6 Ways to Tell if Your Breastfeeding Baby is Full!


New babies are notoriously confusing. They fall asleep after 5 minutes, and then wake up 2 minutes later starving. It’s hard for a new mother to figure out what the baby wants let alone whether they did a good job filling them up! To that end here is a short list to review!
1.) Your baby was really hungry, and had tightly balled fists. As you nurse for a while the little hands open like flowers and become relaxed. Might be full.

2.) Look for Zombie Arm. This is what I call the super floppy arm that happens when a baby is totally milk wasted. You should be able to lift the arm and it drops like a log. Might be full.

3.) Always double check the upper lip. You say you have the Flower Hand, and the Zombie Arm? Check the upper lip by tickling. If you baby hunts for the air nipple, probably not full.

4.) Your baby might look like this:
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or this:







5.) Look at your baby as a whole being. Do they seem relaxed? Are the hands relaxed and open? No tension in the arms or back? Is your baby resting in your hands as you look them over? It their mouth relaxed and not pursed. Might be full.

6.) If you cannot wake your baby up, and you have tried the follow things: A warm washcloth bath, tickled ribs and shoulders, massaged the palms of the hands, and you’ve even tried the dreaded “fake out the baby by pulling the velcro tab on the diaper” trick? Might be full.

(c) Serena Meyer, RN, IBCLC 2016

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10 Tips For Successfully Breastfeeding Your Newborn!

  • A12721663_821694297956914_273166528_n newborn is very alert the first hour of birth. Let your baby relax on your chest without clothes. They will start to stick their tongue in an out, and knead their fingers in the breast like a kitten does. This means it’s time to latch on! Gently scoot them near the breast! Don’t rush the moment, just allow it to happen naturally.
  • Your job is to get your baby close to your nipple so that they can nuzzle and lick your skin for a while first. That part is normal and a necessary first step to breastfeeding! Babies have some expectations; they expect to be on your chest naked and they want to know you. Their experience of life is through their mouth. Relax and allow your baby to learn more about who you are through normal infant behaviors before breastfeeding.
  • Getting that first latch: tickle their upper lip, wait until they open wide, then pull your baby in towards your breast! You want to have your baby rolled inward toward you before you latch, so that you are tummy to tummy. Line your baby up close to nose to nipple right before you tickle the upper lip side to side with the nipple! I usually guide women to use the “cross cradle position” which is one hand on the breast and one hand holding the baby.


    There is an extra helping hand here! The mother is holding the left breast with the left hand, and scooping the baby in toward the breast with the right!

  • Does it hurt/pinch? Breath through it and count to ten, if it still hurts, unlatch right away by breaking suction with a finger placed into the corner of your baby’s mouth. Slowly insert your finger into their mouth and trade out a nipple for a finger! Never pull a baby off a nipple without breaking the seal first! It will probably hurt if you do.
  • What are a few reason for the pinching? Number one is typically that their mouth wasn’t open wide enough before you pulled them toward you for latching. Be patient and really wait for the wide open mouth!  When you see it quickly pull your baby onto the breast.
  • The second common reason for a pinchy latch is that they need to be tummy to tummy with you or they end up pulling the nipple a bit. Spending time lining your baby up into a comfortable position is key.
  • New babies have three jobs! 1.) Look cute, 2.) Smell good, 3.) Open wide.
    That’s it! Your baby can’t get to you yet, so you have to really pull your baby in for a good latch to happen. Once they open wide you can stuff lots of breast into their mouth. That’s how babies get a deep latch and plenty of milk!
  • “My baby is asleep, can I let him just sleep?” A newborn is going to need to be reminded gently during the first few day that it’s time to eat. Hospitals might say every 3 hours, but as an IBCLC I’m going to share the following information. Babies that gain weight well, eat every 1.5-2 hours in the first few days. This means that long periods of rest are not normal. Try and feed your baby very frequently. Your job is to offer the breast.
  • If your baby is just born try and get a latch in the first hour. It’s not called the Golden Hour for nothing! babies that get latched on right away statistically breastfeed better, and more effectively for the following feeds.
  • In the case of a surgical birth or a situation where there is separation, do your best to either start breastfeeding as soon as you are together or start manually moving out milk no later than hour four. Ask for a pump, use breast compressions, and don’t let anyone get in the way of  your success!

(c) Serena Meyer, RN, IBCLC 2016

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The Creator’s Gift to Mothers

This video discusses the importance of breastfeeding, as well as the myths that often prevent moms from breastfeeding. Breastfeeding truly is “the Creator’s gift to mothers!”

For more information about some of the topics discussed in the video, please see:
Frequently asked questions about breastfeeding and diet
Breastfeeding Myths (part 1)
Breastfeeding Myths (part 2)
Breastfeeding information for dads and partners
Breastfeeding and cigarette smoking

For breastfeeding information or support anytime:
La Leche League or toll free at 877-4-LALECHE
The National Breastfeeding Helpline toll free at 800-994-9662
WIC  (find your local office)
Breastfeeding USA
Find an IBCLC

For more information about this video produced by the Shibogama First Nations Council, please see:
The Creator’s Gift to Mothers

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Stress and Breastmilk Production

stressDoes stress reduce milk production?

Consider this scenario: You are late for an important appointment. You are just starting out the door when you discover baby poops through his last clean outfit and all over you, too! Your phone is buzzing in your purse and your hands are full with baby, diaper bag, and poop. That is a stressful moment, right? Every mom experiences high stress moments just like this.

Moms often hear that they should stay calm because feeling stressed will cause milk to “dry up”. The business of daily life, finances, relationship issues, illness, etc. are all common stressors moms face. Sometimes stress is sudden and ongoing such as in the case of natural disaster or war. The woman’s body is made to not only grow a baby, but also nourish and protect him once born. Moms can continue to breastfeed despite incredible circumstances.

Sometimes moms experience stress that is severe and intense, which can temporarily inhibit letdown. This is thought to be a protective mechanism. As one doctor put it so well, you wouldn’t want to be leaving a trail of milk behind if you were running from a tiger! Over a long period of time, it is possible for chronic stress to inhibit letdown often and long enough that milk production can be decreased. This is usually not the case, as breastfeeding releases hormones that helps mothers and babies both relax and have an easier time enduring stress, even under the worst of circumstances.

What can I do if  I’m in a situation where I’m under ongoing, chronic stress and it is affecting my letdown? 

Letdown can be triggered by associations, such as sights, smells, and emotions. Below are some tips for initiating letdown before and during breastfeeding or pumping. You can try any combination of these that makes sense to you.

  • Find a location to feed your baby (or pump) where you feel very comfortable and safe. Choose a place that is free from intrusion and distraction.
  • Make an effort to relax as much as possible before feeding or pumping. Listen to music, take a few cleansing breaths, pray, smell a relaxing scent, or do anything else that helps you feel at peace.
  • Consider trying breast massage prior to nursing or pumping. It has been shown to assist with milk ejection and overall milk removal.
  • Bend over at your waist so that your breasts dangle from your rib cage, and shimmy your shoulders (move them back and forth) so that your breasts shake. This movement helps loosen tension in your neck and shoulders and assists milk in moving forward in the breast.
  • Consider using Reverse Pressure Softening (RPS) to promote letdown: “Steady stimulation of the nerves under the areola automatically triggers the milk ejection reflex, propelling milk forward in the breast, nearly always within 1-2 minutes or less.”–Jean Cotterman
  • Enjoy the moment. If you are with your baby, smell his head and stroke his hair. If you’re away from your baby, smell a piece of his worn clothing and/or listen to his cries on a recording. Some moms like to watch videos of their baby cooing, crying, or breastfeeding on their phone. This creates an emotional connection, and can help promote milk release.
  • Visualize milk spraying forth from your breasts like a waterfall or a rushing river. It sounds strange, but it often works!
  • If you are with someone you trust and feel comfortable asking, have them rub your shoulders and apply pressure between your shoulder blades. This, too, can help trigger the release of oxytocin and assist in milk ejection.
  • Drink water. Moms often sip water while nursing, so that alone may initiate letdown through what is known as conditioned response.
  • If you’re pumping, the hands-on pumping technique can aid in milk ejection and help you maximize milk removal.
  • Consider breastfeeding while bathing with your baby. This can help release tension in your muscles, and may help your milk flow freely.
  • Between feedings, spend time in skin-to-skin contact with your baby. This will help you  both relax, and aid in release of hormones associated with breastfeeding.

Breaking free from stress

  • Talk to a counselor or traditional healer.  Ask family and friends for support. Stress is often relieved by talking through your feelings and concerns, even if there isn’t a solution to your current problem.
  • Contact your IBCLC, WIC PC, or volunteer breastfeeding counselor for continued support, including tips to manage stress as it relates to mothering and breastfeeding.
  • Eat well and exercise. Eating nutrient-dense foods gives your body the necessary vitamins, minerals, and energy needed to overcome stress. Exercise is a well-known stress buster. Even a 30 minute walk around the block can lower blood pressure, ease tension, and clear your mind.
  • Contact a medical or mental health professional if you’re experiencing ongoing, chronic stress. They can provide information for stress management, and evaluate for related issues like depression and anxiety.
  • Consider talking to your doctor about taking a magnesium supplement.  This mineral is often depleted during times of chronic stress, and some experts suggest that supplementation may help reduce stress-related symptoms.

Stress Resources:

Coping With Perinatal Stress and Depression by Cynthia Good Mojab, MS, LMHCA, IBCLC, RLC, CATSM

Mental Health Care for Postpartum Depression During Breastfeeding by Cynthia Good Mojab, MS, LMHCA, IBCLC, RLC, CATSM

American Heart Association: Four Ways to Deal With Stress

American Psychological Association: Coping with Stress and Anxiety

Working Moms and Stress Relief

Stress Management for Parents

Uppity Science Chick: The stress-lowering effects of breastfeeding (list of reference articles)

The Toxic Effects of Stress on American Indians


Chen, D., Nommsen-Rivers, L., Dewey, K., & Lonnerdal, B. (1998). Stress During Labor and Delivery and Early Lactation Performance. Obstetrical & Gynecological Survey, 68(2), 81-82.

Dewey, K. (2001). Maternal and Fetal Stress Are Associated with Impaired Lactogenesis in Humans. The Journal of Nutrition, 133(11), 30125-30155.

Groer, M., Davis, M., & Hemphill, J. (2002). Postpartum Stress: Current Concepts and the Possible Protective Role of Breastfeeding. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 31(4), 411-417.

Heinrichs, M., Neumann, I., & Ehlert, U. (n.d.). Lactation and Stress: Protective Effects of Breast-feeding in Humans. Stress: The International Journal on the Biology of Stress, 195-203.

Lau, C. (2001). Effects of Stress on Lactation. Pediatric Clinics of North America, 48(1), 221-234.

Mezzacappa, E., & Katkin, E. (2002). Breast-feeding is associated with reduced perceived stress and negative mood in mothers. Health Psychology, 21(2), 187-193.

© Jolie Black Bear 2015

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How can I pump more breastmilk?

Moms who need to express their milk exclusively or in addition to breastfeeding are often concerned about their milk production. Combining breast massage and hand expression with pumping can help moms remove more milk and drain the breast more fully. Put simply, hands-on pumping helps maximize the amount of milk removed now and maintain milk production in the future.

What is Hands-on Pumping?

Hands-on pumping is a milk expression technique in which moms use their hands to assist in milk removal. Breast massage and hand expression combined with pumping has been shown to maximize milk removal and subsequently, milk production. When using this technique, it is possible to effectively double the amount of milk expressed!

Why Hands-on?

  • 85 percent of moms with babies between the ages of 1.5 and 4.5 months of age have used a breast pump  (Labiner-Wolfe 2008)
  • The perception of not making enough milk is one of the top three reasons moms give for weaning (Li 2008)
  • When a baby breastfeeds effectively, he uses a combination of vacuum and the action of the jaw and tongue to remove milk (Geddes 2007)
  • The vacuum of a pump alone is less effective at removing milk that is thick and sticky like colostrum or fat-rich breastmilk (Steakly 2012)
  • Hands-on pumping helps moms remove up to 48 percent more milk than expressing by pump alone (Morton 2009)
  • Hands-on pumping increases the amount of fat-rich and calorie-dense milk moms are able to express (Morton 2012)

Hands-on Pumping How-To

  1. Massage your breasts to help stimulate the milk ejection reflex. Use your fingers held flat against your breast and gently massage in a circular motion from the point where the breast meets the chest in a downward direction towards the nipple.

    Massage with hands while double pumping using a hands-free bustier  Image copyright Beth Waldorf--All Rights Reserved

    Massage with hands while double pumping using a hands-free bustier
    Image copyright Beth Walldorf–All Rights Reserved

  2. Double pump. Assure your breastshields fit well. Find a level of suction that is comfortable and effective for you. Consider using a “hands free” pumping bra, bustier, or sports bra with holes cut for the breastshields so that you can pump without having to hold them in place. This frees your hands so you can massage and compress your breasts while pumping.
  3. When the sprays of milk slow to dribbles, stop pumping and repeat massage. Feel for areas of firmness. With gentle pressure, massage behind any area that still feels firm in a downwards direction towards the nipple.

    Use your hands to compress and massage while single pumping.  Image copyright Beth Waldorf--All rights reserved

    Use your hands to compress and massage while single pumping.
    Image copyright Beth Walldorf–All rights reserved

  4. Single pump or hand express to complete your pumping session. Alternate breasts (right to left to right). Give each breast a short rest before expressing it again. Feel for areas of firmness and gently massage them out. Pay close attention to the outside of the breasts, as this will be the areas least likely to be well drained from pumping alone. Let the sprays of milk be your guide as to where your breast needs compression and massage. Experiment and develop your own technique. With practice, you will find what works best for you!
Hand express directly into the breastshield of your pump.  Image copyright Beth Waldorf--All rights reserved

Hand express directly into the breastshield of your pump.
Image copyright Beth Walldorf–All rights reserved








Watch a video: Dr. Jane Morton explains her research, and mothers demonstrate the hands-on technique. Please click the link then click “proceed” in order to view the video.
Maximizing Milk Production With Hands on Pumping

Some additional ways to help maximize and maintain milk production:

  • Spend as much time as possible holding your baby and/or  in skin to skin contact with your baby. Close contact with your baby encourages the “flow” of the breastfeeding hormones prolactin and oxytocin.
  • Keep a flexible schedule for removing milk. Aim to breastfeed or express your milk at least 8 times in 24 hours.
  • Music has been associated with increasing the amount of milk expressed in NICU settings. The music in the study cited in the link above is available as a free download.
  • Consider warming your breastshields before pumping. One study found that using warm breastshields along with maximum comfortable vacuum decreased the time needed to remove 80 percent of the milk volume.
  • If you have difficulty initiating letdown, Reverse Pressure Softening can help by stimulating the nerves that lie under the areola. These nerves control the release of the hormone oxytocin, which is responsible for milk release. Most moms can initiate letdown with RPS in 1-2 minutes. It is especially helpful when engorgement makes latching or pumping difficult.
  • Choose a breastpump that is right for your pumping needs. Talk to an IBCLC to get personalized assistance finding a pump that works for you.

Hands-on pumping was developed by Dr. Jane Morton and studied at Lucile Packard Children’s Hospital and Stanford University School of Medicine.


Geddes, D., Kent, J., Mitoulas, L., & Hartmann, P. (2007). Tongue movement and intra-oral vacuum in breastfeeding infants. Early Human Development, 84(7), 471-477.

Labiner-Wolfe, J., S. B. Fein, K. R. Shealy, and C. Wang. (2008) “Prevalence Of Breast Milk Expression And Associated Factors.” Pediatrics 122. Supplement: S63-S68. Print.

Li, R., S. B. Fein, J. Chen, and L. M. Grummer-Strawn. (2008) “Why Mothers Stop Breastfeeding: Mothers’ Self-reported Reasons For Stopping During The First Year.” Pediatrics 122.Supplement: S69-S76. Print.

Morton, J., Hall, J., Wong, R., Thairu, L., Benitz, W., & Rhine, W. (2009). Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. Journal of Perinatology, 757-764.

Morton, J., Wong, R., Hall, J., Pang, W., Lai, C., Lui, J., Hartmann, PE., Rhine, W. (2012). Combining hand techniques with electric pumping increases the caloric content of milk in mothers of preterm infants. Journal of Perinatology, 32. 791-796.

Steakly, Lia. “Stanford expert discusses breastfeeding techniques.” SCOPE. Stanford School of Medicine. March 2012. Web. 5 Dec. 2013


Illustrations by Beth Whetstone Walldorf

Beth is an experienced and talented artist who works in a variety of mediums, most notably oils and acrylics. She holds a BA from Jacksonville State University and currently teaches art at Decatur High School. She and her husband live in Decatur, AL with their two girls who were both breastfed. Thank you, Beth, for sharing your time and talents for this project!



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Guest Post: A mother’s birth and breastfeeding story

(c) 2014 E. Gomez

(c) 2014 E. Gomez

I decided when I found out I was pregnant, to do all that I could for my child from the start. I changed my household and beauty products. I began to strictly buy the best food available. Thankfully, it is not hard to achieve this on the SF peninsula. I contacted a doula in my area who also became my Yogi & guide to meditation, which I have always struggled with. Early on I decided that my birth would be natural and my children would be breastfed.

Being born in late 70’s to a Mexican immigrant I was not breastfed. It just, “wasn’t done”, was my mothers only explanation. Her mother did not breastfed her children either. Back then they had wet nurses that did the breast feeding. I can not imagine missing out on the connection breastfeeding gave me with my children. But that was part of the culture at the time and I am not willing to judge their choices. Especially since my family was understanding & very supportive of mine.

My sons birth was wonderful and peaceful. Lasting only 3 hours from start to finish. With my Abuela, my Mothers, and husband present. They prayed they even sang, it was wonderful. My doula was an amazing advocate for my choices in the labor & delivery room and after. My son latched on without a problem in the hospital and we were sent home on schedule.

Our first night home was another story completely. It was near 100 degrees and I became so engorged that he could not latch. We cried together most of the night. I called the lactation nurse in a panic she gave me some advice that I did not execute well. After another desperate call full of tears we made an appointment for a at home visit the next day. She came over bright and early and changed our lives. Diego was able to latch and ate with gusto. I decided to join her lactation support group at the local hospital which met once a week. It was pretty much a huge meeting room with chairs lined along the walls women of all ages and races with our brand new to 2 year old babies. That group was my lifesaver throughout the first six months of my son’s life. Whatever questions or thoughts we had we voiced them there. It was a safe space to talk amongst supportive women going through the same things. I learned so very much from them all, and made some forever friends.

At that point my son was a happy very chubby baby that no one could believe I only breastfed. People often commented on the fact that they, “knew”, breastfed babies were skinny, less healthy looking, and never slept through the night. We changed their minds about that quickly. I had decided that I would breastfeed my children for a year. It seemed like a substantial enough amount of time but I was not opposed to breastfeeding for longer if they needed.

When my son was 7 months old I found out I was pregnant with my daughter. Being that my son was such a healthy eater, breastfeeding began to drain me. I was exhausted, I began to try to pump to freeze a reserve for him in case I could not longer continue. Since I am in this country alone without my family I had never been separated from my son at all. I had never had to pump or give him a bottle. This was challenging, he detested the bottle. I bought every brand available no matter the price with no success. I began to donate my stored milk to mothers with low supply or mothers who had adopted infants so that it would not go to waste. Finally we found a nipple he would take. I began to give him one bottle a day just to get him used to the idea. He turned a year old and I began to wean him off my breast, more bottle than mama; I also continued to pump. By the time he was a year and 3 months he was only being bottle fed and had 3 months of stored supply. I was too tired to continue.

When my daughter was born I obviously began the whole process again. He showed some interest, so I fed him from time to time. But he lost interest within a couple months. The world was his oyster now that he was mobile. With my daughter I introduced the bottle a little earlier. I stayed most of that year in Mexico with my family and had help with my daughter so that I could take my son out for some bonding time just he and I. I did not want him to feel jealousy of his baby sister. She was another happy chubby breastfed baby that slept and ate very well. I began to wean her at a year and a month old. And by a year and 4 months she was drinking the 3 months of stores milk I had for her. Breastfeeding was a wonderful experience for me and my children. It took some of my family members some getting used to me feeding in public. But I made sure to do my best to be open to their questions or comments.

I wore my children for the first year of their lives which is “not done” in Mexico any longer either. The classes are less defined today but still exist and the lower classes are the only people you will see feed their children in public or wear their children. Our friends and neighbors became used to seeing me wearing my babies and stopped staring. I am happy to see a change in this generation of a larger middle class. Hopefully soon there will be more education and support for breastfeeding there as well. I have spoken to all my nieces of my experience and a few have even followed my lead. Becoming a mother has made my life so much more meaningful. And I am blessed to have been able to give my children the best start in life possible. I wish that for us all.

(c) 2014 E. Gomez

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