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  • This Mom Shares How She Manages to Breastfeed Despite Grueling Hours as a Medical Intern

    The hours were long but she persisted and pumped in between her 24-hour shifts.
    by Kitty Elicay .
This Mom Shares How She Manages to Breastfeed Despite Grueling Hours as a Medical Intern
PHOTO BY courtesy of Victoria Nepomuceno-Nem Singh
  • Many moms have proven time and again that armed with the right knowledge, patience, and perseverance, you can provide your child with liquid gold. But juggling motherhood and working at the same time can make breastfeeding challenging. At times, it feels like you have to make a choice — at least that was the reality for Victoria Nepomuceno-Nem Singh, an aspiring physician.

    Victoria got pregnant in 2017 while she was waiting to graduate from medical school at the University of Santo Tomas Faculty of Medicine and Surgery. From the time she found out that she was expecting, she was determined to breastfeed her baby.

    “As a child, I saw my younger cousins being breastfed by my aunts, and our neighbors in Bulacan were breastfeeding mothers as well,” the now-32-year-old mom shares with SmartParenting.com.ph in an email interview. “I used to read health-related books, so I learned early on that babies were getting nutrition straight from their mothers — through the placenta while they were still in the womb and through the breast until well after they were born.”

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    Victoria with her daughter Via.
    PHOTO BY courtesy of Victoria Nepomuceno-Nem Singh

    Victoria is already a licensed nurse, so her medical background only strengthened her beliefs in breastfeeding. “I wanted to give my children nothing but the best. I knew it was going to be hard to do since we have a lot of work in the hospital, plus the fact that I will have sleepless nights, but I knew it was worth it,” she says.

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    Though Victoria planned to start her postgraduate internship after her graduation in June 2017, her delicate pregnancy prevented her from doing so. “I was diagnosed with subchorionic hemorrhage and low-lying placenta,” she explains. “I was spotting every single day even with minimal movement and was advised by my ob-gyn to be on bed rest with bathroom privileges for several months.”

    In October 2017, Victoria gave birth to her daughter, Vivienne "Via" Alexa, via emergency C-section. “I spent three months healing, spending time with my baby and establishing breastfeeding and my milk supply,” she says.

    After she had fully recovered, Victoria began her postgraduate internship at the Armed Forces of the Philippines (AFP) Medical Center.

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    A day in the life of a breastfeeding medical intern

    At home, Victoria lets her baby "unli-latch." When she had the flu, she still breastfed but made sure to hold the baby only when breastfeeding, she did frequent and proper handwashing and wore an N95 mask.
    PHOTO BY courtesy of Victoria Nepomuceno-Nem Singh
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    Since Victoria was determined to continue breastfeeding even while working, she had to inform her superiors of her plan. “During the orientation, breastfeeding mothers like myself asked about the hospital’s policies, and luckily, AFP Medical Center was awarded as a mother and baby-friendly workplace. They promote breastfeeding not only among their patients but with their staff as well,” she shares.

    But even with the hospital’s support, it was still a tough journey ahead. Victoria's work week was divided into two: pre-duty status from 7 a.m. to 5 p.m. and actual duty, a 24-hour shift from 7 a.m. to 7 a.m. the next day. “The day after that is what we call the ‘from duty status’ — you can now go home and rest for the whole day,” Victoria explains.

    During pre-duty days, Victoria would wake up at around 5 a.m., especially when Via wants breast milk. She’d get ready for work and be at the hospital by 7 a.m. Her morning workload includes attending morning conferences and fulfilling physicians and residents’ orders — writing requests for procedures, visiting different departments to have the requests approved, writing prescriptions for medications, doing ward work, and assisting in surgeries.

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    Despite a demanding work schedule, Victoria makes time to pump milk for her baby.
    PHOTO BY courtesy of Victoria Nepomuceno-Nem Singh

    At 10 a.m., she would excuse herself and visit the breastfeeding station to express breast milk for 30 to 45 minutes. Then she goes back to work. “If you’re lucky and work fast, you get to eat during lunch break. If there’s too much workload, you eat way past the designated time,” she shares.

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    At 3 p.m., Victoria would express milk again before heading home at 5 p.m.

    If it’s an actual duty, Victoria would continue working and pump milk at 7 p.m., 12 midnight, and 4 a.m. “If we’re lucky and have no patients, we can take naps. We rotate so some stay awake while others nap — we are only human beings after all,” she shares.

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    Breastfeeding amid challenges

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    As a medical intern, one of Victoria's tasks is to assist in surgeries. Since operations sometimes take hours, it affects her pumping schedule.
    PHOTO BY courtesy of Victoria Nepomuceno-Nem Singh

    The hours are long, the job is hard, and things always don’t go according to plan. “Ideally, pumping of breast milk should be done every two to three hours, but since the workload is high, I do it every four hours. However, if we have toxic schedules, meaning more work has to be done, I would only be able to pump my milk after more than four hours,” Victoria shares.

    The erratic pumping schedule affected her milk supply, and there would be months when it was low, and she would have to supplement with formula milk until she can "restock" her breast milk. “When I have enough milk supply again, I discontinue the formula and continue exclusively breastfeeding my daughter,” Victoria says.

    Being away from her baby also takes a toll. She writes about it on a Facebook post that led Smart Parenting to her story, and she details the struggles that come with being a working and breastfeeding mom.

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    “Dahil miss ko na si baby, iiyak ako. Tatawagan si hubby na ihatid si baby sandali, [maghuhugas] at sanitize ng kamay, hubad ng coat at stethoscope, padededehin si baby sa kotse,” Victoria writes. “Iyak. Kiss at hug ang mag-ama ko.”

    She also feels guilty about taking lactation breaks, especially because her co-workers need to cover for her. “Pero nilulunok ko na lang ang guilt kasi kailangan talaga ng gatas ni baby. Magugutom siya at mas gusto niya ang gatas ko kaysa formula milk,” Victoria shares.

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    Victoria continues her breastfeeding journey, thanks to the support of her husband, Kyle.
    PHOTO BY courtesy of Victoria Nepomuceno-Nem Singh
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    “Some [of my workmates] get irked when breastfeeding moms would get more breaks than they do, some get mad when an infectious patient is assigned to them instead of me,” Victoria adds. “Residents advise this to protect not only me but also my child so she won’t get infected with the diseases from the hospital.”

    The hardest challenge of all, however, was physical exhaustion. “During my non-duty days, my sleep would be interrupted because my baby breastfeeds every two hours. Swerte kapag nakatulog siya, pero kapag hindi, susubukan mong buhat-buhat siya habang nagbababad at naglilinis ng napakaraming nagamit na bottles, toys, at pump parts,” Victoria says. “Gutom ka na pero dahil wala si yaya at hindi posibleng magluto ng buhat si baby, init init na lang ng naluto sa ref.”

    Victoria recalls a time when she contracted Influenza A from the hospital and was advised to rest and recuperate for a week. "I was very sick, but it did not stop me from breastfeeding my child. I wore an N95 mask during our feedings because I don’t want to risk my child from contracting the disease. I did frequent and proper handwashing, plus other preventive measures and only held her during breastfeeding to reduce the transmission of the virus," she explains. 

    (Experts say you can continue breastfeeding even when you are feeling unwell. However, it is best to consult with your doctor to get the treatment you need to keep yourself healthy. Read more about it here.)

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    There are times when Victoria thought of giving up, but whenever she sees her happy, healthy little girl, she continues her mission to give her daughter only the best.

    “It is not called ‘liquid gold’ for nothing. It is a product of great sacrifice and sleep loss for 13 months.” —Victoria Nepomuceno-Nem Singh

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    A mom now but also a doctor in the future

    Victoria still hopes to complete her medical internship so she can become a licensed doctor.
    PHOTO BY courtesy of Victoria Nepomuceno-Nem Singh
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    Victoria is proud to have breastfed her daughter for 13 months. While she wants to continue breastfeeding, her ob-gyn advised her to stop breastfeeding for now — Victoria is 31 weeks pregnant.

    “Just like my first, this pregnancy is delicate, so I have to stop. It’s heartbreaking for my child and me, but I promised that after giving birth, I would continue breastfeeding her (if she still wants to) together with her sibling. I will continue to do so until they wean on their own — or until I get pregnant again!”

    She has a month and a half left for her postgraduate internship but is currently on a leave of absence because of her condition. But she will return to finish her internship three months after giving birth. Only then can she take the physician licensure exam.

    Victoria still dreams of becoming a doctor, but she's willing to put it on hold for motherhood. "I hope to pass the physician licensure exam and enroll in a residency program where I can still have time for my family," she shares.

    “Mahirap pagsabayin ang pagiging ina at pagiging doktor. Pero kinaya ko at kakayanin pa sa mga susunod na panahon. Hanggat may gatas ako, itutuloy ko,” Victoria says.

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    I was very sick but it did not stop me from breastfeeding my child. I wore an N95 mask during our feedings because I don’t want to risk my child from contracting the disease from me, frequent and proper handwashing, plus other preventive measures and only hold her during breastfeeding to reduce the transmission of the virus.

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