Before I had my daughter, I had no idea how consumed I would be by breastfeeding. It was a mix of ignorance, getting pregnant faster than expected, no new mom friends and a busy fellowship that made me unprepared. Also, just like the rest of motherhood and doctorhood, you can’t really understand the intricacies of breastfeeding until you are in the middle of it. I used a Facebook resource, Dr. MILK, to support me through a successful year-long breastfeeding relationship with my baby girl. For many reasons, I struggle much more with my son. He is still exclusively breastfeeding but at just over nine months, it is tough.

Before I get into my tips - let’s start with my why. If it is such a challenge, why do it? Well, the American Academy of Pediatrics (AAP) recommends breastfeeding for one year because breastfeeding outmatches formula feeding on a slew of outcomes (infections, development, chronic diseases). Breastfeeding does not work for everyone; however, I feel that it is one parenting thing I can do as a working mom that I know is good even though I’m away from my baby all day. So, with both kids, I resolved that as long as I could be a happy, loving mom and maintain supply, I would breastfeed for one year.

When I made that resolution with number one, I had no idea what I was getting myself into. Some simple math tells me that after breastfeeding my son for a year, I will have spent the time equivalent of 30 days attached to a breast pump. This does not include the time actually spent nursing. One full month of breast pumping. I cannot wait to dump the pump! More than just pumping, the constant pressure of finding time to pump, the unending pumping math, pushing to make it home in time to nurse my baby to avoid yet another date with the pump, the constant fear of underfeeding, painful plugged ducts, waxing and waning supply, making sure to eat and hydrate adequately on top of working- there have been many days I’ve been tempted to quit.

Everyone is different, so take my recommendations with a grain of salt, but if you are interested in exclusively breastfeeding your child, it is possible, even as a full-time working mom. It takes a lot of commitment, calculating, mental bandwidth and time.

My tips:

1. Create some oversupply while you are on maternity leave. This can be achieved by pumping after nursing. It is great if you have someone to help you at home. I did not, which was tough, but still pumped after nursing once a day.
2. Create a stash while you are home, but, do not depend on this stash - they say fresh milk is better than frozen, so I keep my babe on fresh milk and only dig into the stash when I’m unable to keep up with his intake.
3. Pump every two to three hours at work. Ask for accomodation. Pumping to empty and then some takes about 35 minutes including set up for me. Do more inpatient than clinic if you can, because at least you have more control over your time when the patients are admitted. If you do not pump as frequently as your baby eats while you are away, you will likely struggle to keep up with baby’s intake and your supply will tank. The pump does not extract as well as baby, so you still may struggle even pumping this much. This is really hard, but it is a must.
4. Once baby starts sleeping through the night, pump at least once at night. This will help maintain supply and give you a little extra milk to keep up with baby’s intake due to the rigged pump system mentioned above.
5. Stay hydrated. As a diabetes doctor, I hate recommending Gatorade, but even I drink it to keep up supply. Also my tumbler with a straw never leaves my side!
6. Keep a close eye on supply when you are trying to shed the baby weight. It could drop supply or quality of breast milk.
7. Get a car adapter to pump. This is terrible, but I pump in the car every day.
8. Use Milk Savers to collect letdown from the opposite side.
9. Power pump if supply is getting low.
10. Ask another caregiver to wash pump parts and bottles, but pack them yourself. You will be so mad if you show up to work and there is a part missing. Screw on the valve/flange to the bottle the night before.
11. Make sure everyone in your house is aware of how important it is not to waste a single drop of the liquid gold. My cleaning lady dumped a six ounce bottle of milk my nanny was about to feed my son. My nanny cried when she told me, and it made me love her more.
12. Nurse as much as you can! Nothing will stimulate milk production better than actually nursing your baby.

Breastfeeding is such a mixed bag for me. There is truly nothing more rewarding than satisfied, milk-drunk smiles in the morning that are only for me. I’m grateful I have the ability to provide my babies with something nobody else in the world can. But the majority of my breastfeeding life is spent attached to a breast pump, which is just the worst. It is so bad that I wonder if the advent of the electronic breast pump helps working moms or if it just adds to the expectation for women to do more at work and at home.

I hope this is helpful and would love to hear your thoughts, advice and experience on breastfeeding/breast pumping.

Arti Thangudu, MD is an endocrinologist and a 2018–2019 Doximity Author. She specializes in Endocrinology, Diabetes, and Metabolism and is a mom of two beautiful kiddos under three! She works for DGD Clinic in San Antonio. She has also contributed to Medscape and KevinMD. Outside of work, Dr. Thangudu enjoys traveling, cooking, and spending time with her husband and two children.

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