in a bathroom). Find some supportive women around you. They are out there.. They may not be in the surgery department..and may be in Human resources..more family friendly programs, etc. Keep your head up and don't forget your goals. Things will get easier, especially when baby is older, sleeping better and taking on other foods to supplant some of the relience on breast milk. Changing malignant residency programs must happen one person at a time!

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  21. Anonymous,

    Advice to "just give the baby formula" is not "utter crap." It is statements like this that I urge women to ignore when I say not to let anyone make them feel guilty about their choices.

    Surgeons cannot simply scrub out of a case and leave a patient on the OR table to pump, much as they might like to do so. Emergencies are frequent, and you as the resident/surgeon have to be available when they occur. Breastfeeding/pumping is just not practical under these circumstances. It's not about "speaking up." It's about the nature of the beast.

    The guest poster has a "right" to choices, guilt-free. She has to make things work for her in the real world, not the ivory tower.

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  22. I had my second child during my second year of my family practice residency. Unlike you, I was able to take more time, and didn't go back (full time) till my daughter was 4 months old.

    After 1 week it was clear that the time and attention I had to pay to my breasts was cutting in on the time and attention that I had remaining to pay to my baby. I weaned in a week and it was easier on all of us. I never regretted it for a second.

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  23. I am sorry but the "Total crap" comment is not appropriate. I nursed and pumped for a year for each of my three kids so I know its value, but I had a supportive environment for it. You cannot criticize someone for using formula if that is what keeps her sane and her baby fed. She has enough of her own issues without comments like that. If you can continue nursing great; use the hospital facilities as suggested but don't kill yourself over it and compromise the care you give your patients because that is what your attendings will remember about you in the long term.

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  24. Regardless of what you decide, you have options.

    In the new health care bill that was recently passed, any business with 50 or more employees is required to supply you with a private place to pump that is not a bathroom as well as adequate time to pump.

    Maybe you could pump right before you scrub in for surgery and then right after? Definitely get one of the hands free pumps and you could even get one of those privacy curtain things that they make and pump while you are doing charts, following up on phonecalls, emails, etc. Screw the men in the program who are insensitive to you and your personal decisions! Let them hear your pump running and feel uncomfortable. If you want to pump, then you should be able to within limits.

    If you live close enough to the hospital, maybe your husband could bring your baby to you for feedings sometimes? At my med school, this one girl's mother would bring her child to school during lunch time so she could nurse.

    Of course, forumula is also a choice and if you do decide that, don't feel guilty about. And it's not all black and white either, you could do both.

    However, if you feel strongly about breast milk, then you may have to be a trail blazer through this program for the other women who are interested in surgery who come behind you.

    Best of luck to you and congrats on your new baby!

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  25. I know you feel overwhelmed right now. Honestly, the 30-hour shifts were not that bad. I knew my baby was in good hands with his daddy and/or grandma. And if it turned out that I was on my own with baby after coming home post-call, I brought my son into bed with me. We usually both got a pretty good nap.

    I pumped in call rooms, either my own or my friends' (if I wasn't on call). They were easily accessible and cleaner than bathrooms. But if my baby hadn't had such a sensitive tummy, I probably would have switched to formula after a few months.

    Good luck!

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  26. Thank you everyone for taking the time to write these comments. Your advice, personal experiences and home research studies are all very much appreciated.

    I feel better just knowing that you all exist out there and that I really am not as isolated as it feels. I am so glad that I stumbled upon this group. It was just what I needed to see this situation from some different vantage points.

    This is truly invaluable- thank you, again.

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  27. Fizzy- did you change fields or just programs?

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  28. Hang in there! I had a baby August of my intern year--granted, it was pediatrics, not surgery--and survived to tell about it (and even have another baby as a first year fellow). I took 4 weeks off for maternity leave, which sucked big time, but I got through. My babe got at least some formula from the beginning due to milk supply/weight gain issues, but I managed to hang in there with pumping for 11 months. I pumped in call rooms or in the lactation room on the L and D/NICU floor in our hospital. I'm sure peds is different than surgery in support of breastfeeding, and I'm sure your baby would thrive on formula or whatever mix of breastmilk or formula you choose, but hopefully you can find a non-bathroom options if you decide to pump. The thing that helped me the most (strange as it may sound) was knowing that the whole ordeal was hardest on my--my daughter was thriving and well-cared for--I've been able to be much more involved now that she's older.

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  29. Whew.... and fizzy gets accused of being judgmental? I get sad at the back and forth in the formula breastfeeding advice. I don't think the advice to "just give your baby formula now is utter crap" nor do I think she the original poster should give up on her hard earned breast feeding relationship if she doesn't want to.

    This is about what works for her. I don't think she needs to feel guilty, but she needs to make the choice that feels best.

    I had friends that had babies in residency, even during intern year, however I was in a fairly family friendly ob/gyn program. That said, gyn-onc rotations are NOT family friendly, and a couple of them made pumping work.

    The other thing is, it doesn't have to be all or nothing. Yes, this early on you will need to find some pumping time during 30 hour shifts or suddenly you'll have no milk. But, you can do some formula and still breastfeed when you are home. Pump at work when you get the chance (Medela freestyle!!! or ask the NICU about pumping space at the hospital for employees, they usually know), supplement with formula as needed, and enjoy nursing in your time at home. IF YOU WANT TO.

    For me not being able to do that for my kiddo would have stressed me out more. For some, pumping/nursing adds stress.

    I wish we could leave our own choices/baggage behind and acknowledge that there are multiple/valid ways this can work. Also, while using milkbank milk is likely not an option, if providing breast milk is important to her and she isn't able to keep up sufficient supply for 100% herself, milkshares are fabulous and another option worth looking into.

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  30. Congratulations to KC. Your daughter will grow up knowing that women can do anything they want in life, because she learned it from her mother! I imagine that she will have no idea whether she was breast or bottle fed. One of the physician-mentors whom I continue to look up to (7 years later - I am now an attending internist myself) is a 70-something year old plastic surgeon who trained in the 60s and did some of the first breast reconstruction surgeries. She had two children and a husband who was also a surgeon. She did it then, and you can (and will) do it now!

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  31. Congratulations on your new baby! I had my first baby during my second year of anesthesia residency. I took an 8 week maternity leave worked with no call for 2 weeks and then was on a q 2 q 3 OB anesthesia rotation...very busy! I was able to breast feed/pump for my son for a full year. I did this again for my second son and am currently breast feeding/pumping with my 5 month old daughter. My best advise is:
    1) If you want to give your baby only breast milk you need to not tell yourself you need to pump every 2, 3 or 4 hours. You need to try to pump however many times your baby eats when you're away from her.
    2) I trained myself to always pump in the morning with breakfast. If the baby had just eaten before I got out of bed, then I would get up and pump again. Sometimes I would not get much milk, but every ounce adds up!
    3) Even if you can only pump for 5 minutes at a time, it's still milk and can be added to other milk that you pump later.
    4) When breastfeeding at work, I ALWAYS brought my lunch, supper, breakfast so I didn't waste any time going to the cafeteria.
    5) I always pumped in the OR locker room....right out in the open, usually with a scrub jacket over the pump. A lot of people would tell me to go to the NICU, but I didn't want to waste any time walking over to the NICU. I didn't feel the least bit bad if someone (anyone) saw me pumping. 6) I also pump in the car on the way to and from work (with a hands free pumping bra).
    7)A good pump is also key! I agree also with an earlier poster who recommended having multiple parts so you do not spend time washing pumping parts. When I was on call I would just rinse in hot water and reuse the parts.
    8) I also pumped every single day....working or not or post call or not....so there could be extra milk in the fridge.
    9) When you are home and feeding your baby you can also pump one breast while nursing her on the other.
    I hope my experience helps! I am very passionate about breastfeeding, but it is really your decision and you need to be able to function as a resident and a mother, you need to feel ok with your choice!

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  32. I had my wonderful son just 3 months into my intern year, and was also only able to take my vacation as "maternity leave", with two weeks of a slow rotation, then back full force with normal call, so your post really spoke to me. I have friends in residency who were able to pump, but you have to be dedicated, and you have to like it! You need to make sure you can pump in a place and a way that you can still jump up and respond to the code pager when needed. Colleagues do not give women mothers slack for having an infant- you have chosen a profession where you always need to give 100% to your job. I found BFing just too demanding (and with the equipment, space, and insanity, NOT cheaper than formula), but if you can do it, more power to you. Anyways, focus on the time you do have with your child. I can say from experience (both as a MIM and as the daughter of a MIM), that your child won't remember this time anyways, and it's better to do the long hours when they're younger and can't guilt trip you. I also recommend SLEEPING as much as possible post call. Trying to stay up for those few precious extra hours leads to more exhaustion than one can imagine, and you will eventually burn out if you never sleep. Good luck!!

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  33. P.S. The peds floor, ped call rooms, NICU, PICU, and maternity ward at my hospital all have rooms for employees to pump in, as well as equipment you can use (bring your own attachments), and a freezer to store the milk (pumping in the bathroom doesn't work because you still need a good place to store the milk). I know other posters are telling you to fight for a place to pump, but this will just make it more difficult for you at work with your colleagues, and you need all the support you can get right now.
    PPSS I recommend the book, "Balance is a crock, sleep is for the weak" - not perfect for MIMs, but the only working mom book I have read that is not a SAHM book in disguise

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  34. I had my first child as an R5 in a surgical subspecialty and I pumped at work. You tell the staff that you are going to pump and DO IT. You have the right to a healthy baby. I intentionally and loudly talked about pumping. I let them know before a long case that I'd need a break to pump or that I'd need to pump between cases. Some of the male staff were uncomfortable, they didn't want to hear about it, but they weren't going to tell me no. Heck, even some women at work were uncomfortable, but that's their problem. It's good for you and your baby.

    You have the right to pump in a room that is appropriate for pumping (not a restroom), you should talk to your program director. if that doesn't resolve it, talk to the GME office or the HR office. Even if your baby only gets one pumped bottle, it helps. I pumped for 8 months with the first one (11 with the second, but now I'm staff).

    Surgery is important, your training is important, but you have to stick up for yourself and your baby.
    GOOD LUCK, you can do it.
    And internship sucks, but it gets better.

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