Photo credit: Ron Balagot

Hand Expression
Laid-back Nursing
Bottle Feeding
About Sleep
How Partners Can Help
In the Community
Affordable Care Act

What is an IBCLC?

International Board Certified Lactation Consultants are recognized worldwide as vital members of the health care team providing high quality lactation care and services to new parents and infants. IBCLCs possess the only standardized, board certified lactation credential available, and are:

  • Knowledgeable about up-to-date, evidence-based practices in  lactation as demonstrated through a rigorous exam process
  • Experienced in a wide variety of complex breastfeeding situations
  • Competent to assist with establishing and sustaining breastfeeding, even in the midst of difficulties and high-risk situations
  • Sensitive to the needs of parents and children as they work to help parents reach their breastfeeding goals
  • Ethical in their practice, abiding by Standards of Practice  and a Code of Ethics and working within a defined Scope of Practice

For more information, visit

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What is skin-to-skin?


Photo credit: Kim Acridge

Skin-to-skin contact with your baby, also called kangaroo  care, is a wonderful way to bond. The warmth of your body, the sound of your heartbeat, and the tone of your voice will calm and soothe your infant. Skin-to-skin contact will keep your baby warm, and regulate your baby’s heart rate and breathing, which helps to conserve your baby’s energy. Parents should remain in skin-to-skin contact with their new baby as much as possible, as this helps increase breast milk supply and improves breastfeeding. Parents may also take turns! Separation from their parents causes stress for newborns. When your baby cries, you can provide immediate comfort by placing your baby on your chest, skin-to-skin.

Learn more about skin-to-skin contact.

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What is hand expression?

Manual breast stimulation is a simple way to help increase your milk supply. Hand expression of colostrum is recommended frequently in the first few days after birth. Research has shown that this easy technique is very effective, as it accelerates breast milk production and helps produce a more abundant milk supply.

Watch the hand expression video.

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What is colostrum?

Photo credit: Breastmilk Solutions

Many parents are unsure about their milk supply, and worry that their baby may not be getting enough breast milk during feedings. It is normal to see only drops of colostrum in the beginning.  Colostrum is the early milk, considered “liquid gold”, because it is nutrient dense and contains antibodies to help protect your baby from infections.  Every drop of colostrum is valuable. Remember that your baby is born with a very small stomach, so only small amounts of colostrum are needed in the first 1-2 days of your baby’s life.

Learn more about colostrum, and how to hand express colostrum into a spoon.

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What about engorgement?

Colostrum usually changes color and increases in volume 3-5 days after birth. Breasts become larger and  heavier, sometimes hard and uncomfortable, as the breasts begin to produce more milk. Mild engorgement is normal and usually lasts 12-48 hours. During this time, breastfeed your baby as much as possible.  Ensure proper positioning and latch, your breasts should feel softer and more comfortable after nursing.  Continued hand expression may also provide relief from engorgement. If you are having difficulty with breastfeeding, pumping may be necessary.

Watch the video for massage techniques for breast engorgement. Find more information about engorgement here.

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What about the latch?

A comfortable latch is important for successful breastfeeding.  Babies with a deep latch trigger more milk to flow, so babies are well satiated.  A shallow latch often causes pain, nipple damage, and may put breast milk supply at risk.

Tips for a comfortable latch.

Learn more about attaching your baby at the breast.

More information about latching-on.

Watch an animated latch.

More about infant feeding cues.

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What are some common positions?

Find a comfortable position to help your baby breastfeed more effectively. The cross-cradle position is helpful in the beginning, as you are just learning to breastfeed. You may prefer the clutch or “football” hold if you had a cesarean-section or have large breasts. The side-lying and laid-back positions allow you to rest while your baby breastfeeds. Try different positions to see which is most comfortable for you, and remember to hold your baby close, keeping your baby well supported and attached deeply to your breast.

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What is laid-back nursing?

Photo credit: Micaela McDonagh Maguire

Imagine yourself reclined in bed or on the couch watching tv. Lean back on pillows, relax your shoulders, and put your feet up. When breastfeeding, hold your baby close, and position baby on top of you as you recline. This “laid-back” position is often recommended for parents who have soreness and pain during breastfeeding. Laid-back nursing is a comfortable way to keep your baby well supported for feedings and allows gravity to deepen your baby’s latch.

Watch a laid-back nursing video.

Learn more about laid-back breastfeeding here.

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What about pumping?

How to Use Ameda Platinum with HygieniKit. Learn more about the Ameda Platinum hospital-grade breast pump.

Instructions for using the Medela Symphony Breastpump. Learn more about the Medela Symphony hospital-grade breast pump.

Cleaning instructions for Medela pumpsets.

Whether you are having difficulty with breastfeeding or planning to return to work, many parents choose to pump their milk for later use. If your milk supply is plentiful, a breast pump purchased from the baby store will help maintain your milk production. A hospital-grade rental pump is recommended if your baby was born prematurely, if you are having difficulty with breastfeeding, or if you are struggling with low milk supply.

Find more information about breast milk collection and storage.

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Bottle Feeding

Let your baby set the pace of the feeding when using a bottle. The flow of milk is too fast if baby is gagging, coughing, or gulping. Slow the pace if baby looks worried, or if milk is spilling out of the corners of the mouth.

Watch this demonstration of paced bottle feeding.

Learn more about baby-led bottle feeding.

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About Sleep

Newborns sleep approximately 16-18 hours a day, usually 2-3 hours at a time. Remember that your baby has a small stomach, so needs to wake and eat frequently, 8-12 times per day. Although your baby spends much of the time asleep, sleep does not often occur at night. It is common for infants to sleep more during the day, and ‘cluster feed’ at night. For the first few weeks after birth, it is important for you to rest while your baby sleeps.

Watch Safe Sleep with Your Baby.

Learn more about infant sleep.

Find Sweet Sleep strategies here.

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How Partners Can Help

Photo credit: John Davis

Photo credit: John Davis

Support for parents while they work to get breastfeeding established is vitally important. A supportive partner will reduce  stress and anxiety. Remember to keep life simple, to avoid exhaustion. To get more rest, limit visitors in the beginning (unless they agree to cook and clean!). Stay well-nourished and well-rested to help make more milk and improve breastfeeding.

For more suggestions on how your spouse, partner, family and friends can help, read How to Support Your Breastfeeding Partner by Cody Harris.

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In the Community

Attending breastfeeding groups in community clinics and through local organizations can be helpful while you are learning to breastfeed and adjusting to parenthood. Other breastfeeding parents can be a great source of support. Parents can also share tips and offer encouragement. Many groups meet weekly and require registration in advance, but some are drop-in. For now, most groups are meeting only virtually.

Local breastfeeding groups in the San Francisco Bay Area:
Kaiser Permanente Newborn Care Center
La Leche League
Newborn Connections
Nursing Mothers Counsel
San Francisco General Hospital Women’s Health Center
UCSF Women’s Health Resource Center

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Affordable Care Act

The health care law requires most health insurance plans to provide breastfeeding equipment and counseling for pregnant and nursing parents. Your health insurance plan may also cover the cost of a rental breast pump or a new one for you to keep.

Call the LC will provide you with a bill to submit for possible reimbursement from your health insurance provider. Note that some insurance plans require pre-authorization from your doctor. Discuss your lactation needs with your doctor and contact your health insurance provider for questions about your breastfeeding benefits.

Find more information about Affordable Care Act.

The National Women’s Law Center has a toolkit that provides information on the coverage of breastfeeding support and supplies.

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Call the LC is independently owned and operated and has no affiliation with any mentioned or referenced organizations, websites, videos or products.  All referenced articles, websites, videos, products and materials are for general informational purposes only.