Because my boobs are rather large, I put a rolled up flannelette flat nappy underneath to prop it up a bit. However, there have been times where I haven't had the rolled up nappy on hand and I have still been able to feed comfortably using the Milkbar pillow. I'm not sure what I am doing differently though? I use it sitting either semi reclined in a lounge chair or sitting regular in it, or I use it sitting up in bed. I do find it lots easier to use in the football hold when feeding in bed though.