Seventeen years ago, when my daughter was about 5 months old, I was diagnosed with…
By the time my second epidural was placed I had been in labor for 20 hours. I awoke from my morphine sleep with an ocean wave crashing inside me. The epidural wasn’t working. Again.
The nurse call button glowed an angry red as I jammed my finger against it, illuminating my clenched face and inner rage. I asked to speak with the anesthesiologist. Again.
He came to my bedside and explained he didn’t know why my pain was back and why my body remained persistent in its refusal of the medication. Shortly after, the obstetrician came in to check my progress. I was fully dilated. Finally. Fuck it, I thought. I’m pushing.
As a pregnant pediatrician, most people– doctors, friends, family, strangers at the grocery store– assumed I knew all there is to know about pregnancy, birth, and raising a child. These people, you people, couldn’t have gotten it more wrong.
From the moment my labor began, motherhood has been nothing like what I expected– or at all like what I was taught as a physician.
Let’s take breastfeeding as an example. The world at large (my pre-mama self included) assumes that pediatricians are experts on breastfeeding. In reality, there is very little (read: zero) standardized breastfeeding education built into pediatric training programs.
I didn’t truly understand how much this was lacking and how much of a problem it is until I found myself trapped with a sweet, new babe permanently attached to my scabbed, painful nipples and engorged, leaking breasts.
At first, I was angry.
How come nobody told me about this?
How come I wasn’t taught how to help other women with this?
As a primary care pediatrician, I saw new babies and their mothers multiple times in the first few weeks postpartum and so many patients had questions and concerns about breastfeeding. And I really didn’t have any tools to support them. I wanted to call every single patient I ever had and apologize.
If you are reading this and I saw you before I had a baby of my own, I am truly very sorry. I clearly had no idea what you were going through. I get it now. Which got me thinking more and more about the lack of practical education in pediatrics. There is minimal (read: close to zero) time spent on topics like breastfeeding, sleep, nutrition and potty training, just to name a few.
The gap between the parent and the pediatrician is huge.
Sure, some of that is intentional and protective. You want a pediatrician who is objective and knows how to diagnose disease. Who practices medicine. Who stays unemotional and sees clearly through the chaos to diagnose the problem. We do need that.
And maybe it’s just me (it’s definitely not just me), but I also want a pediatrician who gets it. Like really gets it.
Someone who has felt the toe-curling pain of that first, shallow latch and who knows from experience the relentless pressure of being the food source for another human. For me, it feels weird taking breastfeeding advice from someone who has never breastfed— doctor or otherwise. After all, there is no textbook big enough that serves as a substitute for putting a live human to your breast.
Think about it like this: would you want a soccer coach who has never played soccer? Even if they’ve studied all the rules– like really hard– and watched countless games, the experiential piece can not be replaced.
To be clear, pediatricians should be breastfeeding experts, advocates, and facilitators– and many of them are. Because they’ve done additional training and research to be able to support you fully. The training we received in medical school is extensive and intensive (hello residency), but incomplete.
The problem is, how do you find them? How do you know if your baby’s pediatrician is a breastfeeding expert? At the risk of sounding obvious, the first step is to ask!
I encourage all new parents to ask their pediatrician if they have any personal experience breastfeeding. This may mean the person has breastfed a baby themself or has supported a partner through breastfeeding.
You can also ask if your pediatrician has any formal breastfeeding education, such as a lactation counselor certification, or what percentage of their patients are exclusively breastfeeding at 6 months.
Remember: pediatricians (and all doctors) are not dictators. Your healthcare team is just that, a team.
The time is long overdue to talk about the hard parts of motherhood. And ask the uncomfortable questions. Your advocacy for yourself and your baby will help create a team that infuses the practical with evidence-based science. Inform your team how to best support you. And teach your baby to speak up for themselves and others. Remember, you are always and forever the expert in your body and your baby. Period.