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Breastpumping in the ED? Just do it.

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The long term benefits of breastfeeding your child – and of creating a family-friendly ED environment – outweigh the perceived problems.

Since starting medical school none of us has been immune to the challenges of the work-life balance. At no time are these challenges more apparent than when a young physician starts a family and a career at the same time. This is where I found myself two years ago: a fellow, the partner of a hand surgery fellow, and the mother of an infant. Now, two years later, I am an attending, the partner of a busy hand surgeon, and the mother of another new baby.

The issues of breastfeeding and pumping at work bring the challenges of the work-life balance to the forefront for all working mothers, as well as for our colleagues. When I was a resident, we ate our lunches standing up by our computers, we were assigned every third patient whether we were ready or not, and at the end of a shift we frequently realized we hadn’t used the bathroom in 9 hours. When I started my first job as an attending, I needed to pump every 3-4 hours. How was that going to work?

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The reasons to breastfeed don’t need review. “Breast is best” for the first year and possibly longer. For a parent who brings germs home from work, it’s probably even more important. It was never the “why” for me, but always the “how.” A few weeks before my first shift I met another EP who had a new infant and a 3 year old, and I asked her how she did it. Her response was simple and appropriate: you just do it.

We all know that different doctors take different amounts of time to use the bathroom, get coffee and eat (and we all know a few whose time management we disagree with.) Like many new doctors before me, I somehow felt I couldn’t take the time to pump. I worried not just about my efficiency at work, but my perceived efficiency. I worried about how I could possible leave the department to do this when generally I never left the department. How could I not pick up that next chart but instead walk to the call room? Following my friend’s advice, I “just did it” and discovered it wasn’t a problem at all, not for me or for anyone else.

In my 6 months of pumping with my first child it was never an issue. Three women out of our practice of 15 physicians were pumping at the same time I was. We had a call room in our ED with a bathroom, a computer, and a phone where we could pump. We were available at all times, yet never once did someone have to pull me out of the pumping room. I pumped immediately before my shift, which meant coming early, so that I could put off that first pump as long as possible.

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If there was shift overlap I pumped when someone new came on, or just before someone else left. I made sure that an ambulance hadn’t just called with someone sick. I brought my food from home and ate while pumping, while also checking labs and writing notes. I created systems to make pumping as efficient as possible, and I tried to stay efficient during the rest of my shift.

I could see that this could be an issue, from the standpoint of colleagues who have not been through it or have not watched their partners work hard to nourish their children. Breastfeeding, even without the issues of being a working mom, is not easy. But as physicians, we should be encouraging our patients to breastfeed and supporting our colleagues as they breastfeed. We should be practicing what we preach. As more and more women go into emergency medicine this will become a more frequent challenge on a departmental level, but only one of the many challenges of our job.

In the end, breastfeeding only lasts a short while, while the benefits appear to last much longer. The benefits of supporting your co-workers and creating a compassionate, family-friendly workplace, while not studied as much as breastfeeding, are likely also worth the cost.

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