Hello Dear Boobjuicers and Friends!
Here is my first Boobjuice Hero interview. Rachael is a family medicine doctor (MD) with a large county health service in Minneapolis. Eddie is currently a stay at home dad. They have three little ones, ages 10, 7, and 3. I asked if I could interview Rachael as a Boobjuice Hero, and she said I should interview Eddie too, because there is no way she could have managed nursing while in medical school and residency without him. This raises an excellent point. Most of the nursing success stories I have heard involve a lot of critical support from the other grown-ups in the mama's life. Their story is no exception.
Sophie was born when Rachael was 28 and 3 years into medical school. She had intended to take 3-6 months off, but after struggling through two unsuccessful pregnancies, she decided to take a year at home with her new kiddo. Eddie switched from custom woodworking, which he liked, to collections, which he did not like, to make this work. His insurance kicked in the week before Sophie was due, and the new position offered flexible hours. When Sophie was 3-6 months old, Rachael started doing some phone interpreting and phlebotomy to make some money and keep up her Spanish and phlebotomy skills. This enabled her to mostly stay home for the first year.
A week after Sophie's first birthday, Rachael returned to medschool in a midwife rotation. This was a very breastfeeding friendly situation but she was still sobbing when she had to leave Sophie. “I think it's probably easier at a year than it would have been at three months, but it's hard whenever you go back.” A lot of her patients say it's a hard transition, even the ones who are not stay-at-home material “Eddie made it a lot nicer because he would bring her to nurse at lunch time. Eddie has been fabulous through the whole thing, with the pumped milk at home, then bringing her to nurse and I'd hand off the milk I'd pumped during the day, nurse in an exam room or the car, and hand her back, pump in the afternoon, and then go home and nurse when I got home.”
Toughest Times
A couple of different times were really hard. When interviewing for residency programs, Rachael got a lot of rather condescending attitudes towards her breastfeeding. “Oh, that won't last long, we can find you a place if you need it but no one continues to breastfeed in residency. It's just not realistic.” One of the reasons she chose the program she did was because they were so supportive. “By Minnesota law, [employers] have to give you a 15-20 minute break* every 3 hours if you are nursing, in a clean non-bathroom place with a plug and a locking door.” But even with this supportive atmosphere, the way Rachael made it work was to make it an “of course,” an assertion, not a “may I” or a question. As in, at the beginning of each rotation, saying “hi, I'm the new resident, and I'll be pumping breastmilk every three hours and where can I do that?” It helped to have a couple of senior residents who were very supportive at the beginning when, as a first-year resident, she was low, low down on the food chain. Once Rachael got further along she did the same for her residents - “Have you had a chance to pump? Okay, go pump and then go admit patient Mrs. So and so,” to show that it was just as much or more of a priority to take care of their bodies and their babies.
Another hard time was when the kids would get sick, and nurse more at night when Mama was more available. One really tough week, Sophie and Sasha had each been sick, and Rachael had been up every hour for half an hour, had three nights of almost no sleep and then was on call for three days on a family medicine rotation which is pretty relentless. “I had gotten 6 hours of sleep in 96 hours, was tired to the point of falling down on my feet and puking. I had reached the point of completely diminishing returns, would have five hours worth of work to do, work for an hour, and still have five hours of work to do. I fell into my boss's chair crying.” After hearing what was up, wise boss woman sent Rachael home with orders to go to sleep, not do anything useful or play with her kids or anything, just sleep. “Burning the candle at both ends with a blow torch doesn't work.”
It helps to be a little bit crazy, which Rachael says is a prerequisite for med school and residency. But she insists, “I wasn't suffering. I felt more connected to my kids for being able to continue that nursing relationship. Eddie would try to bring them to me at lunch or dinner or bedtime so I could check in with the kids. In residency I was tandem nursing Sophie and Sasha, and would nurse them together. Sophie would get done and we would just chat while Sasha would continue on the other side. Just having that time was tremendously important. Many of my colleagues in residency only saw their kids one day a week. It made a big difference to have a spouse who would make that extra effort. Even if Eddie had been working [outside the home] but had been willing to bring the kids at bedtime and dinner, it would still have made a big difference.”
Weaning
“As far as evidence-based medicine goes, the longer you nurse, the more benefit you get. We have family histories of diabetes and allergies. Plus I have ginormous boobs that are difficult to examine, so it's a good thing to reduce breast cancer risk. When they wean on their own it's easy as heck, harder on the mom than the kid.” Rachael didn't even notice when her son Sasha (kiddo #2) weaned, almost exactly when Gryphon was born. “I thought I would be tandem nursing again, and I had mixed feelings about it either way. Sasha would nurse 2-4 times a day at most, at wake up and bed time, and if he had the chance at the start and end of nap, and when he got sick or hurt.” Sasha was just past four years old when he weaned. Sophie weaned at four and a half, when Sasha turned two. Gryphon is three and still nursing. So if you do the math you will see that Rachael has been lactating continuously for ten years.
So we aren't all Rachael and Eddie. I didn't nurse Robert as long as she nursed her kids, and we aren't all as determined as they are. But as I got to know their story, I realized, well heck, if they can do that I can swing a commute and a few meetings and slinging Bessie the Breastpump around. She's also a great example to hold up when your mother-in-law or nosy neighbor is pressuring you to wean your kid. “Hey, I know a doctor whose kids weaned at four and a half.”
You can do this. Rachael and Eddie are rooting for you, and so am I.
Much love,
Suzi
* This is now federal law, praise be. And frankly I need 40 minutes but 20 is better than nothing.
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