Today, nursing my baby girl a week after my first dose, the vaccine is my liquid hope.
A week ago, I was fortunate to receive a COVID-19 vaccine. But unlike many colleagues who signed up for a vaccine so quickly that the scheduling system crashed, I paused. It wasn’t just my health at stake. I thought of my four-month-old daughter, whose diet consists of my breastmilk.
When the pandemic struck, I was in my second trimester of pregnancy and moved to virtual care. Cloistered at home, I saw patients through my slim laptop screen and expended energy on long walks. As the death toll to the virus mounted and my colleagues faced immense risk and moral distress, I turned inward, trying to build a cocoon of safety and normalcy.
A few months later my daughter arrived, bringing unimaginable joy. Her presence demanded that I somehow integrate my dual (and often dueling) identities: the mother I hope to be and the physician I have become.
I turned to a children’s book, Doc Like Mommy. In its glossy pages, a girl expresses her desire to grow up and be just like Mommy, responding to the call of duty while being there for family. Mommy makes eggs, fixes broken bones, attends ballet recitals, and studies for boards before bedtime. It’s a tale of tenacious doctor mom through her daughter’s adoring eyes.
Behind the uplifting illustrations lurks the demanding, often alienating experience of motherhood during medical training. The colorful scenes elide the guilt of balancing career with caregiving—the physical exhaustion and sheer impossibility of doing it all. And amidst COVID-19, new challenges like distance from family and anxiety of exposing one’s baby to unknown harm.
“Are you pregnant or lactating?” the nurse asks me at my vaccine intake, the last of a series of questions.
I pause, then nod.
“You’ve discussed this with your doctor?”
“Yes,” I mumble, fearful of losing my spot. This is not technically true. I have not seen my own primary care provider, and, after an abrupt six-week postpartum follow-up, my OB broke up with me: “I’ll see you when you have your next kid!”
I did, however, turn to my personal well of wisdom: a group chat with fellow doctor moms. Pregnant together during the pandemic while in residency, we bond over shared struggles—navigating the decision to work with COVID-19 patients or step away from direct care, attending prenatal ultrasounds without partners, giving birth in masks, caring for newborns in quarantine, and seeking safe child care as we return to work with infection rates surging.
I inquire over text. “Are you getting vaccinated?”
Together we weigh the clinical trial evidence, our knowledge of biology, and the irreducible tug of feelings. An oncologist worries that an adverse reaction might affect her ability to breastfeed her daughter. An immunologist speculates about the mechanism by which the injected mRNA may produce IgA antibodies that enter breastmilk. A hospitalist badly wants the vaccine—she will soon be on a COVID-19 team—but cannot get an appointment until late in the month. Her son’s pediatrician gave her the green light.
Seeing my fellow breastfeeding moms opt to vaccinate gives me confidence to schedule my shot. It isn’t our group alone seeking collective reassurance. The online forum Dr. MILK (Mothers Interested in Lactational Knowledge)—a private Facebook group with more than 30,000 members created to help physician mothers navigate breastfeeding—has exploded with vaccine selfies, reactions and updates. Treading unfamiliar ground, we guide each other.
I cannot overstate the historical significance of pregnant and lactating people being allowed to choose vaccination, with an FDA recommendation and society guidelines (ACOG, for example) that support shared decision-making. As I write this, the plastic flanges attached to my chest fill with jets of warm milk. I am accustomed to the machine’s hum, but it alarms my mother when she first sees me pump.
“Like a cow!” she exclaims.
“Yes,” I say, half proud, half resigned.
The labor of breastfeeding quite literally hidden in American culture. We nurse behind fabrics with distracting prints (lemons and roses!) to hide lifegiving rituals from society’s eyes. We face judgment on the best way to feed our babies (whichever option we choose) along with new technologies and immense expectations—like pumping to make bottles, maintain supply, or save a “freezer stash” for work.
A pump session involves setting up plastic tubing and wearing a hands-free bra to support the flanges. Hooked up to a machine that pulls and squeezes to extract milk, I scroll through videos of my daughter giggling or listen to a Lily King novel on Audible. Then the business of storing milk and sterilizing parts. By now I’m ravenous (breastfeeding burns around 500 calories a day) so I pause for water and a snack. The process consumes hours each day.
“Are you pregnant or lactating?” The nurse’s question demands a yes or no, but lactating is not the casual happenstance her tone suggests. It is my way of life: Privilege and pressure, relentless and roiling demand upon my postpartum body.
24 hours after the vaccine, my arm is leaden. I’m tired, but this is usual fare as a new mom. The day passes. Soon I am back to changing diapers and bouncing my daughter on my hip. Nursing at night, I enjoy her lustrous eyes taking me in, her way her fist aimlessly curls and uncurls, her cookies and cream scent. And I pump more zealously, hoping to fill some bottles with elixir against any virus I might bring home clinging to my scrubs or hiding in my airways.
Breastmilk is affectionately called “liquid gold” for its valued antibodies. Right now, many doctor moms like me are stretching ourselves to keep nursing or pumping in hopes of bestowing protection upon our little ones.
In a week, when I return to our overflowing hospital, I’ll pump every three hours, slipping away between rounds, searching for a private room with an outlet to plug in my pump (no easy feat), getting interrupted by the overhead call of Code Blue. Back home, my husband will thaw icy crystals and feed warm milk to our daughter. It will be a time capsule to this moment of pandemic motherhood with all the apprehension it triggers and courage it demands.
Don’t get me wrong: I will still wear an N-95 and face shield when seeing patients. I’ll still practice social distancing. I’ll still carry that knot of dread in my stomach. The vaccine cannot erase the losses rendered by COVID-19 pandemic—and for pregnant health care providers and new moms, the fraught tradeoffs, unthinkable fears and newfound isolation.
But today, nursing my baby girl a week after my first dose, the vaccine is my liquid hope.
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