Ep 16 Update with Katie the Traveling LC

In this update episode Katie Oshita talks through some of the crazy things her clients are told by providers regarding breastfeeding and tongue tie, as well as going over her own tongue tie journey that is starting now for her family.

Podcast host: Katie Oshita, RN, BSN, IBCLC has over 22 years of experience working in Maternal-Infant Medicine.  Katie is a telehealth lactation consultant believing that clients anywhere in the world deserve the best care possible for their needs.  Being an expert on TOTs, Katie helps families everywhere navigate breastfeeding struggles, especially tongue tie and gut/allergy related issues. Email katie@cuddlesandmilk.com or www.cuddlesandmilk.com

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Disclaimer, this content is meant for information only and not as a diagnosis or medical treatment for any condition. If you or a loved one needs help, please seek out a qualified medical professional for assistance. Welcome to the podcast. I'm your host, Katie Osta, BSN, RN, IVCLC, and infant feeding specialist. Quench your thirst for knowledge and travel with me across the nation to discover, learn, collaborate, and better serve clients from all over the globe. Let's ride and thrive together. Thanks for joining me on the podcast again today. I want to give you a little update of things today that have been going on in my journey. If you've been listening to Katie, the traveling lactation consultant, you know that I'm on the road. And I also want to talk about some things that have been happening lately with my clients. So I have about 90%, I'd say, of my clients have tongue tie babies, right? Part of that is occasionally it's just luck. They were just looking for someone in their area. They didn't know baby had tongue tie. But a lot of times I am getting referrals, referrals from a release provider, referrals from body workers, from a doula, or from other parents saying, hey, I had similar symptoms and Katie helped me. She helped us figure out what was wrong and get back on track. You should give her a call. So, you know, I do see a lot of tongue tie babies, but it is just a big part of my practice. And as we know from, you know, emerging research from Brazil, about one in three babies is tongue tied, not the four percent that the American Academy of Pediatrics says in their current research. It's really about one in three. And given what I see, I would highly agree with that. You know, maybe one in four if we want to be really conservative, but I'd say more accurately, I think it is really one in three. So I see a lot of these people with struggling with feeding, whether it's, you know, breast, breast and bottle, sometimes it's just other infant symptoms too. Sometimes I'll see a parent and baby is feeding well to them, right? Baby's been gaining weight, pediatrician's happy, and yet baby is really fussy and spitty and just cranky and seems miserable. But sometimes it's not. Sometimes it is mom's nipples are cracked and bleeding, or baby isn't gaining. But I just have to tell you guys some of the crazy things that I'm hearing lately. And some of these I I knew, and other ones I was just, I really didn't think they got said anymore. I mean, are we using evidence-based practice or what? Like these are things that I knew people, you know, pediatricians said like 50 years ago in the 70s, my mom was told things like this. But really? Let's go down the list. I have quite a few for you here. Let's see. Breastfeeding after a year is no good, is harmful, or your breast milk turns to water. Okay, where is the science there? Because let's be honest, your body doesn't just make water, right? And why would breast milk, something we know to be so nutritious, so full of over a million live cells and like every tiny drop? I mean, we've got pre and probiotics and antioxidants and live cells and protein and carbohydrates and minerals and so many wonderful things, but at a year it's gonna turn to water, really. So that would definitely not fall in the evidence-based category. I would honestly, I want to look at the pediatrician and go, okay, so where is that research? Where are you coming from with that? Because that's pretty strange, you know, or telling a parent that breastfeeding after a year is harmful or does no good. Humans are meant to breastfeed for years, not months. Biologically speaking, first of all, a human should be able to breastfeed, right? That is our biological norm. If a baby could not breastfeed 500 years ago, they died, right? So when a baby comes out not being able to breastfeed, that this baby is really not able to do it, that is not, okay, that's not biologically normal. Humans are supposed to be able to breastfeed. But breastfeeding was so much more than just even the nutrition. Breastfeeding shapes our face. As you guys know, if you're listening, that I'm really big into the tots and airway space, and I really am focused in on tongue tai its effects in infancy, but its untreated effects throughout the lifespan. Breastfeeding is really meant to shape our face, to help with a nice wide jaw, a nice wide palate, to really give us that nice open airway for a good, good life, right? To be healthy. I mean, you don't have a good airway and you're not going to have a healthy body. It's just not going to happen. You're not going to sleep well, you're not going to grow well, you're not going to feel good. And don't even get me started on mental health when you're not sleeping. So humans are really meant to do this for a really long time. There's absolutely no research and no science behind the idea that breastfeeding is not beneficial after a year. Just because we stop pumping at a year and we can give cow's milk or almond or oat or whatever you feel like giving, all that means is that the baby's calories can be met with their regular food diet. That doesn't mean that they don't need breast milk. It doesn't mean that they don't need direct breastfeeding to help shape their face and their airway, to make room for teeth to fit. So they don't hopefully need orthodontra to help have a nice airway so that they can breathe and sleep and grow well. So I think we can pretty much toss that one out. I mean, there's really absolutely no science behind that. So recently, let's see, another client was told that it always hurts with your first baby to nurse and that you just need to toughen up their nipples. Once they got some blisters on there or some calluses, they said, you know, you'd get blisters first, but then a callus, that would be fine. Then they wouldn't feel it anymore. Okay, let's start with the idea of ouch, who wants blisters and calluses on their nipples? I'm like, no, I don't think so. And again, I'm gonna go back to biology. Humans have been around for a very long time. Do you really think humans would breastfeed for years if it hurt that bad? No. I mean, just the science behind it. When we're in pain, cortisol is released. That's our stress hormone that puts us into fight or flight and that makes our bodies in this really hyper-stressed state, right? It slows down digestion, it puts all this change in our hormones and our chemicals, it holds on to things like that. That's why when someone's in a really hyper-stressed state, it's harder to lose weight. It's hard to regulate down and get good sleep and growth. It doesn't make any sense that you would need to toughen up your nipples. There is no science behind that. And I'm gonna go back to my number one thing that I could shout from rooftops: breastfeeding should not be painful, period. There's no ifs, ands, or buts. It should not hurt. Now, when I see a first-time mom, a baby's got a really deep latch and everything, they might feel a twinge initially of, whoa, that feels weird, right? Or, huh, I've never felt anything like that. Should it be painful? No. Should they say, ouch, that really hurts? No. Should they curl their toes and have to take deep breaths and try to make it through? Hell no. This should not be painful. Okay. So yeah, we're gonna toss that one out and say, okay, you clearly don't know what you're talking about. So I think the the one benefit of these crazy things is that when someone says this to you, it shows you that they have absolutely zero breastfeeding knowledge. They are not a provider that you should ask about infant feeding when they say something ridiculous like toughen up your nipples. You know, many of my clients and say most of them a week when I am the first to see the tongue tie and I do a very thorough assessment. I'm not just looking at the anatomy of the mouth because that's only one small aspect of it. I'm really doing a functional assessment. I will watch how baby's tongue moves. I will have mom put her finger in and describe the suctomy. We'll watch the lateral movement, the extension, the elevation. How high can that tongue get up? I'm much more concerned about elevation than I am about extension. So when a pediatrician says, well, the baby can stick out their tongue, they're not tongue-tied, I'm like, the breast is not an ice cream cone. Okay. That is not the movement we super need at the breast. What we need is elevation. The tongue needs to come up off the floor of the mouth and it needs to hold on to the breast to get the milk out. Not to mention the tongue needs to come up off the floor of the mouth and rest against the palate when baby is sleeping to widen that airway and create a good space. That is normal oral rest posture, tongue up against the palate. So when I see a baby that has no elevation, it is clearly a tongue tie, right? We are tied down in the floor of the mouth. So I find it really interesting when I do this very long functional assessment. I will describe what's happening with the parents. We will talk about how we have no lateral movement, we have no elevation, we have very minimal extension, we have no cupping ability. These are things that the baby cannot do, even separate from feeding. These are functions that the mouth needs to have that it's unable to do. And, you know, we'll do even when I'm seeing someone virtual, the parents will be my hands on and I will talk them completely through a virtual exam. We will lay the baby down with good lighting. We'll put a roll under its neck or under the shoulders, get the head to tip back so that chin is off the chest, you know, and I'll talk the parents through where their hands go. And then what's amazing to me is then they put their hands in, and most of the time I'll say, the parents will say, Oh, wow, look, there it is. I can see the tongue tie. And I'm like, uh-huh. When you look, and then they will go back to the pediatrician and say, Oh, yeah, well, my lactation consultant said baby has a tongue tie. So we're gonna meet with this provider, this pediatric dentist, and talk about a release. They will be told, well, tongue tie is just a fad. It doesn't exist, it will stretch, or the pediatri the pediatric dentists are just trying to make money. That one's probably the most funny to me because first of all, doctors are not known for being a poor profession, but to poke at a pediatric dentist, I think is really unprofessional, first of all. And second of all, pediatric dentists will be pretty honest. It can be a fairly lucrative career. And it's easier without tongue tie. There is less insurance issues and easier when you're just treating kids, doing cleanings and talking about spacing, even drilling and filling, which, you know, many of them talk about how that's not really their favorite part of the job. But that's easier and fairly lucrative. For a lot of them, tongue tie has been a much bigger struggle because they're either needing to require cash pay because they have the insurances won't pay at all, or they're struggling with insurance. And if they're doing cash pay, then it's harder because I know a lot of clients can't afford that. And so they're trying to find ways to make it doable. I don't know any pediatric dentists who are release providers who are doing this for the money. I know a lot of them. I've met with many of them throughout this country in the last year. And most of them, if not all, have a personal reason for this. You should ask them. Go and meet with one, and I bet you you will hear all about their story of how they were not heard or their child's issue was not heard, their problems were not seen, and it took fighting for their own answers, and then it led them down this career path. I mean, you can read the Tung Tai book by Dr. Richard Baxter and others. He has multiple other providers write chapters with him, which is fantastic because he's very big on the team approach. And he will talk very candidly about how his twin's birth was a huge impetus in his career. How before that he really didn't know anything about tongue tie, even though he was a board-certified pediatric dentist, that it just hadn't come up. And he said, you know, he knows more about a rare condition that's one in a hundred thousand that he will probably never see in his career, but tongue tie that affects one in three, they didn't teach anything about it. So saying that pediatric dentists are doing this for the money, I think is extremely demeaning and is a way of really trying to scare parents. If you talk to the release providers out there, so many of them are led by personal stories. There are some who are not. There are some who, you know, they learned about it and then they saw the effects for their clients and they thought that was amazing and they kept going. And those are wonderful providers, just as wonderful. But a lot of them are on this because it was their journey as well for their child or themselves or family member. They're not doing this to make money. So, and the tongue tie is a fad. Well, that's pretty ridiculous because there is a tool they use to look at the tongue. It's called the groove tongue director. It looks like a stick with a U at the end. It doesn't cut, you just lift up the tongue, right? And that U goes where the frenum is. And it's just to help you look, right? To hold up the tongue and look. That tool was designed in the 1600s. Okay. We have artwork depicting midwives that would keep one long pinky nail usually. And after birth, if the baby had a tongue tie, they would pop it with their fingernail. So I'm gonna say 400 years is not a fad. Not really. So we can really say that when a provider is using those statements, again, they're clearly not educated in this area. They are not the experts to refer to when they say tongue tie is a fad. Because if you say that, you clearly don't know the history of tongue tie. You don't, you're not acknowledging how long these tools have been around, how long treatment has been around and assessment of tongue tie. And so we can pretty much toss that one out. And the it'll stretch, fascia is not going to stretch like that. And we're not going to change the tongue function. I also especially love, I forgot this one for a lip tie baby. Parents are told, just wait, the baby will eventually fall and rip it. Okay, when is trauma a treatment plan? If the baby had two fingers fused together, would you say just wait? Maybe they'll fall one day and rip them apart. I think not. I think I'm not going to choose trauma for my child that might be, let's start with really traumatic, painful, might not do a good job, might be really ragged and still need treatment because it was incomplete or is bleeding or is just really ineffective. And the idea that a provider would tell a parent to wait and, you know, that their child will have a traumatic event that will fix something rather than a planned procedure with pain management, that's pretty terrible. I I don't know any treatment plan that is supposed to focus on trauma. None. So addressing a lip tie with trauma is very terrible medicine. And again, there are times that these things are said and done because they are children and you know, it's not going to what be painful for them. That's ridiculous. It's not going to affect them and be traumatic. Again, ridiculous. Would you tell an adult that? Just, you know, go fall down the stairs and see if you rip your lip open. I think not. So that's, you know, I think the theme for me is that when we hear all of this, it shows their bias and it shows their lack of education. So when you hear a provider say, you know, oh, toughen up your nipples or tongue tie is a fad, it just shows that they're not the person to talk to. They are clearly not an expert in this because they have no idea the current research, the treatment plans, the history, or the management of tongue tie or breastfeeding management, really. I've had quite a few babies recently that weren't gaining. And the parents are told, just give formula. It won't affect your milk supply, just give a few bottles of formula. Okay, number one, gonna go back again, not an infant feeding specialist, not a breastfeeding specialist. So it is not a good idea to advise parents to do something like that without incorporating a team member who's actually trained in this, like an IBCLC. So these poor parents go home and are told, well, your baby's not gaining, you have to supplement. And now what happens? The milk supply drops. And within a few weeks, baby won't take the breast. They have no breast milk to pump and they're fully formulated. And then the moms are left feeling like they don't know how it happened, but it just slipped right through their fingers. Right. So when a family comes to me, I'm always really happy when they come to me and they say, Hey, my pediatrician, you know, I'm calling you because my pediatrician said I have to supplement. And I'm like, okay, let's take a deep breath and let's look at all the facts and let's create a plan. And I always, always want the baby fat. But there are many ways to do that. It does not need to be a bottle of formula. Mom might have enough milk to pump and give baby. Or we might be doing formula, but we might be using a tube of the breast rather than a bottle, right? To help keep that stimulation for mom and to keep that breastfeeding relationship. There are so many other ways rather than just a bottle of formula that it again, it shows a very big lack of infant feeding knowledge that that is just the go-to. And it's really just because it's easy and they can check off the box and say weight gain wasn't enough, told the parents supplement. Moving on. So it's very unfortunate. Recently, I also had one told to thicken the bottle with formula or oatmeal. So to actually take a bottle of breast milk and add something to thicken it. This one I just about laughed out loud. I tried to keep it in because I didn't want to be unprofessional, but I was so shocked. I thought that really went out in the 70s. There are rare cases where an infant needs thickened food. They have swallowing disorders, they're being followed by a team, they've got a SLP usually, they've had a swallow study. Frequently, these are NICU graduate babies. That's different, right? They've got aspiration risks. That is completely different. And that is the exception to the rule because there's always an exception to the rule. The idea that you're going to take a healthy but non-gaining three-month-old and just shove some oatmeal or rice cereal or formula in the breast milk bottle to thicken it up. I don't even know what to say to that. I'm so shocked. I'm like, what? Okay, I really thought that went out in the 70s. How about we know that using a regular bottle and nipple with thickened formula is going to create such a force for the child to suck through that they're at really high risk of an ear infection or ruptured eardrum? How about the fact that that is really, really not advisable? And again, not evidence-based practice. I'm just so shocked sometimes that we, as lactation consultants, as IBCLCs, I do hear from pediatricians through the parents that, you know, we're not using evidence-based practice on tongue tie, right? That we don't have these big, you know, double-blind IRB studies to show that this is what we should be doing. And I always dress address that first by saying there's lots of evidence out there. And it doesn't all need to be a double-blind IRB for many reasons. One is that when you have a treatment that you know to be beneficial and you're testing out different theories of it, it's very unethical to withhold that treatment from half of the population that you're treating. And like, what are you going to do? A placebo tongue tie and say, oh, we pretended, but we didn't cut. I mean, you know that it can help. It's unethical to withhold it. So working with newborns and breastfeeding parents, it's it's very complicated. So it's much harder to do. I mean, generally, working with infants is really hard to do double blind studies. But there is evidence out there. We do have studies happening. We do have them in the past, 10 years. And it's always, you know, I'll get a provider who says, Oh, this, you know, this study said Teng Tai was way overtreated and didn't need to be cut in 90% of the cases. I'm like, what study? Oh, it's from 2002. Really? So you're going to use a 20-year-old study in a rapidly changing field where we're finally getting traction and looking at airway. Okay, well, how about these other five that were in the last five years? Oh, no, those don't count. Okay. So you only want to use your evidence, not look at all the evidence, because there are studies out there, guys, and there are more studies happening. Dr. Gaheri is doing some great research in Portland. He's an ENT that is very big in this field and a big advocate for really supporting parents and stopping the gaslighting that happens to new parents. Dale Tyler in Santa Barbara, ENT, same thing. She's a huge, staunch advocate of breastfeeding parents and is really tired of the misogynistic and demeaning way that breastfeeding parents are talked to by providers. You know, they're doing research. Dr. Zoghi is always doing research in LA. Richard Baxter is over here doing research in Alabama. I'm in in Florida today. So that's why I said over here because I'm on the East Coast right now, which is such a change for me, but a whole nother discussion. There is research happening and doesn't Come out as fast as we want? No. Does it ever in any field? No. Research is slow. Okay. Anytime it comes out fast, it's going to be tossed away saying it was done too fast anyway. So yes, we are still working on it. Yes, we have some research, but not as much as we want. But you know what? I'd love to see a ton more research. I'd love to see more research on breast milk. Do you know we know more about cow's milk and all of the functions and the properties in cow's milk, how it's made. We know everything about cow's milk because dairy farming is a huge industry in this country, as is cow's milk products. We know more about cow's milk than we do about our own human milk. It's amazing to me. So yeah, there's a lot of research I would love to see, but that doesn't negate the research we already have. Okay. We have great research. And so it's really important to use recent research and to follow and to stay current. You know, I think the universal fact with all of these statements from these providers is that they're just not knowledgeable in this field. They're not feeding specialists, they're not breastfeeding specialists, they really don't know what they're talking about when they say these things. And that makes it very clear. It's amazing to me, but that is just what they're showing. So the thing about staying up on research is that in any field, really any field, you need to stay up on current changes. My husband was a teacher for 15 years, but every year his lesson plans changed. Every year he was coming up with new projects and new lessons and reading books and staying up on the on new changes in his field. Okay. My brothers are electricians. There are changes in the electrical field all the time. Solar wasn't a thing when my grandfather was an electrician. Okay. There are changes. We all have to stay current in our field. Bottom line. That's why, like for me, that's why I love continuing education because there is so much more to learn. And every time I turn around, I'm finding another class that I want to take. And, you know, last year taking the IBCLC masterclass was insanely life-changing for my practice. The depth of understanding that it brought to my practice for tongue tie assessment was helpful, but tongue tie treatment, really understanding oral rehab and how these exercises work, how reflexes play a part, how to assess and deal with reflexes that aren't being exhibited in a newborn. It was very big. I've been, I'm currently taking a great gut class from Jennifer Toe. I'm taking the Tung Thai Academy Light for non-release providers from Dr. Richard Baxter. You know, I just took a pumping and bottle feeding class because I work with plenty of pumping and bottle feeding mamas and I want to support them just as well. So I'm constantly taking more classes. And all of the providers that I have interviewed, that I have worked with, that I am really finding in this space that are doing great things, they're all education junkies. Like we're all taking way more units than we really need. And we're really trying to stay as current as possible. And it's not just the conferences and classes. That's part of it. Part of it's books. Part of it is staying current with other providers. You know, I just being a part of a group of other providers who have taken the master class, have continued to learn because someone will post a new article. Hey, did you see this article? Or they might say, you know, I made a change to my practice recently and I tried this and this is what happened. What do you guys think? You know, having that hive mind, right? Having other people around who are all trying to stay as current as possible and do their best in this space is uplifting. And I think it really resonates with me because we should lift each other up. We should not demean other practitioners, right? You know, I think pediatricians are great. I think they know so much over 18 years. I just think that it's important to know their limits. You know, if they have a child that comes in with cardiac issue, you know, and they are going to send them off to a pediatric cardiologist because they're going to say, I don't do little baby hearts. That's not my thing. I'm a primary care. And that is the appropriate thing for them to refer them off to an expert. What frustrates me is not pediatricians, because pediatricians are really knowledgeable providers. What frustrates me is the fact that they're not referring to IBCLCs as infant feeding specialists as they should. And they're trying to get in that lane and give infant feeding advice when they really don't have the training, the education, and the experience. So I would just, I mean, I've said it before and I'll say it again. I dream about a day when every pediatrician has an IBCLC in their office. And every appointment in the first couple of years, when you come in, you see the pediatrician and then they do their visit and then they leave, and then the IBCLC comes in the room and says, Hey, how is feeding going? And it's not just for breastfeeding parents. I'm more than happy to talk about bottle feeding. I love talking about starting infant food, like actual solid food. I can talk about sleep. I can talk about growth and development and you know, good great cups, because not all sipping cups are created equal or good developmentally appropriate toys. Like there's so much education that we could do if we only had the ability, if we had insurance visits and we could sit down with clients and see them at regular intervals, it would be absolutely amazing. So, and that is my dream. I don't know when or if it will ever happen in my lifetime, but you know, maybe one day I'll be able to make that dream and I will be able to work with a pediatrician and do that. Although my my current practice dream would be to work with a wonderful release provider, a body worker, and me and we all share an office and maybe we bring in a few other people and you know, just to be a one-stop shop where families can come and get the support they need for tongue tie would just be absolutely amazing. So, you know, as I travel, I'm kind of trying to figure out where I end up and thinking about that. So the other thing I really want to talk about today is part of my personal journey, and I haven't shared a whole lot about this. I have in the past talked about the fact that my kids are tongue-tied, that, you know, they're 10 and 13 and I didn't know this when they were babies. And I, you know, I've known for a little while, but it wasn't a rush. You don't need to run out and you don't want to just run out and do a phrenectomy or a phrenioplasty on an eight-year-old. You know, it takes more time and more thought and more preparation. And we were still trying to figure out what we were doing. And traveling has made it extra challenging because we're not in one area really very long. And I wasn't sure how to go about. So we were on our journey and I recorded a great episode with Dr. Maggie Davis, a pediatric dentist here in Tampa. And she was able to see my girls that day for cleanings, which was really wonderful and give them a nice little checkup. It had been like seven months since her last cleaning, so we were a little overdue, and that was great and no cavities, yay. But she pulled me aside and said, you know, we really need to talk about one of my daughters airway. You know, she said her palate is really high. And I said, I know. I said, I just I wasn't sure how we would deal with expansion while traveling. So we were kind of trying to see if we could wait. And she said, Well, I think you need to meet with the provider like right now because she's 10 and a half and you don't have the same time period on girls that you do on boys. Apparently, I'm learning a lot of this as I go. There are, I'm definitely more of an expert on the earlier years of tongue tie than the later years. I'm definitely more comfortable in the release and the body work and the oral rehab of babies, you know, a year or two under, but not as comfortable with oral expansion and learning that route. So been learning, and we met with a provider. And he definitely said that Kira's by her x-ray, her palate looks like it is closing on the early side. So we need to, I said very frankly, can we wait a year or a year and a half to wait on traveling? And he said, no. He said if we wait, her palate will be closed. So apparently you need to do oral expansion, palate expansion while they're in a growth phase before they stop growing. And girls stop growing much earlier than boys. You know, some boys can get away with that at 18 or 19, whereas some girls, they might be done by 12. Not all, right? I mean, there's definitely those might be the extreme ages, but you know, this is this is our reality at the moment. So um, I have been spending the last week trying to figure this journey out. I'm learning a lot. We started myofunctional therapy with Sandra Colson in Denver, who's absolutely amazing. She's probably the most experienced and knowledgeable myo in the country. And I feel very blessed that telehealth allows her to treat my child. We are learning and trying to understand all of this, but it's complex, right? We've got myofascial treatment that will be very beneficial bodywork for us that will be happening pre-release and post-release and hopefully day of release. We've got airway expansion with the palate. We have the tongue release so that it can get up into the palate and hold it open once the expander comes out. And we have trying to figure out the order of all of these things. And I have to say, number one, oh my goodness. I have such empathy for these parents right now. I know a lot of this. Like I said, the palate expansion is not really my forte. Okay. I know a lot of the earlier stuff, but I understand the tongue tie. I understand the airway development. I understand how her palate got to be like that. I understand that we need to fix it to prevent sleep apnea and further issues. I understand that her TMJ and her bruxism and her sleep is all connected to this palate and this tongue staying flat. And yet I was so hugely overwhelmed at this appointment that I was just floored. It definitely gave me a new perspective of when I sit down and talk with parents of like, oh my gosh, I know what you guys are going through. This is an awful lot for me to say, hey, your baby has a tongue diet. And while it may give you the answer you were looking for in some treatment plans, it also is hugely overwhelming. And you add to it that they are new parents, frequently with a baby under three months old. They're sleep deprived and hormonal. And I've just said that there's something wrong with their baby. It's got to be so overwhelming. I just, it gave me a lot of empathy for what new parents are going through and how overwhelming this process is. So I think on the positive side, this will help my practice and help me understand where my clients might be coming from. But there's a lot for me to learn here, right? I'm learning about myofascial treatment because that's not something we do on newborns as much. Some providers do. Where I worked before, we really didn't have any myofascial release providers. So we had cranial sacral and we had Cairo and we had good ones, but we didn't even have any osteopaths really that were great in our in my area. I've recently heard that a new one moved in that's really great, and that's a wonderful option for clients, but it depends upon what you have in the area. So I'm lucky that in the Tampa area, there are like three or four really great myofascial release treatment, you know, therapists. And I've been able to reach out with them and talk start talking about when to meet and that we're gonna do a treatment before the release, day of release, and at least one after. And considering that I'm gonna be doing it for three people, none of this is super cheap, which is also another thing that I definitely feel for all these parents. Only my youngest daughter needs the palette expander, but my older daughter, because I have two, my oldest and myself are both tongue-tied. And that means that we all need releases and we all need my own fascial treatment, and we all we all are gonna walk this journey together. I actually did not even realize that I was tongue-tied because I think I just hadn't really thought about it. I have my own other health issues. I have a chronic pain syndrome, I have small fiber neuropathy, and I had a shoulder replacement and have shoulder issues from an injury. So I just, you know, I wasn't looking at, I was managing those things and I wasn't looking at anything else. And it wasn't until I was actually at Richard's that I was sitting looking at Richard Baxter's office, looking at his intake forms, and I looked at the child, and then I looked at the teen and the adult, and I was like, oh, I have every possible check mark on here. I mean, if you look at my childhood, I did breastfeed for a year and a half, but it was painful in the beginning. I was very colicky, very colicky, and it did a lot of spitting up and not a lot of sleeping. I wet the bed as a school age kid until I was about eight, I'd say. I slept very, very deeply, like unable to wake me deeply or extremely light. And from the time I was about four to seven, I had grandma seizures. So I had mouth breathing, right? We know that tongue tie, open your mouth to breathe. Then I got enlarged tonsils and adenoids. And, you know, there's no way to know 100%, but I had two different providers. I had a really fantastic, knowledgeable pediatrician at the time, and I had a neurologist, and they had differing opinions. My neurologist felt that I had, you know, some neurological issue that she couldn't quite figure out yet. My pediatrician felt that my tonsils and adenoids were compressing my airway, my trachea, and that they, that my body was causing a grandma's seizure to move them. And that once they moved and I could breathe, the seizure stopped. And they only occurred when I was sleeping. So, you know, fast forward a couple of years when I was about seven, the tonsils and adenoids were removed, and I never had another seizure. I was on meds until I was about 10. Those were terrible of phenobarb and tegra tall were not fun as a little kid. But when I look back and I'm like, and I was in speech therapy, I still occasionally get a little self-conscious when I say words like girl and world, my tongue has trouble with the RL. And overall, people don't generally notice it. I think I do in my head, I'll hear it when I say something, especially if I'm talking quickly, which I tend to do, or if I'm, you know, hanging out with a SLP as I do sometimes, they notice it because it's what they do, right? But like I had all these symptoms, and I don't know for sure that the seizures were 100% caused by the tongue tie. I don't think it's possible to know, and I haven't really heard of that. But again, if you take mouth breathing to enlarge tonsils and adenoids, and the tonsils and adenoids were causing the seizures, that's all based on the tongue tie, right? And I think, my gosh, all the years of poor sleep and you know, this forward tongue posture low in my jaw that has crowded my mouth so much. I had a ton of cavities at three, despite oral hygiene that was good for my parents. I had eight teeth pulled in order to try to fit what I have, and I still don't have quite enough room because I have a very narrow pointy jaw. And we know that a narrow, pointy jaw does not have a good airway, that like a nice, wide, square jaw has more space to breathe. So I am lucky in the sense that at this time in my life, I now have a pretty flat palette. My tongue can rest nicely up there. I don't know how that managed to happen, but I do have it. So I will address my tongue, but thankfully I don't need to worry about my palate. I'm not sure that palate expansion at my age is possible, but very difficult and a much, much longer process than it is on a 10-year-old. So I'm lucky in that sense. But this whole process is overwhelming for me, and I know a lot of this. I am shocked and amazed by the resiliency and just the strength in humans that these parents are able to understand and pull this all together and move forward. It's a lot. It's a lot to learn, it's a lot to do, it's a lot of cost and a lot of time. You know, we were supposed to leave Florida on March 9th and start our journey slowly up towards DC to be there in April and, you know, had plans of heading into Georgia and going to Savannah and Charleston and heading up to the Great Smokies and heading up to Shenandoah and DC. And we like to move at a somewhat slower pace. I mean, I don't like to drive four days in a row and just drive, but we also generally like to stay a week to 10 days in an area. It's very unusual that we stay longer. We did stay in New Orleans for a month, but New Orleans, in my mind, is a very special place, or at least it is now. But we won't be leaving in March. You know, I'm hoping that we can get out sometime in early April so we can still get up to DC in time for, you know, cherry blossoms and enjoying DC and taking my kids to all the museums and the monuments and Smithsonians and all of these things before the intensity of summer. Um, I definitely don't want to be in DC in summer, crowds and weather. So, you know, I think that it's going to take a lot of adjustment for us. And I don't have all the answers yet. Still trying to work out timing and what part comes first. Like I said, we started Mayo, but only just started Mayo, like this week. And so we need to have a little bit more Mayo and figure out our plan. You know, when everyone's plan can look a little bit different. There isn't always one right answer, but having a good team makes it all come together, right? Feeling heard and having support is huge, absolutely huge. So I will be hanging out in the Tampa area longer. I don't know exactly what that will mean for all of us, but I know that, you know, it'll give us a chance to hang out in an area and we will learn more about Tampa. And we've been enjoying it. I mean, we went to a manatee viewing area the other day, and there were so many manatees. I mean, there were like probably more than like a hundred manatee in this area. It was unbelievable. And there were baby manatees, they were so cute. But, anyways, we do enjoy the traveling. And right now we're just gonna have to put a little pause in it and stay in Florida while we figure out how to do all of this. And as I said, I don't really have a full plan and dates figured out yet. By the time I do my next update in a couple months, I'm sure I will have a lot more information to share with you guys. And I'm excited to share, I will be sharing my photos pre-imposed. My kids are not on social media. I'm pretty old school. So even though they are at that age of 10 and 13 where those things could happen, I'm not doing that yet. So I will share mine. I will share info of my kiddos, but not their photos. And so you'll get to see my tongue tie and I'll talk about my myofascial treatments and how that works and what it's like, and you know, really, really highlight what this is and what it's like from an older perspective of teens and adults instead of babies, which I know so well, but that's not my reality right now. So I am excited to share this journey with you guys and you'll have to stay tuned to hear more. But before my next update, you have some other great episodes coming up because you let's see. This episode will be airing in March. Before that, you'll hear from Dr. Maggie, who is the release provider who's probably going to do our tongue tie releases. Um, and then there's after this update, you'll be hearing from um Richard Baxter to Alabama Tongue Thai, and you'll be hearing from Dr. Casey Lynn. And I have more and more episodes scheduled. You guys, there's so many great providers that I'm just dying to meet with that I am really enjoying this process. I'm learning so much, and it's really very beneficial. So I'm hoping that you are enjoying this process as much as I am. And I look forward to sharing the journey with you. So reach out, let me know what you think. Let me know your questions and thoughts and comments. You know, if you have a provider you think I should talk to or spend a day with, please share. I would love to know about more providers in this TOTS Airway space that I should reach out to. And if you have questions for me, please send them my way. I am Katie, the traveling lactation consultant on Instagram and Facebook. You can find me on my um private practice website as well at cuddlesandmilk.com. And I'm excited to hear from my listeners. So thank you so much and have a great day. When you change the way you look at things, the things you look at change you. I hope that you enjoyed the podcast today and learned something new. If you know someone who would benefit from this podcast, please share.