Are Purees Making Our Babies Jaws Weak? with Nicole Goldfarb, MA, CCC-SLP, COM

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<v SPEAKER_1>Are you trying to squeeze the starting solid food stuff into your already busy schedule?

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<v SPEAKER_1>Well, I have an all-in-one, done-for-you solution that's going to take the guesswork out of feeding your baby.

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<v SPEAKER_1>My online program is called Baby-Led Weaning With Katie Ferraro.

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<v SPEAKER_1>Contains all of my Baby-Led Weaning training videos, the original 100 First Foods content library, plus a 100-day meal plan with recipes, like the exact sequence of which foods to feed in which order.

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<v SPEAKER_1>So if you want to stop trying to piece all this feeding stuff together on your own, I would be honored if you would join me inside of the program.

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<v SPEAKER_1>You can get signed up at babyledweaning.co/program.

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<v SPEAKER_1>So which foods are not safe for your baby to eat?

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<v SPEAKER_1>You guys know I'm usually all about sharing all of the foods that your baby can safely eat, but there are definitely some foods that we steer clear of when starting solid foods.

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<v SPEAKER_1>I have a free feeding guide called 15 Foods Never to Feed that will help you recognize which foods aren't safe.

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<v SPEAKER_1>Now, most of the foods inside the 15 Foods Never to Feed guide we avoid because they're choking hazards, but I'm providing you with tips on how to modify those foods so they are safe for your baby to eat.

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<v SPEAKER_1>You can download the 15 Foods Never to Feed free feeding guide by going to babyledweaning.co/resources.

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<v SPEAKER_1>Again, that's babyledweaning.co/resources to download your free feeding guide 15 Foods Never to Feed with the modification tips on how to make those foods safer.

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<v SPEAKER_1>Happy feeding.

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<v SPEAKER_2>That is probably one of the largest causes of the changing human face.

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<v SPEAKER_2>And they call it epigenetics.

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<v SPEAKER_2>The changing human face has a lot to do with the way we're eating or not eating well.

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<v SPEAKER_2>And it's not just the nutrition, but the mechanics of eating.

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<v SPEAKER_2>Mastication, so chewing, builds and forms bone.

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<v SPEAKER_2>Three, four, 500 years ago, there was no malocclusion.

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<v SPEAKER_2>There was no issues that needed orthodontics.

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<v SPEAKER_2>The jawbones fit all 32 adult teeth.

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<v SPEAKER_2>But as the foods changed and foods became processed, the pre-industrialized revolution, foods became processed, sugars were added, foods became cooked and soft.

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<v SPEAKER_2>Human beings stopped using their jaw muscles as much.

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<v SPEAKER_2>And what happens is the jawbones didn't grow enough.

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<v SPEAKER_1>Hey there, I'm Katie Ferraro, registered dietitian, college nutrition professor and mom of seven, specializing in baby-led weaning.

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<v SPEAKER_1>Here on the Baby-Led Weaning with Katie Ferraro podcast, I help you strip out all of the noise and nonsense about feeding, giving you the confidence and knowledge you need to give your baby a safe start to solid foods using baby-led weaning.

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<v SPEAKER_1>Are purees and pouches making our babies' mouths lazy and their jaws weak?

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<v SPEAKER_1>There's some evidence to support this idea that even as recently as a few centuries ago, reliance on a less processed diet that had a variety of textures that required active chewing of food earlier in the lifespan led to a stronger oral cavity and draw structure that could fit all of your adult teeth.

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<v SPEAKER_1>And there weren't all of these orthodontic problems in the airway and the sleep and the breathing issues that routinely plague both pediatric, but particularly adult populations now.

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<v SPEAKER_1>My guest today is Nicole Goldfarb.

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<v SPEAKER_1>Nicole is a speech language pathologist and an oral myofunctional therapist.

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<v SPEAKER_1>So she's gonna explain what oral myofunctional therapy is, but essentially it involves the muscles of the mouth and the face and how they work or function or dysfunction.

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<v SPEAKER_1>And I struggled a lot with breastfeeding my oldest baby.

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<v SPEAKER_1>I remember going to every lactation consultant in town and I could not figure out why would my daughter latch perfectly, but then transfer exactly zero breast milk.

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<v SPEAKER_1>I eventually got a referral to an oral myofunctional therapist.

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<v SPEAKER_1>And I remember I was like in a very dark place with regard to breastfeeding.

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<v SPEAKER_1>I was willing to try anything.

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<v SPEAKER_1>And to be honest, I was not super impressed with, nor did I have much in the way of results from our few therapy sessions, but it turned out my daughter had pretty severe nerve damage due to a traumatic birth experience that no amount of therapy was going to undo.

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<v SPEAKER_1>But once things got settled down, I switched to exclusive pumping.

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<v SPEAKER_1>I felt like a little bit of a human being again and willing to venture out with my baby.

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<v SPEAKER_1>I remember meeting my neighbor, Nicole, and had met a lot of neighbors we were relatively new to our neighborhood.

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<v SPEAKER_1>Nicole, of all things, happened to be one of the leading oral myofunctional therapists, certainly in the United States.

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<v SPEAKER_1>We've become friends.

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<v SPEAKER_1>We've stayed in touch personally and professionally over the years.

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<v SPEAKER_1>And I'm always, every time we chat, I'm like amazed how overlapping our fields are, even though they wouldn't sound related, because Nicole specializes in airway and breathing and sleeping disorders, which stem from oral myodysfunctions, but they're also severe.

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<v SPEAKER_1>Eating implications here too, right?

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<v SPEAKER_1>Because you don't just learn how to eat in your mouth or breathe in your mouth or speak from your mouth.

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<v SPEAKER_1>These are all overlapping experiences that happen simultaneously.

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<v SPEAKER_1>So recently I was a guest on Nicole's podcast, which is called Airway Answers by Airway Circle.

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<v SPEAKER_1>And we were talking about baby-led weaning, but we kind of like went off on this tangent about the detrimental effects of just relying on purees and allowing babies to only eat purees and how this is doing a disservice to both the muscular function, as well as the jaw and the bone development.

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<v SPEAKER_1>So I wanted to have Nicole on my podcast to explore some more of these ideas and whether or not a heavy reliance on pouches and purees is indeed making our babies' mouths and jaws weak.

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<v SPEAKER_1>So with no further ado, here is Nicole Goldfarb teaching us a little bit about what oral myofunctional therapists do and how we can help our babies have better and stronger jaw and bone structures by challenging them with trickier textures.

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<v SPEAKER_2>I went to Target, you know, 11, 12 years ago with my son and pulled off all the sucking pouches and bought all those.

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<v SPEAKER_2>And, oh, that looks great.

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<v SPEAKER_2>Like pureed apricots, you know, it's easy.

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<v SPEAKER_2>And I thought that was normal.

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<v SPEAKER_2>I would puree all the foods for him too.

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<v SPEAKER_2>And I was like, oh, well, I'm making it.

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<v SPEAKER_2>So it's better.

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<v SPEAKER_2>So I would, you know, blend it all up.

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<v SPEAKER_2>I didn't know about this stuff back then.

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<v SPEAKER_2>Pacifiers, sippy cups.

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<v SPEAKER_1>And Nicole, you are a speech language pathologist, but your area of expertise and specialty is so unique.

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<v SPEAKER_1>How did you come to specialize in oral myofunctional therapy?

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<v SPEAKER_1>And what exactly is that?

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<v SPEAKER_1>Because I know I never even heard of it until my pediatrician referred me with my oldest daughter.

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<v SPEAKER_1>And then I was like, wait a minute, I think this is what Nicole does, which is like very, very rare, because not many SLPs do this.

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<v SPEAKER_1>So what is it about and how did you get involved?

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<v SPEAKER_2>Yes, an amazing pediatrician knew what it was and referred you, because that doesn't happen often.

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<v SPEAKER_2>I wouldn't say the majority of our referrals are from pediatricians.

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<v SPEAKER_2>It's more dentists, orthodontists, some ear, nose and throat doctors.

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<v SPEAKER_2>So oral facial myofunctional therapy is like the longest word ever or string of words, but I like to break it down for patients and people who aren't sure what it is into its components.

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<v SPEAKER_2>So oral is mouth, facial is face, myo is muscle, and function is what those muscles do for chewing and swallowing of foods, liquids, saliva, for speech sounds, and oral rest posture.

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<v SPEAKER_2>So how our lips and our tongue rest when our mouth is not moving.

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<v SPEAKER_2>So we work with patients who have oral facial myofunctional disorders.

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<v SPEAKER_2>So any problem with the oral facial muscles.

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<v SPEAKER_2>And oftentimes it will be people who are undergoing orthodontic treatment.

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<v SPEAKER_2>So most cases where somebody needs orthodontic treatment, it's actually caused by a oral facial myofunctional disorder, or we call it soft tissue dysfunction.

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<v SPEAKER_2>Now this is where it gets interesting.

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<v SPEAKER_2>The mouth is supposed to rest in a certain way from even fetal development throughout childhood, throughout adulthood.

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<v SPEAKER_2>We should be resting with our lips closed, sealed.

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<v SPEAKER_2>Our tongue sucked up to the palate, sucked up to the roof of the mouth, front, middle, back of tongue, gently suction to the roof of the mouth, behind the front teeth and within the dental arch.

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<v SPEAKER_2>Okay, so our tongue should kind of fit up on the roof of the mouth with our lips closed and our teeth should be slightly apart.

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<v SPEAKER_2>We should be nose breathing all the time, except if we're congested or you're really breathing quickly because you're exercising and you're out of breath.

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<v SPEAKER_2>But otherwise, that's the normal healthy way for our mouth to rest and breathe.

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<v SPEAKER_2>And our oral structures like our tongue and our lips are actually natural orthodontic appliances.

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<v SPEAKER_2>So the pressure from the tongue on the roof of the mouth will help grow the roof of the mouth wide and forward the way it should grow.

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<v SPEAKER_2>And the lips closed will help the teeth grow in a correct patterning to their genetic potential.

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<v SPEAKER_2>But when we have people, and this is a very common thing, it's kind of like the human condition where people have allergies and large tonsils, adenoids, all different issues, tongue tie, lip tie, that can cause the person to rest with their mouth open.

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<v SPEAKER_2>So lips open, mouth breathing, we might call it, or the tongue low or forward in the mouth, putting pressure on the teeth or between the teeth.

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<v SPEAKER_2>This will impact the way the face grows and the jawbones grow.

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<v SPEAKER_2>And if we want to take it a step further, the way we breathe and how much space we have to breathe in our upper airway is determined by the shape of our jaws and how far forward they've grown, how wide they've grown, and whether or not we're nose breathing.

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<v SPEAKER_2>And if there is oral facial dysfunction and our articulators aren't resting in the correct position throughout birth and growth and development, we're probably gonna get dental malocclusion.

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<v SPEAKER_2>So narrow palate, crowded teeth, crooked teeth, jaws that might be back or like an underbite or issues like that.

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<v SPEAKER_2>And that can all impact our breathing, which impacts, can further impact to the quality of our sleep.

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<v SPEAKER_2>And that's a long discussion.

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<v SPEAKER_2>I can get more into that if you're interested, but all of that is kind of like a cascade of events that can impact overall health and wellbeing.

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<v SPEAKER_2>So I got interested in this because I was a speech pathologist for about seven years working in a school district.

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<v SPEAKER_2>And this is not in any speech therapy graduate training program.

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<v SPEAKER_2>Oral facial myofunctional therapy is not in any program.

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<v SPEAKER_2>So although most people with speech articulation issues have an underlying oral facial myofunctional issue, that was missed.

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<v SPEAKER_2>That's like the underlying cause.

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<v SPEAKER_2>And so when we see kids with a LISP or they say there are like a W, like wabbit instead of rabbit, or a frontal LISP would be like the word bust, they might say bust with their tongue sticking forward, or even on the sides kind of sounds slushy, like bust.

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<v SPEAKER_2>Those almost all of those cases, it's actually an oral facial myofunctional disorder.

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<v SPEAKER_2>And the symptom is you're hearing a LISP, okay?

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<v SPEAKER_2>So if you don't treat the underlying cause, those kids can be in speech therapy for years and years and years, and it may never fully resolve or it may take many, many years to resolve.

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<v SPEAKER_2>So that's how I got interested, was I worked in the schools, pulling kids from class 30 minutes, once or twice a week for years.

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<v SPEAKER_2>I mean, they're missing class to kind of do drill and kill work on their speech sounds, like say the word, Sam sells socks three times in a row.

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<v SPEAKER_2>We're just drilling this.

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<v SPEAKER_2>And I see these kids, most of them are doing really well, but it's not carrying over.

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<v SPEAKER_2>It's, they're getting better.

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<v SPEAKER_2>And then when they were ready to leave the speech session to tell me about their upcoming vacation, they all of a sudden have the lisp again.

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<v SPEAKER_2>And I also notice, well, wait, a lot of these kids are mouth breathers, their tongue is low and four, their tongue kind of looks large.

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<v SPEAKER_2>And so that's when I went and got training in oral facial, myofunctional therapy, and my entire career and life changed.

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<v SPEAKER_2>I did not look at anybody, patients, students, friends, family members, the same, because once you see this, you can't unsee it.

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<v SPEAKER_2>And that's kind of where I shifted to be specialized in oral facial, myofunctional therapy and even more focused on airway disorders, snoring and sleep apnea, things like that.

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<v SPEAKER_1>Hey, we're gonna take a quick break, but I'll be right back.

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00:12:35.012 --> 00:12:40.652

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<v SPEAKER_1>I remember when my kids were little, I would be like, look at their mouth, what is this?

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<v SPEAKER_1>Is this normal, is this okay?

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<v SPEAKER_1>You kind of have to see it to believe it, and obviously you've seen more than almost anyone.

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<v SPEAKER_1>Now, tell me about what sort of underlying feeding-related issues could cause oral-facial dysfunction, just some ideas that would, you know, you mentioned the tongue tie, rather, that got missed, that of course could infect, I mean, in the child's case that you were telling us the story of that, that person was on a feeding tube because of an inability to meet their nutrition needs from an oral diet alone.

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<v SPEAKER_1>What are some other things besides a tongue tie that might lead to this oral facial dysfunction that you see in your clinic and your practice?

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<v SPEAKER_2>And tongue tie and lip tie.

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<v SPEAKER_2>So usually when there's a lip tie, like upper lip tie, nearly every case there's also a tongue tie.

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<v SPEAKER_2>And if that's not diagnosed and someone says, oh, your child just has a lip tie, they probably missed the tongue tie.

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<v SPEAKER_2>So we really need specialists who are specifically trained in evaluating lip and tongue tie to look at these issues.

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<v SPEAKER_2>So we see lip and tongue tie, premature babies.

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<v SPEAKER_2>So prematurity is 37 weeks or earlier.

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<v SPEAKER_2>And most premature babies have not had, okay, this is actually really interesting.

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<v SPEAKER_2>The last three months in utero are considered, the fetus is considered like an athlete.

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<v SPEAKER_2>So a sleep specialist in our field, the father of sleep apnea, Dr.

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<v SPEAKER_2>Christian Guimano, he's no longer alive, but he describes these last three months in utero as like an athletic phase for the fetus.

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<v SPEAKER_2>And I find this just so interesting because you just think like, oh, I'm carrying this baby and it's going to come out and we're getting started.

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<v SPEAKER_2>But that's actually the baby is training in oral motor reflexes in utero.

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<v SPEAKER_2>So they're sucking and swallowing, but not for nutrition.

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<v SPEAKER_2>They're sucking and swallowing amniotic fluid to practice strengthening and working the muscles.

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<v SPEAKER_2>They're breathing, but not for oxygen because they get the oxygen from the placenta, but they're actually working the lungs and practicing breathing.

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<v SPEAKER_2>And if there's a tongue tie in utero, the tongue then is already resting low.

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<v SPEAKER_2>So we already see the baby is going to be born with some dysfunction.

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<v SPEAKER_2>So premature babies, that training time in utero is actually cut short.

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<v SPEAKER_2>So most babies have hypotonia of prematurity.

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<v SPEAKER_2>They have low muscle tone.

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<v SPEAKER_2>So that is one of the big populations where we're going to see the babies being born that are going to need extra support.

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<v SPEAKER_2>They're going to need stimulation of the oral facial muscles and it could be an OT.

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<v SPEAKER_2>It could be a speech language pathologist, but they need specific training in oral sensory motor for the early intervention, that infancy age group, which I don't have that training and you don't want someone to just, any speech therapist, right?

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<v SPEAKER_2>You need to be specifically trained working with that age group.

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<v SPEAKER_2>So the low muscle tone, what happens is there's less sucking and swallowing going on, less of the muscular skills being used and we need to stimulate the reflexes, stimulate the muscles.

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<v SPEAKER_2>There are certain pacifiers, certain programs that are gonna help trigger those reflexes so those babies can get caught up because when there's less of the sucking patterns that are good with good muscle strength and tone, that's going to impact the way the bones of the face grow.

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<v SPEAKER_2>So we might see those types of issues.

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<v SPEAKER_2>Congestion is a big issue.

00:17:19.423 --> 00:17:32.083

<v SPEAKER_2>So allergies, environmental allergies, or even milk type allergies, anything that's gonna cause the person to not be able to breathe through the nose is going to impact how the muscles work.

00:17:32.403 --> 00:17:38.743

<v SPEAKER_2>Gonna trigger that mouth breathing because if you have to breathe through your mouth because your nose is plugged, of course you're gonna have to breathe through your mouth.

00:17:38.763 --> 00:17:47.103

<v SPEAKER_2>So that's gonna change the pattern of growth and development of the face and that can contribute to feeding issues, even simply chewing with the mouth open, right?

00:17:47.843 --> 00:17:53.663

<v SPEAKER_2>When kids are chewing with their mouth, smacking with the mouth open, that's a sign we might wanna look at what's going on.

00:17:54.543 --> 00:18:01.403

<v SPEAKER_2>Enlarged adenoids and enlarged tonsils that can contribute to feeding issues.

00:18:01.923 --> 00:18:10.603

<v SPEAKER_2>My son, he had issues when he was born and nursing is the catalyst for good oral facial growth and development.

00:18:10.883 --> 00:18:21.303

<v SPEAKER_2>Now I know not every parent can nurse their baby, maybe not every mother can nurse, but those who are able to nurse, nursing is like oral facial myofunctional therapy for an infant.

00:18:21.623 --> 00:18:23.383

<v SPEAKER_2>It's actually working the muscles.

00:18:23.963 --> 00:18:31.063

<v SPEAKER_2>So the peristaltic, like that wave-like motion of the tongue when the baby's nursing is like a workout.

00:18:31.223 --> 00:18:32.563

<v SPEAKER_2>It's like a muscular workout.

00:18:32.923 --> 00:18:37.143

<v SPEAKER_2>Now, if there's a tongue die, but they're gonna compensate and nurse differently, and that's a different story.

00:18:37.683 --> 00:18:56.783

<v SPEAKER_2>But babies who can't nurse or who are having a difficult time nursing, who are making clicking sounds, having latch issues, milk coming out of the nose, reflux, spitting up, projectile vomiting, those are all signs of oral, facial, myofunctional issues that need to be investigated further.

00:18:57.503 --> 00:19:03.303

<v SPEAKER_2>Even mothers who have low milk supply, the breastfeeding is a dynamic, right?

00:19:03.343 --> 00:19:08.663

<v SPEAKER_2>And the mother's milk supply is dependent on the infant's ability to nurse effectively.

00:19:09.583 --> 00:19:22.223

<v SPEAKER_2>And so it's not the mother's fault in most cases, but the infant might not be nursing with good oral motor skills that could impact how much milk is being drained from the breast, whole variety of issues.

00:19:22.743 --> 00:19:27.063

<v SPEAKER_1>And you mentioned those in utero studies that look at babies swallowing amniotic fluid.

00:19:27.083 --> 00:19:29.463

<v SPEAKER_1>I love, there's like these great flavor development studies.

00:19:29.483 --> 00:19:41.883

<v SPEAKER_1>And sometimes I'm like, I don't know how rigorous the design is, but like they basically look at what the mom eats when she's pregnant and then they analyze like how many times the baby swallows and try to like develop a scale for like, how much does the baby like carrots or whatever the case may be?

00:19:41.903 --> 00:19:42.123

<v SPEAKER_2>But-

00:19:42.143 --> 00:19:43.183

<v SPEAKER_2>That's really interesting.

00:19:43.203 --> 00:19:44.023

<v SPEAKER_2>That's actually kind of-

00:19:44.043 --> 00:19:45.263

<v SPEAKER_1>I know, it's kind of, it's cool.

00:19:45.283 --> 00:19:57.943

<v SPEAKER_1>And it's just like this idea of like, yes, you can study babies swallowing amniotic fluid in utero, but I've also seen these other studies by anthropologists that kind of are trying to tie links between like what the current structure of the mouth looks like and all the need for orthodontics that we have now.

00:19:58.203 --> 00:20:15.543

<v SPEAKER_1>And they'll oftentimes tie it back to like, well, we're talking about populations eating at this point, like very highly processed and refined diets with minimal amounts of fiber, which from a texture standpoint, oftentimes means like things that are like highly pureed or that have been very processed to the point where like all the fiber has been obliterated.

00:20:16.043 --> 00:20:25.103

<v SPEAKER_1>Are you seeing that as well in your practice, like a lower fiber diet or perhaps, you know, over-reliance on very soft textures, quote unquote, makes the jaw weak?

00:20:25.123 --> 00:20:26.403

<v SPEAKER_1>I mean, we're talking about exercise.

00:20:26.423 --> 00:20:33.383

<v SPEAKER_1>Like we're not essentially exercising the mouth in the way that generations and millennia had in the past and the oral structure was stronger and more teeth could fit.

00:20:33.403 --> 00:20:36.663

<v SPEAKER_1>Like I see those studies sometimes and I'm like, this feels like it's like right up Nicole's alley.

00:20:36.763 --> 00:20:38.123

<v SPEAKER_1>Is there any validity to those?

00:20:38.143 --> 00:20:39.563

<v SPEAKER_2>Oh, completely.

00:20:39.803 --> 00:20:45.303

<v SPEAKER_2>That is probably one of the largest causes of the changing human face.

00:20:45.783 --> 00:20:47.323

<v SPEAKER_2>And they call it epigenetics.

00:20:47.423 --> 00:20:55.963

<v SPEAKER_2>It's not genetic changes because genes take hundreds of thousands of millions, I don't know, so many years to cause changes seen in a population.

00:20:56.243 --> 00:21:00.043

<v SPEAKER_2>But epigenetic changes can be seen within one or two generations.

00:21:00.423 --> 00:21:07.663

<v SPEAKER_2>And the changing and you're probably, you could probably describe that really well too from all the anthropological studies you've read.

00:21:07.963 --> 00:21:14.383

<v SPEAKER_2>The changing human face has a lot to do with the way we're eating or not eating well.

00:21:14.823 --> 00:21:17.803

<v SPEAKER_2>And it's not just the nutrition, but the mechanics of eating.

00:21:18.183 --> 00:21:22.243

<v SPEAKER_2>So if you think of, it's called the Wolf's Law of Bone Formation.

00:21:22.483 --> 00:21:27.183

<v SPEAKER_2>So muscle pressure, so muscle use triggers bone formation.

00:21:27.603 --> 00:21:33.003

<v SPEAKER_2>So that like mechanical strain on the bones causes the bones to strengthen and grow.

00:21:33.583 --> 00:21:37.303

<v SPEAKER_2>Mastication, so chewing builds and forms bone.

00:21:38.003 --> 00:21:41.783

<v SPEAKER_2>And three, four, 500 years ago, there was no malocclusion.

00:21:41.883 --> 00:21:44.803

<v SPEAKER_2>There was no issues that needed orthodontics.

00:21:45.203 --> 00:21:49.343

<v SPEAKER_2>The mouth, the jawbones fit all 32 adult teeth.

00:21:49.923 --> 00:22:05.923

<v SPEAKER_2>But as the foods changed and foods became processed, the pre-industrialized revolution, foods became processed, sugars were added, foods became cooked and soft, then human beings stopped using their jaw muscles as much.

00:22:06.363 --> 00:22:08.543

<v SPEAKER_2>And what happens is the jawbones didn't grow enough.

00:22:08.743 --> 00:22:13.303

<v SPEAKER_2>And our teeth, we still have the same number of teeth, but not enough space for the teeth.

00:22:13.323 --> 00:22:24.463

<v SPEAKER_2>So then we start seeing crowding of the teeth, other issues of teeth being crooked, not fitting together well, and then environmental factors like toxins in the environment, allergies.

00:22:24.803 --> 00:22:28.263

<v SPEAKER_2>So then people have to start breathing through their mouth because they're congested.

00:22:28.763 --> 00:22:42.483

<v SPEAKER_2>And then the face of human beings has changed from our caveman days, where you think of like wide, broad, forward jaws, to now we're like getting like these skinny long faces that are like retruded, pushed back jaws.

00:22:42.903 --> 00:22:46.723

<v SPEAKER_2>But what we really wanna do is make sure our kids are chewing.

00:22:47.023 --> 00:22:57.523

<v SPEAKER_2>So we don't want sucking of foods, sucking pouches, sucking is not the normal best way for us to be eating.

00:22:58.163 --> 00:23:00.483

<v SPEAKER_2>So we don't wanna puree all the foods.

00:23:00.483 --> 00:23:02.083

<v SPEAKER_2>We want textured foods.

00:23:02.103 --> 00:23:04.503

<v SPEAKER_2>We want strain on the bones.

00:23:04.523 --> 00:23:05.563

<v SPEAKER_2>We wanna use our muscles.

00:23:05.563 --> 00:23:10.303

<v SPEAKER_2>I mean, imagine if like you didn't walk and you just sat.

00:23:10.323 --> 00:23:17.043

<v SPEAKER_2>I don't know if you can compare it to maybe, let's say you didn't walk on the ground or run, but you just like were in a swimming pool your entire life.

00:23:17.403 --> 00:23:18.683

<v SPEAKER_2>I bet that would impact.

00:23:18.703 --> 00:23:21.663

<v SPEAKER_2>I bet you'd have these little skinny legs with no muscles.

00:23:21.683 --> 00:23:22.543

<v SPEAKER_2>Your bones wouldn't grow.

00:23:22.903 --> 00:23:25.163

<v SPEAKER_1>Yeah, it reminds me of like rickets and osteomalacia.

00:23:25.183 --> 00:23:36.283

<v SPEAKER_1>It's like due to vitamin D deficiency as a result of the industrial revolution, everyone spending time indoors with a low nutrient, highly refined diet, but it was the absence of sunlight, right?

00:23:36.303 --> 00:23:42.063

<v SPEAKER_1>Vitamin D strengthening those bones and then causing this physical malformation.

00:23:42.083 --> 00:23:44.983

<v SPEAKER_1>There's a lot of similarities that I'm seeing or thinking from that.

00:23:45.463 --> 00:23:57.523

<v SPEAKER_2>And picture like if you ever saw someone who maybe broke like their leg or their arm or something and they're casted for a while and they take the cast off and the muscle's like totally atrophied, the leg just looks skinny and different.

00:23:57.543 --> 00:24:00.503

<v SPEAKER_2>You've got to be working the muscles to have those bones grow.

00:24:00.583 --> 00:24:01.843

<v SPEAKER_2>Same thing for the face, right?

00:24:02.163 --> 00:24:03.523

<v SPEAKER_2>Even this is kind of fascinating.

00:24:03.543 --> 00:24:13.403

<v SPEAKER_2>So not just like chewing on harder textured foods on both sides of the mouth, working those facial muscles, but even just breathing through your nose triggers growth of the mid face.

00:24:13.923 --> 00:24:15.943

<v SPEAKER_2>So it's kind of like use it or lose it.

00:24:16.363 --> 00:24:23.803

<v SPEAKER_1>Well, I wanted to ask you, because I know you said you're not a feeding therapist, but as a speech language pathologist, you are uniquely qualified, especially with this specialty that you have.

00:24:23.823 --> 00:24:36.063

<v SPEAKER_1>And if you see a baby, like you're at the park, okay, let's say you're at a neighborhood park, we used to hang out there all the time, and you're watching other kids and you see, there's certain behaviors where like, ooh, that kid's smacking his food or his mouth is always open.

00:24:36.083 --> 00:24:40.603

<v SPEAKER_1>Like what are the signs of these dysfunctions that parents can be looking for?

00:24:40.623 --> 00:24:46.183

<v SPEAKER_1>Or should they not be looking for like, are we making neurotic parents by being like, if your baby's mouth is open, they're gonna be a mouth breather and they have myofunctional disorder.

00:24:46.423 --> 00:24:52.543

<v SPEAKER_1>Or there's certain things that you're like, oh wow, especially with your experience having been in the schools, that you're like, no, that is indicative of a larger problem.

00:24:52.563 --> 00:24:56.103

<v SPEAKER_1>That to a parent might just be like, oh, I thought he was just like a mouth breather.

00:24:56.683 --> 00:25:06.463

<v SPEAKER_2>Yeah, so the thing is, I think it is good to identify these things early because that's when we can initiate the most change and have the least amount of therapy in the future.

00:25:06.983 --> 00:25:10.943

<v SPEAKER_2>So things to look for would be mouth breathing, open mouth breathing.

00:25:11.363 --> 00:25:17.843

<v SPEAKER_2>We should not be sitting, our baby should not be sitting with their mouth wide open, tongue low and forward, sitting between the teeth.

00:25:18.283 --> 00:25:19.483

<v SPEAKER_2>Both my kids did that.

00:25:19.563 --> 00:25:21.423

<v SPEAKER_2>I have pictures after they were born.

00:25:21.443 --> 00:25:25.843

<v SPEAKER_2>I look back on pictures, I'm like, oh my gosh, mouth was wide open from birth.

00:25:25.943 --> 00:25:28.023

<v SPEAKER_2>And there's reasons why these things may occur.

00:25:28.043 --> 00:25:30.623

<v SPEAKER_2>And that's where the specialists can investigate.

00:25:30.963 --> 00:25:34.903

<v SPEAKER_2>But we don't want our kids to be congested all the time.

00:25:35.443 --> 00:25:37.503

<v SPEAKER_2>So yeah, if they're sick, that's normal.

00:25:37.563 --> 00:25:48.203

<v SPEAKER_2>But if your kid's congested, stuffy nose, runny nose all the time, breathing through their mouth, snoring is a really big factor that there's something wrong.

00:25:48.283 --> 00:25:52.783

<v SPEAKER_2>And not to freak people out because a lot of people think, oh, snoring is normal.

00:25:53.303 --> 00:26:03.283

<v SPEAKER_2>It might be common, but snoring is a sign that there's a lot of airflow resistance when breathing and the airway is not large enough, so everything's kind of vibrating.

00:26:03.523 --> 00:26:05.183

<v SPEAKER_2>So our children should not be snoring.

00:26:05.663 --> 00:26:09.223

<v SPEAKER_2>Limited diet, pocketing food in the cheeks.

00:26:09.843 --> 00:26:16.283

<v SPEAKER_2>A lot of the children or adults who have tongue tied tend to pocket their food and store it in their cheeks.

00:26:17.243 --> 00:26:31.663

<v SPEAKER_2>Choking, gagging, during infancy, I did talk about a few of the breastfeeding signs or even bottle feeding, where they can't maintain that seal on the nipple, either breastfeeding or bottle feeding, where you hear like a clicking sound.

00:26:31.823 --> 00:26:34.463

<v SPEAKER_1>Hey, we're going to take a quick break, but I'll be right back.

00:26:40.743 --> 00:26:42.243

<v SPEAKER_4>The Bachelorette is back.

00:26:44.103 --> 00:26:45.003

<v SPEAKER_5>And the power.

00:26:46.383 --> 00:26:47.883

<v SPEAKER_5>Is in Jen's hands.

00:26:48.263 --> 00:26:49.363

<v SPEAKER_3>I'm going to do it my way.

00:26:50.043 --> 00:26:51.163

<v SPEAKER_5>ABC Monday.

00:26:51.443 --> 00:26:52.703

<v SPEAKER_1>Everything about her is great.

00:26:54.403 --> 00:26:55.363

<v SPEAKER_4>Jen's looking like a queen.

00:26:55.383 --> 00:26:56.703

<v SPEAKER_3>My men are very, very hot.

00:26:56.823 --> 00:26:58.203

<v SPEAKER_4>I'm going to call 911.

00:26:58.223 --> 00:26:59.783

<v SPEAKER_4>You are looking so fired.

00:26:59.923 --> 00:27:01.983

<v SPEAKER_4>This is the beginning of a new era.

00:27:02.563 --> 00:27:08.403

<v SPEAKER_1>The Bachelorette season premiere, Monday, 8, 7 Central on ABC and stream on Hulu.

00:27:13.583 --> 00:27:20.563

<v SPEAKER_1>If you don't mind sharing more about yourself, like if you're at a point where at two years old and you're down to one food, which is yogurt, I mean, that is feeding therapy red flag.

00:27:20.583 --> 00:27:23.843

<v SPEAKER_1>We need to get this child some help, but you went a different route.

00:27:23.863 --> 00:27:29.103

<v SPEAKER_1>You did the oral myofunctional therapy without sharing too much about his medical history.

00:27:29.463 --> 00:27:31.223

<v SPEAKER_1>Did it resolve his eating issues?

00:27:31.243 --> 00:27:35.263

<v SPEAKER_1>Was he able to broaden the number and the types of foods that he ate?

00:27:35.423 --> 00:27:37.503

<v SPEAKER_1>And what helped him along that trajectory?

00:27:37.523 --> 00:27:39.403

<v SPEAKER_2>Yeah, that's a great question.

00:27:39.423 --> 00:27:45.263

<v SPEAKER_2>I don't mind sharing all the details about his case, because this is where I feel like I've learned so much is through personal experience, right?

00:27:45.443 --> 00:27:51.543

<v SPEAKER_2>Both my kids and then, you know, my whole family looking at all these sort of oral facial myofunctional issues.

00:27:51.563 --> 00:27:54.703

<v SPEAKER_1>You got to be careful when you hang out with Nicole because she's like always like, this is wrong with your mouth.

00:27:54.723 --> 00:27:55.423

<v SPEAKER_1>That's wrong with your mouth.

00:27:55.943 --> 00:27:57.423

<v SPEAKER_2>No one wants to be friends with me now.

00:27:57.643 --> 00:27:58.883

<v SPEAKER_2>No, but it's so funny.

00:27:58.903 --> 00:28:04.243

<v SPEAKER_2>Like, yeah, sometimes people talk and I was like, oh my gosh, I wasn't even listening because I was looking at their tongue tie.

00:28:04.363 --> 00:28:05.563

<v SPEAKER_2>No, I'm just kidding.

00:28:05.723 --> 00:28:09.283

<v SPEAKER_2>It's so hard to like, I was looking at their teeth or their palate or their mouth.

00:28:09.623 --> 00:28:16.683

<v SPEAKER_2>So no, really though, at the time, it was part of my learning process because I was just getting into this at that time.

00:28:16.703 --> 00:28:20.943

<v SPEAKER_2>I was speech therapist for many years, but just getting into the myofunctional therapy realm.

00:28:21.243 --> 00:28:23.983

<v SPEAKER_2>So I didn't realize all these things were not normal.

00:28:24.443 --> 00:28:28.543

<v SPEAKER_2>When the pediatrician recommended the webinar pacifier, which is that...

00:28:28.583 --> 00:28:31.463

<v SPEAKER_1>It has like a two pound of something hanging out of it, that one.

00:28:31.483 --> 00:28:39.123

<v SPEAKER_2>Yeah, oh my gosh, research just came out now about how damaging that can be to the teeth and the growing mouth because of the added weight.

00:28:39.323 --> 00:28:47.643

<v SPEAKER_2>Not only are pacifiers in many cases not good beyond a certain age, depending on the case, but in most cases, we don't want to use pacifiers.

00:28:47.663 --> 00:28:53.243

<v SPEAKER_2>But then when you hang the stuff, the plushie off of it, hello, that makes perfect sense why that would be even worse.

00:28:53.503 --> 00:28:55.003

<v SPEAKER_2>But anyway, so I did all those things.

00:28:55.283 --> 00:28:56.203

<v SPEAKER_2>Guilty, right?

00:28:56.223 --> 00:28:56.843

<v SPEAKER_2>Like I did all that.

00:28:57.043 --> 00:29:00.923

<v SPEAKER_2>I didn't know all these things were not normal or problems with my first child.

00:29:00.943 --> 00:29:13.703

<v SPEAKER_2>But when he was two, I mean, there were the breastfeeding issues from the start and I still nursed him till 18 months, even though I had to clear his nose out with the nose-freeda, you know that thing?

00:29:13.823 --> 00:29:14.123

<v SPEAKER_2>Yeah.

00:29:14.143 --> 00:29:17.923

<v SPEAKER_2>It's not out of their nose in order to nurse him because he was so congested.

00:29:18.163 --> 00:29:21.263

<v SPEAKER_2>Milk and reflux was like going into his nose when I nursed him.

00:29:22.063 --> 00:29:27.343

<v SPEAKER_2>So there was dysfunction there to begin with and he would choke a lot, you know, spit up.

00:29:27.363 --> 00:29:36.603

<v SPEAKER_2>A lot of these kids have colic, quote unquote, which in many cases is actually aerophasia induced reflux.

00:29:36.623 --> 00:29:41.763

<v SPEAKER_2>They're swallowing air due to dysfunction of the tongue, a lot of times from a tongue tie.

00:29:42.223 --> 00:29:48.183

<v SPEAKER_2>So when that tongue is restricted and the back of the tongue can't elevate all the way to the soft palate, air goes down.

00:29:48.523 --> 00:29:52.323

<v SPEAKER_2>What happens is the belly becomes distended, maybe not in all cases.

00:29:52.543 --> 00:29:58.703

<v SPEAKER_2>I look back on pictures of my son, his stomach was just sticking out and he was miserable, crying all the time.

00:29:58.723 --> 00:30:02.623

<v SPEAKER_2>I mean, you might have heard him across the street down the block screaming and crying.

00:30:02.663 --> 00:30:03.483

<v SPEAKER_2>It was horrible.

00:30:04.043 --> 00:30:05.803

<v SPEAKER_2>He would cry and they called it the witching hour.

00:30:05.823 --> 00:30:07.143

<v SPEAKER_2>So I'm like, oh, it's the witching hour.

00:30:07.203 --> 00:30:10.623

<v SPEAKER_2>Like thinking that's normal to cry for four hours every night, right?

00:30:11.023 --> 00:30:13.403

<v SPEAKER_2>So, and then he would just projectile vomit.

00:30:14.023 --> 00:30:16.563

<v SPEAKER_2>Later I learned he was actually swallowing air.

00:30:17.163 --> 00:30:29.683

<v SPEAKER_2>Milk would come out of his nose when he nursed, he'd make clicking sounds, and I was told to actually, he'd fall asleep when nursing, which is also another red flag because they're working so hard to nurse that they're exhausted.

00:30:29.863 --> 00:30:34.503

<v SPEAKER_2>So I was told to put ice cold towels on his back, like washcloths to keep him awake.

00:30:35.063 --> 00:30:41.003

<v SPEAKER_2>You feel really bad putting an ice cold washcloth on your baby's back when they're falling asleep nursing.

00:30:41.723 --> 00:30:49.983

<v SPEAKER_2>And yeah, there was a whole array of things that I just persisted and kept moving on because I didn't know that there was something causing that.

00:30:50.003 --> 00:30:51.963

<v SPEAKER_2>I just thought, well, people have this.

00:30:52.183 --> 00:30:53.163

<v SPEAKER_2>This is common.

00:30:53.503 --> 00:30:59.083

<v SPEAKER_2>And so when he was two and there was snoring, mouth breathing, snoring got louder.

00:30:59.083 --> 00:31:02.263

<v SPEAKER_2>He was ADHD all over the place, couldn't sit still.

00:31:03.063 --> 00:31:11.003

<v SPEAKER_2>What's important to know is when children are sleep deprived, so either they're not sleeping enough or their sleep quality is not good.

00:31:11.083 --> 00:31:14.663

<v SPEAKER_2>So they're snoring or mouth breathing and their brain is waking up.

00:31:15.323 --> 00:31:19.823

<v SPEAKER_2>Maybe their body doesn't wake up, but their brain, like if you did an EEG, their brain would wake up.

00:31:19.843 --> 00:31:21.503

<v SPEAKER_2>So maybe they toss and turn throughout the night.

00:31:22.163 --> 00:31:26.883

<v SPEAKER_2>Children become hyperactive in response to sleep deprivation.

00:31:27.203 --> 00:31:31.263

<v SPEAKER_2>Us adults, we take naps usually, fall asleep, can't stay awake.

00:31:31.483 --> 00:31:33.963

<v SPEAKER_2>Kids tend to have the opposite effect.

00:31:34.023 --> 00:31:42.743

<v SPEAKER_2>So 92 to like 97% of kids, I believe the number is, will become hyperactive in response to sleep deprivation or poor quality sleep.

00:31:43.303 --> 00:31:50.263

<v SPEAKER_2>So I'm the mom with my first kid take him to every class, music class, baby massage, all this stuff, cause I'm, you know, all gung-ho, I'm gonna be the best mom.

00:31:50.423 --> 00:31:53.263

<v SPEAKER_2>And I'm like, why is my kid all over the place?

00:31:53.523 --> 00:31:58.043

<v SPEAKER_2>Like we're in the music class and everybody's sitting there in the circle and my kid's running in circles around the room.

00:31:58.243 --> 00:32:04.063

<v SPEAKER_2>So there were all these red flags and signs that I didn't know of until when he was two and the snoring got really loud.

00:32:04.723 --> 00:32:07.683

<v SPEAKER_2>And I took him to my mentor who's a myofunctional therapist.

00:32:08.163 --> 00:32:14.963

<v SPEAKER_2>And then to ear, nose and throat doctors who were totally on board that his tonsils and adenoids were large.

00:32:14.983 --> 00:32:16.063

<v SPEAKER_2>They need to be removed.

00:32:16.483 --> 00:32:18.883

<v SPEAKER_2>Tung-Tai need to be released, but it wasn't everything.

00:32:19.023 --> 00:32:21.403

<v SPEAKER_2>So it's a big journey and a big process.

00:32:21.423 --> 00:32:22.703

<v SPEAKER_2>And he was two years, 11 months.

00:32:22.723 --> 00:32:24.443

<v SPEAKER_2>So almost three years at that point.

00:32:25.063 --> 00:32:28.383

<v SPEAKER_2>And what you need to do is these issues are multifactorial.

00:32:28.403 --> 00:32:32.063

<v SPEAKER_2>So we need to treat anything contributing, which were also allergies.

00:32:32.483 --> 00:32:34.143

<v SPEAKER_2>We need to rehabilitate the muscles.

00:32:34.863 --> 00:32:36.943

<v SPEAKER_2>At that point, the jaws didn't grow so well.

00:32:36.963 --> 00:32:38.223

<v SPEAKER_2>He had a narrow roof of the mouth.

00:32:38.983 --> 00:32:40.923

<v SPEAKER_2>So we had to do early orthodontic treatment.

00:32:40.963 --> 00:32:44.723

<v SPEAKER_2>So it's kind of a big journey and process.

00:32:45.603 --> 00:32:50.043

<v SPEAKER_2>And we never went to a feeding specialist or a feeding therapist.

00:32:50.363 --> 00:32:55.063

<v SPEAKER_2>And maybe we should have, and we probably still should because he is still a very picky eater.

00:32:55.863 --> 00:32:59.803

<v SPEAKER_2>There's still, we're not fully resolved with these issues.

00:33:00.303 --> 00:33:13.163

<v SPEAKER_1>And I know every time you and I talk, we're always like, okay, we're from different areas of expertise, but there is so much overlap and so much of what you do is supportive of the baby-led weaning approach and so much of what we do in baby-led weaning would align with what you would recommend.

00:33:13.383 --> 00:33:26.383

<v SPEAKER_1>Could you talk a little bit more, like you kind of touched on it, like you're in target with the pureed apricots and like you just think the only foods that babies can eat are purees, but we know from the baby-led weaning approach that babies can eat a variety of different textures.

00:33:26.403 --> 00:33:36.463

<v SPEAKER_1>And in fact, even the American Academy of Pediatrics recommends finger foods starting to be age appropriate at six months of age, which finger foods imply a variety of non-puree textures.

00:33:36.483 --> 00:33:38.343

<v SPEAKER_1>Could you talk a little bit about some of the benefits?

00:33:38.383 --> 00:33:43.023

<v SPEAKER_1>Because we have parents listening to me, like, I'm just scared to death to give my baby anything except purees.

00:33:43.043 --> 00:33:50.723

<v SPEAKER_1>And I always point to the research that shows, look, babies who've had the least amount of experience with finger foods are actually at elevated risk of choking.

00:33:50.743 --> 00:33:54.163

<v SPEAKER_1>And we know that because of practice makes progress and they're learning how to use the muscles of the mouth.

00:33:54.183 --> 00:34:02.763

<v SPEAKER_1>But could you maybe further encourage parents who are scared about anything except purees as to the benefits of them from an oral facial standpoint?

00:34:03.243 --> 00:34:04.603

<v SPEAKER_2>Yeah, oral mechanical.

00:34:04.623 --> 00:34:05.783

<v SPEAKER_2>I just thought of that right now.

00:34:05.803 --> 00:34:19.343

<v SPEAKER_2>And we can even call it that because exactly it is like doing a workout of the facial muscles, the tongue, the lips, the cheeks, the master, the chewing muscles when we're actually using those muscles correctly.

00:34:19.363 --> 00:34:27.443

<v SPEAKER_2>It is not normal to suck our food down at six months of age even that's when we move to open cup drinking.

00:34:27.963 --> 00:34:31.663

<v SPEAKER_2>And we want all drinking to be free flow at that point.

00:34:32.083 --> 00:34:36.923

<v SPEAKER_2>We don't want babies to have to suck on sippy cups to get the liquid out.

00:34:36.943 --> 00:34:38.323

<v SPEAKER_2>And I know you've talked about this before.

00:34:38.343 --> 00:34:42.703

<v SPEAKER_2>We talked about it once too, like the 360 cup or the well cup.

00:34:43.303 --> 00:34:47.343

<v SPEAKER_2>Just because the cup doesn't have a spout does not mean it's necessarily appropriate.

00:34:47.683 --> 00:35:01.343

<v SPEAKER_2>When a child has to suck or even an adult to suck to get the liquid out, that negative pressure, that suction in the mouth will actually cause the cheeks to pull inwards on the teeth at the sides and can narrow the arch, can narrow the roof of the mouth.

00:35:01.803 --> 00:35:07.063

<v SPEAKER_2>So we want drinking to be free flow, which will encourage normal swallowing patterns.

00:35:07.583 --> 00:35:11.763

<v SPEAKER_2>We want to be chewing on both sides, using the muscles of the mouth.

00:35:11.783 --> 00:35:17.503

<v SPEAKER_2>Food will start being chewed at the back teeth, not just munching with the front teeth, but going to the back molars.

00:35:17.583 --> 00:35:24.703

<v SPEAKER_2>All of this is sensory, oral motor, mechanical, muscular development for the mouth.

00:35:24.943 --> 00:35:26.103

<v SPEAKER_2>And that is normal.

00:35:26.303 --> 00:35:29.483

<v SPEAKER_2>Somehow we all got thrown off track, I think, when lives got really busy.

00:35:30.043 --> 00:35:42.223

<v SPEAKER_2>And we said, oh, we could just put foods in little containers and our babies can eat in the car or wherever, bring this to the park and they can just suck on this package and it's not gonna spill or it's maybe gonna be easier.

00:35:42.243 --> 00:35:46.823

<v SPEAKER_2>So a lot of the things that make our lives easier are actually making things worse in the long run.

00:35:46.843 --> 00:35:51.563

<v SPEAKER_1>Yeah, and if you've never had a baby, it's like, well, there's this whole aisle of pouches at Target.

00:35:51.683 --> 00:35:55.203

<v SPEAKER_1>I guess this is what babies drink after breast milk or formula.

00:35:55.283 --> 00:35:57.463

<v SPEAKER_1>And that's not necessarily true.

00:35:57.483 --> 00:36:00.403

<v SPEAKER_1>I mean, purees are an important texture for your baby to master, as I always say.

00:36:00.603 --> 00:36:03.743

<v SPEAKER_1>They're just not the only texture that babies can handle.

00:36:03.763 --> 00:36:07.343

<v SPEAKER_1>And I think beyond purees, parents like, well, shoot, how do I make those foods?

00:36:07.363 --> 00:36:08.883

<v SPEAKER_1>It's like, you can't just buy those foods.

00:36:08.903 --> 00:36:11.603

<v SPEAKER_1>We need to make them, but I can show you how to do that so it's safe.

00:36:11.623 --> 00:36:17.703

<v SPEAKER_1>But we really do want to be challenging our babies, even from their first bites, because I teach a purees for a few days approach.

00:36:17.723 --> 00:36:24.523

<v SPEAKER_1>It's for parents who are particularly anxious about just making the leap from a liquid only diet, which is infant milk, breast milk or formula.

00:36:24.543 --> 00:36:29.043

<v SPEAKER_1>And like, I don't think my baby can handle soft strips of avocado on day one, and you're doing lamb on day four.

00:36:29.063 --> 00:36:30.903

<v SPEAKER_1>It's like, fine, let's do purees for three days.

00:36:31.203 --> 00:36:37.283

<v SPEAKER_1>Do three different varying degrees of thin puree with breast milk or formula, a chunkier puree, and then the soft, solid strips of food.

00:36:37.283 --> 00:36:40.703

<v SPEAKER_1>And parents see that for three days and they're like, oh yeah, my baby can swallow something besides purees.

00:36:40.723 --> 00:36:44.683

<v SPEAKER_1>And it's like, yeah, but you didn't, what if you waited three or four months to do that?

00:36:44.703 --> 00:36:55.583

<v SPEAKER_1>What I'm hearing you say, Nicole, is that like these muscles are still actively forming and if we're not exercising them, they're gonna get lazier or get deformed, which I think is what you end up seeing a lot of the aftermath of that, is that correct?

00:36:56.143 --> 00:37:03.303

<v SPEAKER_2>Yeah, and just think it's the bones, the skeletal component, the bones that are getting impacted because the muscles aren't being used.

00:37:03.763 --> 00:37:09.543

<v SPEAKER_2>And the face grows significantly in those first few years of life.

00:37:09.563 --> 00:37:16.043

<v SPEAKER_2>So 60% of facial growth is reached by the age of four, 90% by the age of 11.

00:37:16.563 --> 00:37:21.703

<v SPEAKER_2>So the face has done a lot of its growing in those very early years.

00:37:22.063 --> 00:37:33.103

<v SPEAKER_2>So we want to get those bones growing correctly by moving the tongue around, moving different textures in the mouth, putting some strain on the muscles and the bones.

00:37:33.443 --> 00:37:39.903

<v SPEAKER_2>So I think it's great, your program and how you can guide parents, because I honestly wouldn't know what to do.

00:37:40.003 --> 00:37:44.283

<v SPEAKER_2>And we think it's normal to just buy those sucking pouches.

00:37:44.403 --> 00:37:49.583

<v SPEAKER_2>And it's scary to think, oh, my baby might eat real foods.

00:37:49.603 --> 00:37:50.343

<v SPEAKER_2>How do I do that?

00:37:50.363 --> 00:37:59.863

<v SPEAKER_2>So I feel like if I had you guiding me, I would maybe be in a different place now, because I'm still having one child that's a very picky eater and he's 11 years old.

00:38:00.303 --> 00:38:06.363

<v SPEAKER_1>So Nicole, I'm interested to know your feedback or your thoughts about these concept of oral development tools.

00:38:06.383 --> 00:38:12.523

<v SPEAKER_1>Like I know in the feeding space, there's a lot of focus on pre-feeding and exercises that parents can do for babies who are four and five months of age.

00:38:12.543 --> 00:38:24.963

<v SPEAKER_1>Of course, they're not safe to start or eat anything except infant milk until six months of age, but there are now all these oral development tools out there that I think sometimes are developed by therapists, but they cross over into the typically developing infant population.

00:38:24.963 --> 00:38:27.583

<v SPEAKER_1>And I'm just curious if you think that these are beneficial for babies.

00:38:28.123 --> 00:38:29.083

<v SPEAKER_2>Yeah, definitely.

00:38:29.123 --> 00:38:35.323

<v SPEAKER_2>So there's a group called Talk Tools, and they're specifically geared for like speech pathologists and OTs.

00:38:35.803 --> 00:38:41.563

<v SPEAKER_2>There's all different oral motor tools that are like teathers and chewies.

00:38:41.583 --> 00:38:48.823

<v SPEAKER_2>There's like the Beckman Try Chew and Chewy Tubes and different things that your baby can chew on in different ages.

00:38:48.843 --> 00:38:56.363

<v SPEAKER_2>And if you go on their website, it'll tell you like what's age appropriate that could replace pacifiers or be used instead of a pacifier.

00:38:56.983 --> 00:39:03.503

<v SPEAKER_2>And there's a lot of speech therapists and OTs where that's their specific area of expertise in guiding in that realm.

00:39:03.703 --> 00:39:11.983

<v SPEAKER_2>And yeah, we want our babies working the muscles and using appropriate chewy toys and two teathers are very good.

00:39:12.263 --> 00:39:17.803

<v SPEAKER_2>We even have our patients use a lot of, they're like chewy tubes that are on that website.

00:39:18.243 --> 00:39:21.523

<v SPEAKER_2>And we have them chew to help strengthen the jaw muscles.

00:39:22.023 --> 00:39:33.663

<v SPEAKER_2>And there's even something called the Myomunchie, M-Y-O, M-U-N-C-H-E-E, that they just developed the BB version, BB, the baby version, but it's based out of Australia.

00:39:33.683 --> 00:39:36.283

<v SPEAKER_2>I think it's aged six months and beyond.

00:39:36.623 --> 00:39:41.943

<v SPEAKER_2>And it's something that can promote lips closed, nose breathing and chewing.

00:39:42.323 --> 00:39:49.723

<v SPEAKER_2>And you put it in the baby's mouth and you replace that with the pacifier, which the pacifier goes on top of the tongue, narrows the palate, pushes the tongue low and forward.

00:39:49.923 --> 00:39:55.183

<v SPEAKER_2>This has nothing on the palate, but it triggers lips closed, triggers jaw motion and chewing.

00:39:55.463 --> 00:40:03.943

<v SPEAKER_2>So if you look up the M-Y-O Munchy website, and there's probably a bunch of videos of little babies using these, we recommend those all throughout childhood, through the adult years.

00:40:04.483 --> 00:40:15.023

<v SPEAKER_2>There's different sizes to help as a tool to help with our goal of lips closed, tongue up, and appropriate nasal breathing and jaw strength.

00:40:15.323 --> 00:40:17.923

<v SPEAKER_1>Hey, we're gonna take a quick break, but I'll be right back.

00:40:17.943 --> 00:40:26.477

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00:41:27.650 --> 00:41:32.210

<v SPEAKER_1>Nicole, for parents who are listening, you're like, okay, I've never heard of this oral myofunctional therapy.

00:41:32.230 --> 00:41:45.710

<v SPEAKER_1>And I know, like on your email signature, you're like, I'm one of three of these certified people in all of San Diego, like if parents are like, I need to get this help for my baby, or I wanna look into it, because yes, they are snoring or breathing with their mouth open, or there is that weird clicking noise.

00:41:46.110 --> 00:41:52.370

<v SPEAKER_1>How would parents get in touch with you or with the other people that you have trained, or people who specialize in this?

00:41:52.750 --> 00:41:56.750

<v SPEAKER_1>Because it is not as mainstream or widespread as, I'm sure you would hope.

00:41:57.110 --> 00:41:59.930

<v SPEAKER_1>What are your suggestions for referrals if we're seeking further help?

00:42:00.210 --> 00:42:00.590

<v SPEAKER_2>Sure, yeah.

00:42:00.710 --> 00:42:01.530

<v SPEAKER_2>And let me back up too.

00:42:01.550 --> 00:42:03.110

<v SPEAKER_2>I'm not one of three in San Diego.

00:42:03.110 --> 00:42:06.490

<v SPEAKER_2>I do have a speech pathologist and a certified oral facial myelodist.

00:42:06.890 --> 00:42:10.690

<v SPEAKER_2>There's a small few that have both of those credentials or training.

00:42:10.710 --> 00:42:11.990

<v SPEAKER_1>But there's not a lot, right?

00:42:12.230 --> 00:42:14.530

<v SPEAKER_2>But there's not a lot, but it's growing.

00:42:14.670 --> 00:42:23.130

<v SPEAKER_2>And there are, some are dental hygienists, some are speech therapists, there's some OTs who are trained in bio-functional therapy and some physical therapists.

00:42:23.290 --> 00:42:26.370

<v SPEAKER_2>But I would say the majority are speech pathologists or speech therapists.

00:42:26.990 --> 00:42:28.090

<v SPEAKER_2>And dental hygienists.

00:42:28.690 --> 00:42:30.690

<v SPEAKER_2>And where can you get more information?

00:42:30.790 --> 00:42:36.770

<v SPEAKER_2>Look up oral-facial myofunctional therapy online and you will find tons of information.

00:42:37.070 --> 00:42:46.550

<v SPEAKER_2>There is a lot of different resources, there's a lot of different groups that advertise about this, have videos on what this is.

00:42:47.330 --> 00:42:57.030

<v SPEAKER_2>And if you're looking for a therapist trained in oral-facial myofunctional therapy, there's a few different websites you can go to because there's different organizations that do trainings.

00:42:57.610 --> 00:43:04.750

<v SPEAKER_2>There's directories on the IAOM, which is the International Association of Oral-Facial Myology.

00:43:05.250 --> 00:43:10.410

<v SPEAKER_2>There's also the American Academy of Myofunctional Sciences has a directory.

00:43:11.270 --> 00:43:16.730

<v SPEAKER_2>And I work with Airway Circle, and I do a podcast with Airway Circle.

00:43:16.750 --> 00:43:20.290

<v SPEAKER_2>It's called Airway Answers, Expanding Your Breath of Knowledge.

00:43:20.790 --> 00:43:27.630

<v SPEAKER_2>And Airway Circle has an international directory of therapists who are trained in myofunctional therapy.

00:43:27.950 --> 00:43:41.890

<v SPEAKER_2>And what you want to do is look at what your child's issues, or even for parents, adults, what your issues are to find the right therapist, because sometimes you need that person to be a speech therapist, whereas other times it can be a dental hygienist.

00:43:41.910 --> 00:43:47.510

<v SPEAKER_2>So you want to see, are there speech sound issues, feeding issues, swallowing issues?

00:43:47.530 --> 00:43:51.650

<v SPEAKER_2>That's more of the speech pathologist realm when there's that dysphagia type work.

00:43:51.650 --> 00:43:58.250

<v SPEAKER_2>And then any children under the age, like birth to four, it's not really a myofunctional therapy program.

00:43:58.470 --> 00:44:02.270

<v SPEAKER_2>And we can kind of think of myofunctional therapy as like physical therapy of the mouth.

00:44:02.670 --> 00:44:12.330

<v SPEAKER_2>Before the age of four, the children are young, they can't imitate, they don't have the cognitive abilities to know like, okay, my goal is my lips closed, my tongue is sucked up, breathing through my nose, right?

00:44:12.530 --> 00:44:14.150

<v SPEAKER_2>They don't get that, they're too young.

00:44:14.310 --> 00:44:19.530

<v SPEAKER_2>They need foundational oral sensory motor skills and feeding therapy.

00:44:19.530 --> 00:44:22.310

<v SPEAKER_2>And that's from somebody specifically trained in that.

00:44:22.630 --> 00:44:28.730

<v SPEAKER_2>And with all the information I know and everything I can do, and I think I do a great job, I don't claim to do that.

00:44:28.750 --> 00:44:37.330

<v SPEAKER_2>So I don't work with that under three-year-old population who has feeding issues or infant population with oral sensory motor issues.

00:44:37.350 --> 00:44:47.970

<v SPEAKER_2>So you wanna find someone that's a speech pathologist specifically trained in the birth to three or that infant population and who has training in oral sensory motor and feeding.

00:44:48.070 --> 00:44:57.150

<v SPEAKER_2>Okay, because I think a lot of people get confused and like, oh, myofunctional therapy, my two-year-old is doing myofunctional therapy and it's not really the same thing, it's not appropriate.

00:44:57.170 --> 00:45:03.410

<v SPEAKER_2>So when they're younger than four, you're usually gonna be using tools to help stimulate the muscles.

00:45:03.770 --> 00:45:18.750

<v SPEAKER_2>You're gonna use tools that might vibrate or different sensory type tools and you're gonna be triggering reflexes in the mouth and triggering muscles to work versus exercises like what we do with older children born up in adults.

00:45:19.050 --> 00:45:20.070

<v SPEAKER_2>If that does that make sense?

00:45:20.530 --> 00:45:21.290

<v SPEAKER_1>Yeah, absolutely.

00:45:21.310 --> 00:45:23.490

<v SPEAKER_1>And I started listening to your podcast.

00:45:23.510 --> 00:45:31.090

<v SPEAKER_1>It is fascinating because it's, I mean, it makes sense when you say it, like food and muscles and bone and sleep and speech.

00:45:31.110 --> 00:45:33.050

<v SPEAKER_1>It's like, it's all coming out of your mouth.

00:45:33.070 --> 00:45:38.770

<v SPEAKER_1>But I think the sleep piece too is the part that, especially adults are just starting to pay a lot more attention to sleep science.

00:45:38.870 --> 00:45:43.730

<v SPEAKER_1>And I appreciate that there's credentialed experts in the space who are kind of leading the way.

00:45:43.750 --> 00:45:52.510

<v SPEAKER_1>I'm like, okay, well, this is how these things are interrelated because of course, we're not doing things in a vacuum, like sleeping or eating or speaking that they're all happening in unison.

00:45:52.530 --> 00:45:56.570

<v SPEAKER_1>And if something goes wrong on one path, we see it affect so many other areas.

00:45:56.590 --> 00:46:02.070

<v SPEAKER_1>So thank you for coming on today and talking about this issue, which again, I think we're going to start hearing more about this.

00:46:02.210 --> 00:46:04.830

<v SPEAKER_1>And I know a lot of it is due to the work that you and your colleagues are doing.

00:46:04.850 --> 00:46:05.670

<v SPEAKER_1>So thank you, Nicole.

00:46:06.130 --> 00:46:08.170

<v SPEAKER_2>And can I recommend a book for the families too?

00:46:08.170 --> 00:46:08.910

<v SPEAKER_1>Absolutely.

00:46:08.930 --> 00:46:16.150

<v SPEAKER_2>This is a relatively new book, just came out on 2023, and it's called Breathe, Sleep, Thrive by Dr.

00:46:16.170 --> 00:46:20.070

<v SPEAKER_2>Shereen Lim, who's a fabulous airway focused dentist in Australia.

00:46:20.190 --> 00:46:30.410

<v SPEAKER_2>Every parent should read this book, Breathe, Sleep, Thrive for their child and for that information for the child, the pediatric population, even therapists, professionals should be reading this.

00:46:30.630 --> 00:46:36.530

<v SPEAKER_2>And then if you're interested in this information as an adult, there's a great book called Breath by James Nestor.

00:46:36.550 --> 00:46:44.110

<v SPEAKER_2>And it's very interesting, entertaining book, download it on Audible because then he narrates it and it's really great.

00:46:44.230 --> 00:46:50.270

<v SPEAKER_2>So I think those are two great resources and thank you for spreading the awareness with the baby-led weaning because that is the beginning.

00:46:50.290 --> 00:46:53.690

<v SPEAKER_2>Like I said, nursing is a catalyst for good oral facial growth and development.

00:46:53.970 --> 00:47:02.650

<v SPEAKER_2>I believe a baby-led weaning approach where you're chewing, using muscles, using textures, moving the mouth is also a catalyst for good growth and development of the mouth and face.

00:47:02.790 --> 00:47:03.990

<v SPEAKER_2>So thank you for all you do.

00:47:04.310 --> 00:47:05.230

<v SPEAKER_1>Thanks, Nicole.

00:47:06.290 --> 00:47:08.970

<v SPEAKER_1>Well, I hope you enjoyed that interview with Nicole Goldfarb.

00:47:08.990 --> 00:47:10.650

<v SPEAKER_1>Again, she's a speech language pathologist.

00:47:10.850 --> 00:47:14.150

<v SPEAKER_1>She is an oral myofunctional therapist.

00:47:14.170 --> 00:47:19.250

<v SPEAKER_1>That's definitely quite a mouthful, but if anyone is equipped to deal with mouth related stuff, it is Nicole.

00:47:19.370 --> 00:47:27.450

<v SPEAKER_1>I'll put a link to all of her resources on the show notes page for this episode, which you can find at blwpodcast.com forward slash four four six.

00:47:27.910 --> 00:47:33.130

<v SPEAKER_1>And we are online at blwpodcast.com if you want to check out some more resources.

00:47:33.150 --> 00:47:36.310

<v SPEAKER_1>I also love that she provided this with some books and some different organizations.

00:47:36.330 --> 00:47:39.310

<v SPEAKER_1>I know this topic will be of interest to a lot of people listening.

00:47:39.330 --> 00:47:41.010

<v SPEAKER_1>So I'm so grateful that Nicole could come on.

00:47:41.230 --> 00:47:44.890

<v SPEAKER_1>I also wanted to say a special thank you to our partners at Airwave Media.

00:47:45.110 --> 00:47:50.330

<v SPEAKER_1>If you guys like podcasts that feature food and science and using your brain, check out some of the podcasts from Airwave.

00:47:50.410 --> 00:47:52.670

<v SPEAKER_1>Thank you so much for listening and I'll see you next time.

00:48:02.230 --> 00:48:16.339

<v SPEAKER_3>At a time when change is constant and we are pulled in far too many directions, we need a way to stay present to life and to increase our ability to remain calm, think clearly, and maintain our well-being.

00:48:16.939 --> 00:48:22.119

<v SPEAKER_3>Many studies indicate mindfulness improves our mental, emotional, and physical health.

00:48:23.319 --> 00:48:29.779

<v SPEAKER_3>On a mindful moment with Teresa McKee, you can learn how to practice mindfulness and enjoy its many benefits.

00:48:30.159 --> 00:48:39.039

<v SPEAKER_3>Tune in for guided meditations and to hear tips and advice from some of the most respected experts in the fields of mental health and mindfulness.

00:48:39.659 --> 00:48:42.039

<v SPEAKER_3>The world truly can be a better place.

00:48:42.639 --> 00:48:44.939

<v SPEAKER_3>It all starts with a mindful moment.