“What is it like to lactate?”

I was asked by a woman I just met in my living room. I couldn’t escape as she peppered me with questions. Many new moms have been on the receiving end of such curiosity. As invasive as the questions seemed at the time, I understand how such burning questions can arise for people who don’t yet have children. It is hard to imagine what it’s like to feed another human with breastmilk until you do it. In this post, I share my best breastfeeding and pumping hacks for breastfeeding moms, especially those in busy surgical fields like interventional radiology.

I breastfed and pumped milk at work for about a year. Here are my suggestions for interventional radiologists, surgeons, and other professional moms, who wonder how the heck breastfeeding will work for them. 

1. The decision/ commitment

Breastfeeding these days is optional, so it takes a willing, motivated mom to stick it out, especially after returning to work.  Although breast feeding yields benefits for baby and mom alike, there are costs, mostly in the form of mom’s time and energy. Some moms have enough to do without being tethered to their baby or breast-pump for several times a day. Plenty of women have had trouble breastfeeding.  Some babies are allergic to components of mom’s diet. There are many challenges that can preclude breastfeeding and pumping milk for your baby. Further, some women have no desire to do so, and if that’s the case, then, as they say, “Fed is best.” There is always formula to fall back on.

A goal can guide you.

Pumping is a part-time job: pump, store, wash, repeat. Therefore, I found it motivating to have a goal. I decided to aim for one year, after which I planned to wean. Thinking of the immune benefits for my son kept me going, even as my daily pumped volume dwindled from 12 to 3 ounces per day.  

2. Get a breast pump from your insurance company.

   I settled on a Medela Pump in Style, a truly embarrassing name. The motor is not terribly loud or annoying. A colleague saw it sitting on my desk and asked what kind of new speaker I had purchased for my office. Sorry, Shervin!

3. Nipple pain for everyone.

It seems nipple pain is nearly universal in the first couple weeks of breast feeding. Ignore your mother’s advice to “rough up your nipples” with sandpaper, in preparation for breastfeeding. Yikes. There is no evidence to show maneuvers like this prevent nipple pain, and abrasion puts you at risk for infection.  

In my experience, nipple pain was a deep, aching pain, as though someone had run a half marathon on my retroareolar tissue.  Plastic nipple shields were key in getting through those initial weeks, so that I could continue to breastfeed while minimizing pain. My postpartum doula, also a lactation consultant, assured me that using a shield would not cause nipple confusion, a worry of many new moms. I got my first nipple shield at the hospital, and it lasted for weeks. They are made by both Medela and Lansinoh. For loss of contact, a bit of lanolin can help with adhesion.

Lansinoh gel pads were soothing between nursing sessions, like gel orthotics for the nipples.

4. Stay productive

Freemie cups are a self-contained system to pump discreetly.  They can be slipped into a nursing bra or tank top, and are less cumbersome than standard phalanges. These allowed me to pump during my drive to work, without attracting unwanted stares. At work, if a pumping session was interrupted by a small task like a patient consent or paracentesis, I could disconnect from the pump, throw my white coat over my scrubs, and complete the task, with my Freemie cups still in place. With this setup, I could return to my office to resume pumping a few minutes later. Freemies were key for minimizing workflow interruptions.

For lactating women who operate many hours at a time, the wireless Willow pump is an option. Since my procedures generally last between a few minutes and a few hours, I could pump regularly, most of the time. Therefore, I kept it simple with a conventional pump and the setup described above. 

5. Udder support

I lived in Medela nursing tanks. I wore them under scrubs in place of a bra, and they held my collection cups in place securely.  The tanks were comfortable and supportive. They went through laundry again and again. I even wore them on their own at times, but please don’t tell anyone.  

6. Toting gear

A Medela pump bag was an adequate size, and not unattractive to carry. I used a dry bag to store pump parts in the fridge between pumping sessions. 

If I was working in the same office for two or more days in a row, I could leave my pump at work, and rely on breastfeeding to “empty the breast” at home. This saved some time schlepping the pump back and forth.

7. Stockpiling the freezer

Lansinoh breastmilk storage bags worked well. We laid them flat to freeze, then stacked them in a box in the freezer. A tissue box or shoebox was helpful to conserve space and organize the milk by date. I tried the gift bag trick, and it resulted in a freezer avalanche. The bags slid over each other within the gift bag, and didn’t remain in date order. If you are curious, check out the explanatory video here. 

8. Watch your health, take care of you.  

It’s important to get enough rest while serving as a milk machine. I attended a conference out of town, and was away from my baby for the first time. For four days, I pumped exclusively. Since a pump is not as effective at emptying the breast as a baby, this can lead to blocked milk ducts, if you aren’t paying attention. I was burning the candle at both ends during the conference, and found hard lumps on my chest. The smooth muscle lining the ducts can be affected by exhaustion. I was terrified of landing in the hospital with mastitis or a breast abscess. My post partum doula instructed me to take ibuprofen, prioritize rest, and use soaking hot compresses before and after pumping. 

9. the Breastfeeding diet: eat everything

Calories beget breastmilk. If you are prone to skipping meals as a surgical subspecialist, consider snacking, and prioritizing meals, if possible. Likewise, becoming dehydrated can compromise supply.  Some advocate carrying around the largest bottle of water you can find. I found a large tea more chuggable. Or, I’d alternate with something with flavor. Some breastfeeding moms swear by Gatorade to boost their supply, or if you want something touted as more natural, you can try Body Armor or coconut milk.

10. Supplements

I tried mother’s milk tea, and ate Fenugreek capsules. Supplementing made me feel as though I was being proactive, whether or not I noticed a large difference in milk production. Oatmeal and foods containing oats (hello, oatmeal cookies!) can increase supply. I even bought brewer’s yeast for the first time, for a recipe called “Boobie Bites.”

I noticed the most impressive results after drinking a bottle of Guiness. This was the only “supplement” which resulted in noticeable engorgement.

11. Resources

Hospital lactation consultants 

https://kellymom.com/

Postpartum doula support

Your local family education center: the one near me is called Healthy Beginnings

Online forums & Facebook groups like Dr. Milk

Books:

I liked Ina May’s Guide to Breastfeeding and

The Womanly Art of Breastfeeding.

12. Weaning, a bittersweet feeling.  

Baby still needs you like no one else.

Start moving again, if you haven’t already. I gained ten pounds without noticing.

It’s time to stop eating everything. I decreased the fried foods, donuts and cookies I’d added.

Nix the sugary drinks. I cut out juice, for example. 

Skipping a meal becomes OK again, in the context of a busy day.   

After your pregnancy and breastfeeding journey come to a close, with their associated joys, challenges, and restrictions, your body will start to feel like it belongs to you again.

What an amazing thing you’ve done.