My husband recently found a bag of breast milk in the freezer as he scrounged for dinner ingredients. This milk was pumped over four years ago for my third baby who turns five next week. Just like I did for her older siblings, I religiously pumped breast milk at work until her first birthday. On the day that she turned one, I stopped lugging my pump bag to work, stopped scrambling to find the flanges and the little yellow connectors and the filters the size of thumbnails each morning. Stopped calculating when I could fit pumping in between rounding and seeing those last few patients. Stopped gambling that an admit or PICU transfer would interrupt my afternoon pumping session. Stopped hoping that the PCPs I called while pumping wouldn’t recognize the drone of the pump accompanying our handoff conversations. I stopped defrosting milk and parceling it out into precise aliquots to sustain my baby at daycare. I stopped washing the pump parts each night and whipping the tubing around like a lasso in an attempt to rid it of water droplets. I stopped buying breast milk bags at Target and started wearing regular bras. I gained back an hour per day.
Although pumping was time-consuming and a hassle and even physically uncomfortable, it was so much easier with my second two. By then, I had taken a hospitalist job where I worked at one hospital and had an office (shared with several other women) on site. When I was pumping for my oldest, I worked for a practice that rotated through six different hospitals. We had a group office on the top floor of an office building that was not convenient to any of the hospitals. During that year I pumped in public bathrooms, empty patient rooms, nurses’ offices, locker rooms, and resident call rooms.
As a pediatrician, I knew that “breast is best” and wanted to practice what I preached. I was fortunate enough to have babies that nursed well and an adequate milk supply. Aside from a little formula supplementation during my 36-weeker’s first month, it was exclusively breast milk for their entire first years. Although I stopped pumping on their first birthdays, I continued to nurse them when I was home. I became, somewhat to my chagrin, a mom whose toddlers verbally asked to nurse (my son asked for “night-night couch,” and my youngest wanted “milk-milk”). My son was abruptly cut off at two-and-a-half when I had a breast biopsy after finding a lump during my pregnancy with his younger sister. We both sobbed that night when I had to turn him away. My youngest continued to nurse, mainly at night, past the age of three. By then I had passed the threshold of recommended mammograms but put them off due to my lactating breast tissue. I was also being woken up several times each night when she wanted to nurse. Eventually, I decided that enough was enough and told her that the “milk-milks” didn’t work anymore. She adapted well, though still wanted to pat my breasts and talk about them for a while.
After breastfeeding for a combined seven years out of a decade, I was suddenly done. It was a great relief to regain some uninterrupted sleep. I also felt that I had reclaimed part of my body that had been up for grabs for years. I knew that I had started to resent my youngest for waking me up and for our involuntary symbiosis, but then I felt guilty for feeling resentful. I had been somewhat conflicted about the stigma of breastfeeding a three-year-old. I heard comments from my mostly female colleagues (physicians and nurses) about moms who were “still nursing the two-year-old! And the newborn, too!” I didn’t speak up, though I should have. It was clear what majority opinion was, even in a children’s hospital.
During my residency, I learned about breastfeeding, but it was not until I became a mom that I understood. I understood that the latch of an infant could be so painful that a new mom might bite down on a pillow to keep herself from screaming out loud. I understood the pressure that came with being solely responsible for the growth of another human. I understood the insecurity of feeling like my milk might be deficient in quantity or quality, but not having many tools to reassure myself. I understood the agony of spilling an ounce of my precious harvest onto the counter when I rushed to transfer it into freezer bags. I understood that I was the only person who could nurse my baby — sometimes that left me feeling awed and privileged, but sometimes it left me feeling resentful.
The day I stopped nursing my youngest was significant — sure, I was relieved in some ways, but I was also very aware of how finite it was. I was 42 and unlikely to have another baby. Nursing my children was deeply intertwined with mothering them. It seemed like an occasion to mourn as well as celebrate, so I just kept moving forward without dwelling on it. Eventually, I packed up the leftover milk bags and pump parts and nursing bras and dumped them at the Goodwill. My youngest talked about my “milk-milks” less often. My breasts were mine again.
Until I saw that four-year-old bag of frozen breast milk — a few months later, it is still in the freezer. I know that it will never be used, but I can’t bear to let it go. Those four ounces are all that is left of the overwhelmingly emotional time when my babies were still babies. They are jam-packed with hormones and joy and exhaustion and love. I really believe that all of the milk and sweat and tears were worth it — not just for my babies but for my patients and the mamas who are doing their best to love and nourish those babies too.
Lisa Sieczkowski is a pediatrician.
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