S8:E77 - Dr. Marielly Mitchell: Feeding Therapy, Baby Biohacking, and Proper Airway Management

Show Notes:

Throughout the episode, Dr. Mitchell mentions several resources that may be useful for both parents and medical professionals. This blog post is dedicated on providing all of that supporting material:

• TherePlay LA - Dr. Marielly Mitchell's website
• MyoMunchee
• Breath: The New Science of a Lost Art, by James Nestor
• ALF Appliance/Orthodontics
• The Airway Huddle - CAFF Parent's Facebook Support Group
• Airway Circle
• The Ultimate Guide to Creating Your Child's Care Team

Episode Transcript

(00:00):
Hi everyone, and welcome to another episode of The

(00:29):
Children's Airway First Foundation. I'm your host, Rebecca St. James.
My guest today is Dr. Mary Lee Mitchell. With a clinical doctorate in pediatric
occupational therapy and nearly 13 years of hands-on experience, Dr. Mary Lee is

(00:50):
more than a leading expert. She's a beacon of hope for countless families.
Her personal journey, marked by sensory challenges and ear infections during her youth,
has given her a deep, empathetic understanding of the children she serves.
You can read Dr. Mary Lee's full bio on our blog and find out more about her and her practice at

(01:12):
theroplayla.com. And now, let's jump into my interview with Dr. Mary Lee Mitchell.
Thank you so much for joining us today, Dr. Mary Lee. I really, really appreciate you being on here.
Yeah, of course. Thank you. Thanks for having me.
Absolutely. So lots of questions, and you and I have spent some time. We've spent a lot of time talking before we even got going.

(01:37):
There's just so much to cover. To me, that's kind of a sign. I mean, not kidding. We've spent 40 minutes just talking.
So I want to encourage parents to visit your website, because that's part of what we were talking about is,
I had a very hard time putting the guide together today because there was so much on your website that I wanted to talk about.
There's so much amazing information. So the link will be in the show notes. Absolutely encourage parents to go, get some tea,

(02:04):
hunker down, spend some time on it. There's a lot of great stuff there.
Thanks.
Yeah. So as we, as we, it's kind of a launching point just for the podcast today.
A lot of times, people that are in Airway have had some kind of journey that has brought them here for whether it's, you know, personal or personal.
But we just take a few minutes to reflect on how you got on this path because an OT background that is focused on Airway and sleep of all things is incredibly rare.

(02:34):
I mean, I have not run across it. That's why I spent so much time on your website. So how did you end up here?
Yeah. So, so I'm a doctor of occupational therapy and I went to USC, University of Southern California.
And my one of my first electives other than sensory integration, which was like my true first love, like neuro is my first really like something that I was really drawn to in grad school.

(02:57):
After I did sensory processing and neuro, I went into my first elective, which was about swallowing. So it was really kind of medically based elective about the first, the swallowing structures and different phases of the swallow.
And in my field, from my understanding, there's different states that allow OTs to operate and work in more medical based settings where we have an acronym behind our credentials that's labeled SWC.

(03:24):
So it means I have a swallowing certification. So I'm an expert in the all phases of the swallow because over more states that are more populated need basically backup, like there's not enough SLPs in the hospital setting or in geriatric settings and things like that to do the modified
barium swallows and feeding therapy, etc. And so I basically write out of grad school what I became CIP certified when I was finishing my doctorate, which is the sense of integration practice. It's not even a certification anymore, they changed it.

(03:53):
So mostly we don't have that but they still have advanced training. After that, I took five years post doc work to get my SWC and so I flew around the country and basically really prioritize education and found a place where it could work to learn more about
weaning kids off of G tubes and tubes, swallowing issues, feeding issues, all sorts of things. And I took a lot of time in my career to focus on that.

(04:17):
That led me into being more of a feeding and swallowing specialist with like a neuro background. And then I discovered my through an osteopath who was sharing a patient with me and he was like you really need to look into this and I was like, Okay, and the universe has always kind of guided me in the right
direction when someone brings something to light to me, I always I just say yes, I don't really, I just know that it's gonna kind of like the breadcrumbs are there. And so I followed that and then I was I joined molar I emailed Joy molar and she was like kind enough to have me in her

(04:48):
office and I opened my mouth and she was like, Oh, well, you got all these things going on and I was like and she connect all these dots for me. Someone who had grown up having ear infections until I was like 30 and I had like, tonight is from an ear infection for like three years after it and had an ear
infection. And when I was around 30 years old, but I canceled a trip for that I literally cancel work for a month because I couldn't hear and the tonight is was so loud.

(05:13):
I really had a lot of oral facial malfunction issues I had braces, I was a mouth breather when I was younger. It's interesting how it manifests in people differently for me it was my ears like I never had tonsils, I don't know it's I think I had struck
maybe like once or twice when I was younger but nothing major. It was my ears. And so, having been a patient and a practitioner. I was like highly motivated to learn more about this. And so I kind of went into orthodontics I went into the elf I've had laser treatments I'm still being expanded

(05:42):
you know, clinicians are kind of the worst patients and so COVID hit I kind of COVID hit I kind of got derailed at my own treatment plan and I got to go back and get expanded and then we'll have my release done but I've had so many sessions of orally
I've done osteopathy I've done craniosycho therapy like I'm, I'm in it like I'm just as in it as my patients are. Yeah, a master piece is never done. So, I'm a work in progress but yeah it's kind of, I really got into professionally because I've just been fast.

(06:12):
There's no other part of the body that does more in this area than a females reproductive system. You really think about it. Like, we breathe we eat we choose saliva the first steps of digestion you're hearing your balance like it's wild if you really think about like you don't
know what it is out of your mouth and that's literally the only thing you're not doing like it does everything else right. Yeah, and it's like it can impact that. Absolutely. And it's like a portal to your health like when I go to these dental conventions and I'm like so lucky to be part of them

(06:45):
you know yeah we can tell you from a saliva swab like how like close someone might be to like a heart attack and predicting the, like, the occurrence of that I'm just like, Oh my God, like how is how are people not diving deeper into the mouth and to the airway and what it's like
to dive into how well this and I've just always thought that. So, yeah, that was my kind of professional journey that then morphed into a personal journey that has now transitioned into both for me. And, and honestly, like, I just don't want anyone else have to go through

(07:18):
like and it wasn't for me isn't that bad like I'm you know I'm functional like I'm a small business owner I'm an entrepreneur and I'm a healthcare professional like I've got it together for the most part and like, but you know those ear infections like I remember those as a kid that was like
a big pain. And, and you know I was more of a sensory seeker and like was that because my vestibular system was impacted because of what was going on my inner ear, probably, you know, did I trip did I channel that correctly with sports and I had equipment at home my parents were just

(07:48):
like, I guess if I wanted to trampoline or swing like they just did that. Yeah, but like not every kid gets that. And, I really think that we're onto something that can really change and I see it day and day out in my clinic, it can change the trajectory of someone's
if you get them breathing and sleeping and you help give their nervous system what it's looking for. And it's a lot easier to say that it's complicated. But, but yeah that's kind of where how I got here professionally and personally and why it's so important to me.

(08:20):
Yeah, and that I do think just kind of cooperate that a little bit, having that personal experience. I think that does something to your passion to it makes you far more passionate because you couldn't understand and empathize with your patients, but you're going to work that much
harder to make sure they don't go through what you went through. Absolutely. Yeah, 100%. And like, you know, when kids cancel and they have an ear infection and just like, Oh, God, like, I know what that feels like, or like, you know,

(08:49):
we start seeing less ear infections because their swallow is improved because things are draining, or they get the alf put in or they're expanded and things kind of just start to fall into place or they sleep better.
It's just kind of like incredible, like an honor to witness that. And yeah, there's definitely like on a very like, you know, it's I'm aware of that. But I think deeply in a subconscious way, it's very part of like what my like purposes here.

(09:17):
And I do think that like, there is something in me and in my mission and like getting this information out to people like it is truly a silent epidemic that is really, really a major part of in our country due to the lack of maternity leave and breastfeeding here.
But like in the support for that. But it's this is international. This is this is not an isolated place. But it is, you know, it's very prevalent here because of a lot of so many.

(09:43):
Sure, it's compounded, of course, of course. And you made a great statement to that. I think it's important for parents to hear if they missed it.
You've gone on to do all these great things with your education and your small business in your life.
But somehow you figured out how to function, but you weren't thriving. So getting treatment and it's very different.

(10:05):
Yeah, and look like I'm almost 40, like I'm a kid from like the 90s and the 80s and like, so different world pre COVID is different world pre iPad, like I was outside.
And these nervous systems that come into my like clinic, like they're so dysregulated. And I think I had a better chance with things because of the environment that I had.

(10:26):
And things were for me and I wasn't so stimulated all the time by technology and the level of dopamine that my brain required going to a park compared to being in front of an iPad.
And then there's no like shame and screen hygiene, like parents are so overworked and things like that. But the way the perfect storm of how airway and sleep and all of these things can like manifest for these future generations.

(10:50):
It's really difficult for these kids to be able to kind of pull away from some things. And it's just, it's really, it's just, it's a complete different world. It's a totally different world.
And so I feel like I have been able to kind of overcome these hurdles that were biological and physiological and to an extent neurological.
But I don't think it's as easy for kids with these challenges like these issues now, it's just not.

(11:16):
You have to fight and pay to eat clean food in this country. Like that's like something doesn't it.
It says a lot. It's hard for you to detox and already your main pumping and dumping system other than your digestive system isn't working in like your ears or in your tonsils or your adenoids and your lymphatic system.
Like that's that's a lot for a tight you have to remember these are like kids like they are so like things their immune systems growing and our nervous systems growing and to have to double the work of detoxing and pumping and dumping is very taxing.

(11:49):
And you don't get good sleep when things are supposed to restore themselves.
It's like the perfect storm.
Yeah, there's a lot there. There's so much.
So I'm going to shift just a little bit because you did touch on it. So I'm going to shift over to that and then we'll kind of work our way up and through older kids.
But let's start with the teens and let's talk about feeding therapy because you talk about this on your website.

(12:12):
So what exactly is this and who are the candidates for this?
You said for teens like teenagers.
No, no, no, no, no, no, we're going to start with the teens little ones.
Yeah, it's like basically from like, like, like there was a cute podcast in Australia that I was listening to yesterday was like from boob to food.
And it's like the truly like you like the feeding therapy starts as young as you know they're born like with my training. I'm not a lactation consultant, but I do work with a lot of infants, specifically for tongue tie but more so than anything regulating them because a lot of

(12:49):
children like birth is a minor car accident. Like that's really what it is for all parties involved.
It's very traumatic.
It's very traumatic. It's a lot. You have to kind of unsquish from it and there's a lot of you can see quite quickly if a child is having challenges that they don't have their sex full of breathe rhythm they can't latch is it anatomical is there some compression and the nerve can't conduct like there's a lot going on if you've got a baby who's

(13:12):
mouth breathing off the bat and then you stick a bottle or breast tissue in their mouth like how are they going to breathe and activate their nose like a lot of them have challenges with that and you have to remember that little person has been
swallowing for months and you two already so there's something kind of not starting off. Yeah. Right. And then like so feeding therapy can look like helping children who need to nurse nurse and become more regulated to do so helping the mother kind of learn the positioning for that or however that might be making sure that the child's not swallowing

(13:43):
into air and creating arophagia and they're really creating more of a like a risk for them to regurgitate and have reflux. And that's kind of where it looks like an infancy for the first like calling the fourth trimester but like the first few months of life.
And then at six months what we really work on is like exposure to solids like I do I like to have a kind of more of like a heavier dose of like baby lead weaning with my approach to feeding if it's appropriate for that child like to find out what their profile is, but really working on like a

(14:14):
listening that chewing pattern, getting them to like chomp and use their jaws for jaw development and then sensory exposure to different textures and things like that, and getting them comfortable just with the occupation of feeding and eating the social component to it
modeling, all that kind of stuff. So feeding therapy like from zero to six can kind of focus on like, making sure that they're growing, making sure that like they're actually getting everything that they need in managing like reflux and things like that and then once it's

(14:43):
six months to 12 months we're really working on basically like exposure and like intake and nutritional intake but also oral motor skills. Can they choose swallow and eat are they massacating well can they eat a various amount of textures are they comfortable with this
how's our gag reflex looking is it too sensitive are they gagging as they should kids need to gag people get really about gagging gagging versus choking and you people need to remember you need to have an integrated gag reflex a super hyper sensitive one like puts throws people off like I have kids here who they

(15:11):
gag very easily through every meal and then they're vomiting and then they get this like negative association right with feeding, because it's uncomfortable to throw up all the time, and it's scary.
So, six to 12 months is kind of there and then that 12 months we kind of as long as everything's good like then you're good but if there's like a lot of like, like, they can't chew their like spitting everything out there's like no nutritional

(15:36):
intake whatsoever. And it's also like a balance of making sure that they're not just always like not eating a lick like drinking liquid all the time like you people don't remember that these little bodies like will not really overeat like we will, you don't really see like a morbidly obese
like three year old, like they will eat what their caloric intake is supposed to be whether it's Coca Cola in a bottle or breast milk or actual food. And so you want to have a balance of exposing them to food getting to have the right nutritional

(16:03):
intake and caloric intake while still giving them the milk that they might need or whatever it might be or the formula. And as I get older, I call this like the parent booby trap but like a lot of parents like 18 to 24 months like 36 months
sometimes two, when kids learn to say no, and the autonomy of that. They say no to food. Because people are like, what do you want to eat and it's like right.

(16:27):
Chicken nuggets, mac and cheese. But it's like they just start to say no anyway, like you could ask them anything, you know, still going to say no. And but it's just like, unfortunate like well mannered well meaning parent who's like, oh my God, like now they're saying no to
everything and it's like, yeah, but like, he's like 18 months like you shouldn't like, why don't ask him like, like, this is what we're having for dinner. Like this is what this is what we're having right. And I'm all about like, like autonomy and developing like like having a social

(16:56):
emotional like, like, like independence and all that kind of stuff but nutrition wise like kids are always going to pick what tastes the best and what's the easiest when you're a raw little nervous system most of us are like avoiding pain or seeking pleasure at any given time
that's like what humans do right and like right a little one like yeah. And so that's kind of what feeding can look like and then selective eating is like okay they're four they're five got like six foods that they eat they only eat these things they eat like, you know, the tan diet or they only

(17:29):
eat like these certain foods and then the usually there's a protein issue that's one of the main things. And, and yeah so we'll work on one of the main things I think that makes our clinic a little different is I really prioritize anatomy. So, a lot of people don't remember that
like if you've got a really big overbite or an underbite your molars now don't touch as they should. Like how can you bite and tear and shred like I've got parents who you know they're like an apple and I'm like well yeah like look at his mouth like how could he right.

(17:59):
And then we do therapy get the kids in the malmunchie and like I think start moving and get in better alignment and they can chew. Right. It's like the car wheels are crooked and you're trying to make a U turn you just it's just you're going to go in circles like you just kind of can't.
Right.
You have to take steps to get in there that right to address one thing at a time and as you're working towards this this change in eating.

(18:21):
And feeding is complicated there's anatomy there's sensory there's oral motor there's behavioral there's social there's nutrition like it's not just like everything you know he's kind of complicated but like feeding is very complicated because there's so many factors but I think something that goes amiss in a lot of
cases that we prioritize a lot is anatomy and respecting the principles of not and but not me you you have to get the anatomy as best in alignment as possible because if not then they compensate in some sort of way.

(18:49):
Right. Which makes sense. Yeah. And it's so funny that at this point we can just call it the tan diet and every parent goes oh yeah we all know what's on that menu.
Because we've all experienced it and again we say this every episode you don't know what you don't know but the mom guilt side we all did it right we all did it I juice pouched in like little.
Pouched my kids and goldfish dumb and we all did it. Totally. Yeah. Yeah. Now we know so you go from this point forward and you change. Yeah. And like through education there's empowerment and and yeah and with our older kids like I come from a really big

(19:27):
I guess as a person as a therapist like I never really want to lie to the kids about what they're doing and why and you know obviously with like really delicate bedside manner and explaining something but like some of our older kids like with our fit and stuff like that
like I explain them like look bud like like I don't make the rules here like protein makes muscles like if you like you need to grow like this isn't like really like my choice or your choice is just like how it works like we kind of have to start integrating this into your life

(19:54):
anyway. Right. Yeah. Try to make this as enjoyable as possible like let's find some potential recipes you might want to try like let's get you more involved with cooking let's just get you like used to this but I think there's something to be said with older kids that
educating them about nutrition and elimination and being responsible for like did I today am I hungry like should I be hungry thinking about the kids really like need to under what and when they can and they're available to understand these things.

(20:23):
And they tend to think differently and they look at it differently and it's not an emotional reaction it's more of like a like a critical thinking reaction of like why am I doing it like that why do and then you just kind of like talk them through that right you're not
forcing them to then they can tell you it's a texture thing or I have trouble swallowing that I can't chew that or whatever it is. Yeah. And I mean just this year alone we've had three kids who reported to us like, well it doesn't hurt to swallow

(20:51):
after their tonsils are out. You know, and we got a lot of selective eaters they got some big tonsils and it's like I don't know that reality, but like that hurts like to have a four year old a seven year old and nine year old tell you that there's
something to be said and people just I think people also think that kids don't experience pain, or like headaches or jaw pain and I that's one of the things like our clinic really prioritizes is asking the kid hey like how's it going like how are you feeling today, like do you have any pain

(21:19):
anywhere. And you'll be surprised like oh yeah my tummy hurt earlier today or like our like our older ones will are going nine year olds will be like yeah like I got like a like tension here like and you have to like help them go through that
words right because they don't really know the words but they can tell you something's wrong. Yeah. Or my throat hurts a lot like our tonsils kids will say that a lot. Yeah. And you know we're waiting for the E&T appointment and stuff like that but the the

(21:43):
the selective eating like we had a kid who gained 10 pounds look the kids not eating everything or something by any means at this point but like he gained 10 pounds over summer after his tonsils got taken out because he didn't hurt to eat anymore.
E. Right and this is this goes back to I guess a couple of things. One of the things that Shereen Lim and her book talks about it's about thriving. Right these kids may be going through life. I'm with you I'm just ahead of you because I'm the MTV generation so

(22:11):
we probably ever laugh a little bit here but yeah what was put in front of you. Right. But we were outside all the time. Yeah. And and if something hurt you you you kind of knew it and we figured out.
So the deal with that you didn't always say anything. And I think that's one of these things a lot of these kids do they just figure well this is how I am. Exactly. And you just kind of work through it and their bodies doing these weird things to compensate for it.

(22:37):
And now you have to unwrap. Yeah. And that's the other thing is like you know like going back to being like a patient of this as well like I had like a like a full septal pasty and like my sleep proved so much that I didn't realize how poorly I was sleeping until that happened.
And like I felt like I like I feel like I was like behind standing behind a jet plane and air was being blown in my face because it was like I broke my nose twice in basketball and like these kids just like don't know what they don't know and that's always been like they might have a stomach ache since they were an infant having

(23:13):
reflux silent reflux and nobody knows you know add that they're nonverbal. Now it's like yeah yeah and it's and people really like really dismissed that a lot like they really do I've had kids with two fakes that are like hospitalized when they're trying to that are
nonverbal they're trying to communicate that their mouth hurts and people put them all sorts of stuff like give the kid pain meds. It's one of the things I always ask me please go out your pediatrician if we can test if there's any pain going on right my nonverbal kids

(23:45):
what do they do with their motor skills that they have they're hitting their face they're hitting their job. They can't sit and co-contract and rub their face like you and I might or like our belly.
They might head bang if they have a headache right and these behaviors look really aggressive and then ABA is like oh it's a behavior we gotta do this or something like behavioral like attention seeking it's kind of like whoa like first can we rule out if this gets any pain like what

(24:06):
right behaviors that form a communication and with kids who are nonverbal people have to really kind of like think about it's like when an infant starts pulling out their ear that's if that infant has the manual dexterity and find motor skills to do so.
My OT kids they're gross motor that's you is barely find their midline to try to leave you that it hurts yeah go and smash their head against stuff and then it's like we test with the pain med or whatever alleviating it or something like that or whatever we can get our hands on the the

(24:36):
the pediatrician or someone will recommend for the pain management it's like oh yeah like he was in pain whether it's TV and ear infection.
I just didn't know how to say it yeah I think that's it me make you touched on this and in you and I had talked about this a little bit before.
And this to me kind of correlates it's that whole ADHD thing as well right where we're just assuming.

(24:57):
They have this attention issue but what we're finding more and more is okay maybe but can we park that every year let's back up a little bit and see what is their mouth like is anyone looking inside how are they sleeping how are they breathing.
To your point how are they chewing how are they swallowing and we're finding a lot and a lot of cases not all cases.

(25:20):
That when this is addressed that quote ADHD diagnosis that has had a medication associated with it.
Subtracts and now we have a very different child just from addressing the map. Yep, the symptoms of the severity or the symptoms in general go down significantly because these kids are finally getting restored of sleep that their brain has

(25:43):
needed for years. You know it's like literally when you don't produce nitric oxide and oxygen like you know this it's like I call it frontal cortex deactivation impulse control self regulation emotional regulation.
It's like it's like it's gone. The brain doesn't have the like bandwidth, nor the resources to provide for that. So what does it do focuses on heart rate, blood pressure, digestion, all the bear necessities to keep the human alive.

(26:13):
And so you know like person and whatever city they might be in because doesn't have the bandwidth to do so. And, and yeah and I really believe in more and more what I do and Dan Dan out here with like what I see in my clinic, and all the research coming out
and everything to know all the great work that you guys are doing and stuff but like, I really respect it's it's like really complicated but it's also not.

(26:38):
Like like I'm like the anatomy is off. It's fixing anatomy. You also have to just respect biology and physiology before you go into neurology and psychology.
You would never a psychologist would never diagnose someone with depression if they had sleep apnea that was super severe and they knew that, and they would rule that out and get a medical clearance of that and if the the symptoms persisted then they would address it.

(27:00):
Right. And it's so interesting was it year before last the surgeon general put out the number one priority was teen depression and suicide.
That was that's what he said was the priority. And you know, we've got that on our website if anybody wants to look at it but now we're starting to understand how much sleep and airway plays into that.

(27:21):
Absolutely. So it's so important like you have to have the basic like gas exchange to charge the electrical components for things to work for those nerves to fire for your brain to do what it needs to do like you know what is like what are the ABC is the first one's airway right
paramedics. First thing you check because if not and like I feel like when your mouth breathing or you have breathing issues or deviated septum or large tonsils or all that. I feel like you're like almost I hate to say this but like you're slowly kind of dying it's a slow like

(27:53):
You're in survival mode. Yeah as you're dying because you are impacting the other thing we're finding you're impacting your ability to thrive you're impacting your health span and you're setting yourself up down the road for cardiac issues or cardiovascular issues all timers they're connecting it with and dementia
dementia.
And we could we could address it here.

(28:15):
I know.
To prevent it there.
Yeah. And it makes me so sad to like think about that but it's so true like if you're in fight or flight your entire pediatric life and your heart is going to be so taxed and your nervous system is going to be so tax you be so dysregulated and then if you haven't been sleeping since you were born
well. Yeah.
Risk for Parkinson's dementia like what we're seeing now with the gray matter and all those things it is insane and people like

(28:43):
it's like not something like I don't know why people are like aren't like screaming like it's like what like I don't know what else like it could be more important like it's like neuro cognitive degenerative like disease but like a slow slow burn and it's like
it manifests in pediatrics and like ADHD or whatever you want to call it or things like that and like the symptoms of that right but it's it's so it's such a basic need and that's what I'm trying to say like it is so complicated like the orthodontics and the therapy and this it's not easy right

(29:15):
right.
Everybody works together on this channel.
Yeah, and then it's a lot easier but it's but at the same time it also is very like I got to get this kid breathing and sleeping and then maybe they'll start eating better because they're going to be in a better mood and then maybe
I mean and breathing has so much to do with digestion and then maybe like if they're nervous this is a little bit more subtle on her.

(29:37):
They'll poop maybe your veins will activate me like you know what I'm saying like it's just like, again like biology and physiology like over like before neurology and psychology I say that all the time, because it's just so I don't even know it's just true.
Yeah, and I agree I agree.

(30:24):
You can find out more about the Children's Airway first Foundation and our mission to fix before six on our website at Children's Airway first.org.
The CAF website offers tons of great resources for both parents and medical professionals.

(30:49):
Visit our parents portal clinicians corner resource center and video library to see for yourself.
We also encourage parents to join the airway huddle our Facebook support group, which was created for parents of children with airway and sleep related issues.
You can access the airway huddle support group at facebook.com backslash groups backslash airway huddle.

(31:13):
As a reminder, this podcast and the opinions expressed here are not a medical diagnosis.
If you suspect your child might have an airway issue, contact your pediatric airway dentist or pediatrician.
And now let's jump back into today's episode.

(31:55):
So it's interesting because one of the things we're talking about is before we came on.
Your website was so fascinating to me because it's so sleep is so interwoven.
Yeah, and I don't see this a lot, especially not on O2 website.
I just don't see this.
So and then and I will encourage parents again, go to this website and the School of Sleep specifically was a great section.

(32:24):
And you talked a little bit about some of the behaviors that you see that, you know, where you can work on improving with proper sleep.
I mean, something so simple.
But just and one of the things that you mentioned, which I haven't seen, I just kind of wanted to clarify it was less reliance on medication.
So what medications are you talking about there?

(32:46):
Yeah, I mean, we've had so many kids who come in and they're on like really high doses of like anxiety medication or they're on heavy doses of their medications for like attention or regulation, Adderall, Ritalin, things like that.
And a lot of times most of these cases there's been a really big kind of what I call like smoking gun in the case it's been either not addressed or not discovered yet and a lot of those times there's been like tonsils and adenoids that kind of no one's talked about.

(33:15):
And post tonsil adenoid and like a few months of therapy and proper orthodontic intervention and things like that. And these kids start breathing and sleeping so much better.
And they start minimizing the use of their medication. Right. And that's not something that I say like I'm going to do this, but like does that happen? Yeah, it does.
Am I am I elated for that to happen? Absolutely. Is there a time and place for medication? 100%. I'm not against them at all.

(33:40):
I think there's a balance to it. I do think you have to kind of rule things in or out and kind of see how things go. But yeah, we've had lots of cases like that where when you address these things and your user really integrated approach, they can kind of decrease their reliance on that and that's been really amazing to kind of be a part of that process for people.

(34:02):
It truly like changes like their trajectory. Like and it's something that is never like a goal or report or anything like that. Like my goal is just to get them sleeping and breathing better and from a regulated and more integrated.
And then these kids are a lot calmer. And so yeah, and that's not my responsibility to kind of manage the medication. But then the people on their team who do that do that. So yeah, it's really interesting to kind of see those things.

(34:27):
But I think that is very interesting. Another thing that you talk about is go back to the tiny people again. Like babies as another sign that you put on there that again, I haven't seen it somewhere, which is why it makes my interest only sleeping when hell.
Yeah, yeah. So there's some babies, you know, who, you know, I forgot what the statistic is, what they say is that like sometimes a baby does it for there's for months that they don't even know that they're separate from the mother, right? And they want to be next to the mom for, for a long time for quite some time.

(34:58):
And there's a there's a period of time where like, it's a healthy thing. But for some, some babies or some kids tallers that goes for far too long, right? And they need to be held or they need to be rocked.
And a lot of the times there's like this, like, if you really like zoom out and think about it, there's like a sensory ritual that's happening. I have they need to be bouncing the birth ball, I need to be rocking back and forth.

(35:19):
They need to, they need to be swaddled or they need to have this like weight compression suit thing that I'm not a big fan of those. You know, it needs to be a certain kind of way and things like that.
What you want to do is eventually create a nervous system that can be more resilient to adapting to environments, right? And if there's an I'm all for people sleeping with how they think is best suited for their families and things like that.

(35:42):
When people come to me and they want that change, then we kind of look into this. I'm not critical of this if this is something that works for people, right? If that works for them, great.
But then by the time the other kid rolls around or mom's pregnant, they frantically come to us like, I have to get this kid off me. Like they need to be able to sleep on their own, right? Or the like, it's they need to start going to daycare, whatever, whatever the case might be, like they need to kind of start being able to self regulate in that way.

(36:09):
And so we kind of analyze like what is like, okay, let's also look at the schedule, the nap time, where should they how much sleep should they be getting? Is it good restorative sleep? The OT that like has partnered with me in that way is Esther.
She does more of the sleep hygiene and schedule and things like that. I look at the child and look at the airway and make sure that they're breathing is how it should be and that their tongue should be where it is and there isn't any medical issues or more structural issues that might be impacting those things.

(36:35):
And then she looks at all kind of more the external things. Is it like the schedule with also feeding? Is it the setting? Is it like are the rooms really bright? Like whatever the case might be. And then we kind of combine it and talk and basically see what's suited best for that little person so that they can sleep on their own, right?
It's basically allowing that little person to understand like when they should sleep for how long and like getting the appropriate restorative sleep as they should because again, if a family brings this up to us and it is kind of past the point of where they should be in development, then we will address it.

(37:11):
Because it is, it's not something that is sustainable, especially with a household with multiple kids, right? If mom eats, she's pregnant or she's breastfeeding the next baby or whatever the case may be.
And that can really impact the quality of life in the household because then no one's really sleeping and that's an issue.

(37:32):
Yeah. That's something like in general, like I do remind my team of that a lot. Like if the kids are at our clinic, like we have a specific, I mean, we welcome everyone, right? But like we're kind of known for kids who like our sensory kids, motor kids, all those things.
But also typically they've got some sleep stuff going on. And I remind everybody, I'm like, and my friend does this, you know, it's like, yeah, they're not sleeping like, you know, parents aren't sleeping, right? It's like not, like you just know that.

(37:58):
Like they're, oh, yeah. Like if you have a little toddler that crawls into your bed every night, right? And now they're kicking you and you're tossing and turning and you wake up to their teeth grinding.
Like, and now you're worried about that. Like that's going to impact the parents.
Right. And that's that's where when the kids start sleeping, everyone kind of starts sleeping. And that's really what the school is sleep, especially postpartum. And like the first year of life, it's really amazing to see that.

(38:22):
And especially under three to what Esther's work does and how we work together in that way. It's amazing. Like it really does get everyone on a really good, healthy like sleep schedule.
Yeah. And you, yeah, having that caregiver, healthy. And then that right mindset and calm. Once again, now that's going to go back and it's going to reciprocate. Now that's going to go back to the child.

(38:45):
Yeah. There's a ripple effect that happens within everyone around them in the household. Yeah. And you have to prioritize that. And, you know, there's also sometimes there's time crunches because maternity leave ends and things like that.
And there's, yeah, and they're like, I need to get this kid sleeping. It's like, okay, like, let's like, let's like take like zoom out. Like Esther kind of takes like the zoom out. Like let's look at everything that's contributing to this.

(39:06):
And I kind of like zoom into the mouth and the nose and the airway. Like, is there anything here that's an issue that we need to be addressing? Right.
So usually the kids have kind of gone through my process and that there's still something second have to go on or like there's a time crunch. She will kind of take that the lead on that.
Yeah. So again, it's back to that collaboration with us for the child. Everybody working together. I really have that. And you also talk about biohacking.

(39:29):
Yeah. Yeah. Yeah. Yeah. I mean, so you kind of remember like, especially for like, I think some of your listeners like they're going to know who like James Nester is Andy Huberman.
It's like, do you really think about what I've done or what I'm doing is I'm taking the principles from the biohacking space and applying it to the special needs world.
So I, you know, like the kids when they're in these sessions, if that we have air clearance in the ENT like kids are doing regular OT stuff on a swing catching or throwing, you know, coloring using their pencils scissors or whatever, but their mouth is taped.

(39:59):
Or they've got a mild munching in their mouth or we're doing, you know, like all sorts of coordination exercises and they've got something in their mouth and the therapist is there checking what's going on with their mouth all the time and yeah, it's bio like I really kind of feel like that's the best way to kind of say what we're doing.
And then from what when the school sleep, it's like biohacking is essentially we're trying to do everything in our environment to like elicit an optimal environment so that we can get optimal like sleep.

(40:31):
And so we can function as best as possible, right, because that's what biohacking is it's what can I do to myself or my environment to create like optimal outcomes like right now I'm sitting on a pad that has like red light on it.
And that's just something like that's important to me like I've always been someone who, you know, will buy like the first edition of technology to see kind of what it is. I've always just kind of been very curious in that way.

(40:55):
And I think that's kind of what's led me to my own also just in general as a person in my own health wellness I really kind of always want to know like what is what's next like and I think that really make kind of as a clinic that helps me as a clinician.
But yeah, we're basically trying to like biohack like a baby's environment, really to get the most optimal environment for whatever passive development it is whether it's feeding whether it's sleeping whether it's sensory motor experiences general development things like that.

(41:28):
And there's lots of things that people just like don't know because they don't know.
Right. Yeah, a lot of people in our country especially like there's a lot of people are really more into like the Western approach to medicine and like, you know, I, you know, I only say this because parents report it but when they come from huge institutions or things like that like they are doing things that are outdated from like 10 years

(41:53):
ago 15 years ago and it's like, you guys like the tech like, okay, here's a good example. I love my profession, I do. But like, Pam certification physical agent modality certification is kind of like my swc, but the high tech that you can use with that is ultrasound.
There's leaders out now that are changing the game.

(42:16):
So, boards is not even having a conversation of like, pts are starting to do them. Oh, he's like, why are we not talking about that? Why are we not like, and like, look, I wish I had like three of me so I could be like standing at the Capitol like with the sign being like let me do this laser.
Right.
But like, it's, and I get it medicine has to move slow for safety, you know, I get it but I also am kind of like, I don't know.

(42:40):
I mean, you don't get it. Yeah, there's a difference between safety and let's talk about the impact on the lives, because we're not moving.
Yeah, so that's what this generation just like S.L. because I have to like wait for this like it's kind of like, I don't know, you know, and it's like, I get it but I'm also kind of like, well, what about these guys like they don't there's like, sorry, buddy, like I
got to wait for this to come out and like, it's different for the medication that I understand like RTT is not that but in the little it's not as like, we're not like cutting, you know what I mean like I'm not looking at a CO2 laser but like the what I'm just trying to say is that like, so many of the

(43:15):
people in this field like we're on the forefront of things which can come with pros and also comes with its like challenges right.
It's frustrating because you know, but you can't do. You can do and then it's like people come to me really frustrated because they've been working in like institutions or in certain settings or in certain places or clinics that are doing stuff that is like really

(43:39):
like old school and it's like, well, no, like there's there we are like there's like so much more to do here. And it's like there's still that thinking of like, oh, well I want to see the studies and peer reviewed and airway now we have all that like there's no like, put this ring on like
you know what me to tell you like let the ring tell you like it's not completely objective now right so it's just it's something that is like a professional I always kind of have to like, I feel for a lot of families that come to me because they come I'm like their third or fourth

(44:10):
right they're like annoyed by the time they get to my door and if they're like if they're like you know somehow here and I'm their first OT like they kind of even really know how different we are right. But the other ones are like, what do you mean like I have to do this part again
or like wow how did this not stick. How why doesn't he know is left from his right so we've been here and OT for four years and like his he's never been sleeping like he's that little short term memory never turned into long term because he was never sleeping this entire time, and people

(44:42):
never they pissed rightfully so sure. And I get it but it's like it's so it's hard in that way and then it's also like it's it's limiting with what the technology that's out there and the access that the people in our field particularly like don't always have like you know I'm
sure dentists feel frustrated in that way to like I can tell I can see these things right it's like oh but the doctor has to say it's kind of like.

(45:06):
Right right or not or even it will right because that's a huge one in this this collaboration which again not their fault they've been taught to stay in these silos.
But as we're finding you know if you go up to worries and you hang out with Dr. Boyd for a while.
Collaborating.
Mind blowing changes right just that simple little act you can take that child's health to a whole new level.

(45:28):
I mean it's just it's it's just we know it's a fact but even to your point like technology. Some dentists with CBCT they're never going to go back because of what you can see in the different she can make.
So many that don't have them out there or parents can't get to Dennis and providers that have this equipment.
Yeah yeah and then it's like the double edged sword to is like small practice owners that invest in like a giant piece of equipment that's like over 100 grand and people are like oh my gosh it's like so expensive the dentist and it's like yeah that dentist like has like hundreds of

(46:00):
dollars a thousand dollars a debt and from schooling and equipment and building a practice and like I think there's like a lack of understanding on the patient side of it right and it's like we're all doing our best and like we need like to advance with this technology and it's like truly just like a reflection of the system that like people don't have the
access and medical care that is the most advanced and there's like I don't think any country has it perfect but like it's so just

(46:26):
it's like really like it's frustrating like for me as like a human and as a professional and as a business owner because it's like you want to be like advancing but then it's also like not everyone can kind of get there or they can't find you and then it's like you're trying to help them as
best you can but like this is all you can do like you can only consult them like if they're not near you right or like in California like I work with people in Northern California and I find them clinicians and stuff like that and they're like oh but this dentist doesn't have that and like oh and I don't

(46:55):
want to say like can you just fly to LA and a lot of people just do that like this is like the Mecca a lot of people just like fly here and they stay here for a month and they see everybody and they do the CBCT they see the
osteopath come back six months later put the orthodontic thing in the alpha whatever do some therapy and like keep going because like it's just it's it is one of the hubs kind of like Chicago is and so is New York and these are the hubs for this right and kind of and you and I were talking before we came on and you seem to be in the same boat that so many people are whereas if you just don't take insurance

(47:33):
now suddenly you can open up the world to okay now we're going to focus on sleep and airway it doesn't matter what is or isn't covered this is the right thing to do.
Yep.
Yeah, and it kind of goes back to you know we as lay people don't always understand that I mean it's frustrating for us because we're thinking but you're who I want to go to.
Yeah, but there's a cost to it right now, literally.

(47:54):
Totally yeah and your insurance company won't cover any of it and they think like they're not they don't even talk about it like unless someone like maybe you'll get your super bill reimbursed from your dentist for like orally treatment if you have a sleep apnea diagnosis right and it's mind boggling that like I have kids that go to these like larger institutions
and do these overnight sleep studies and people are just like yeah but it's like mild sleep.

(48:19):
It's mild.
And I'm like that still kills me.
Yeah, I'm like I'm like I'm like I'm here.
Right.
Like what?
Like how.
No one ever says oh you have mild cancer.
Exactly.
Oh, like it's just kind of like it's not fair like it's just not.
And then the parents kind of like it's kind of like get really confused right because they've now gone to different clinicians and they're very kind of like well they they said this and that and Boba and I'm just kind of like.

(48:46):
You wouldn't be here if everything was fine like why are you are you like okay but like it's not like it's not it's not okay that like you're two year old is going to see Pat machine like you know it's not just because it's just because it's common.
I love this quote from Oralia.
Yep, it's not normal.
Yeah, it's not.
Yeah, yeah, it's it's and that's the sad thing is is that we have made this so we've normalized almost no way glorified people who don't sit back.

(49:15):
Oh my God I got here in college.
Oh my God in C plus now like I was working all night.
Like America, I think because of like our kind of like set up in a way right like we are economy like we glamorize people who like work really hard and like don't sleep.
And it's kind of like wow, but it's also like at what cost like I'm I'm a myself like I am to.

(49:37):
And I'll tell you what it is night and day I used to brag oh I come from this long line of people we sleep about four hours a night.
Once I started sleeping six or seven my whole world changed.
Yeah, just something that simple.
My anxiety dropped and just like that.
And then so did my weight.
And you're starting to see me just something so simple.

(49:59):
Totally.
Again, and I'm an adult.
What if you did this to a kid that's just starting.
I know.
Amazing.
I know and I like talk to like the school administrators to like we've got a lot of kids like my private schools that are open to this like we've got like a lot of these kids are gonna sleep in really do you think they should come to school late.
I'm like yeah.
And if the parents can and they go late world difference.
Yeah.

(50:20):
That hour 45 minutes like if you're waking your kid up like something you know is and like why they have to start so early like I don't know why that is like there's historically there's a lot to that but like it's it's just like so unfortunate that we're just like driving humans at this
like pace that's like so unnatural in a way.

(50:42):
The level of it's unnatural.
It's super unnatural like everyone's circadian rhythms off like there's now your car has a giant screen like so many of our family I love I like don't be wrong I would totally own a Tesla but like our kids will come out of recessions like regulated we do a drop off in our parking lot because like we've automatically fragile kids here so we don't have extra like
bodies in here and their Tesla kids get in and they're like automatically dysregulated.

(51:05):
Right because there's the screen.
They're they just go nuts and they just want to touch the screen these things and all this and it's just kind of like you have a chance to not get stimulated like you don't have a chance.
You know as a parent try to take a cell phone away from a child when you ground them.
Right.
And our day.
That was part of grounding right you can't be on the phone.
Okay.

(51:26):
So you just go do something else.
It was not a big deal but I didn't really understand it.
Because my first one went through it by the time I second one came up I understood it's not that she can't have her phone to talk to people.
It's that stimulant.
Right we're taking that away.
And what's interesting is that like what I see is that like children now have such a challenge when they're not stimulated that they don't know what to do and they won't ideate like no one's comfortable with boredom anymore and boredom is where I'm so bored.

(51:58):
And it's like and it's like okay like go find a stick like go find a bucket like I don't know like like play with something or like ideate something and but what happens is when you have a tolerance of like we're like Cocoa Mellon is like what's stimulating you and that's like so visually
so stimulating almost vestibular there's so much movement it's such bright colors the scene changes every three one to three seconds like that is insanely stimulating and like you're asked to like look at a piece of paper and look at a book or like not look at anything

(52:32):
or just like look out the window and be stimulated it's like you have now created a dependency of a dopamine hit with that stimulation so heavily and I'm not here to like screen hygiene shame anybody I just want people to know.
No, no, yeah, what's what's a thing.
Neurological level with these like you have to remember developing brains that are so susceptible that you are literally creating the tolerance of what they require to be satiated and people wonder why like kids like don't want to look at a piece of paper that's blank it's like yeah because it's like not moving and jumping out of them.

(53:05):
It doesn't say and it's stressful I don't know what to do with it.
I have to do with it. And it just really creates this tolerance that's like not achievable without that and it's such a new technology and it's so like the accessibility of it is just so it's too accessible.

(53:26):
It's far too well and it's it really is like I have such a pattern in my my my practice where I just for different motor like skills right visual motor integration visual perceptual and motor coordination that's just like one test okay.
But a lot of kids will come in and their motor skills are really low but their visual perceptual skills are so high.
And I will ask and I'll say how many hours you think your kids on the screen. When I asked it on my intake to say oh like three or four and I'm like I can tell.

(53:56):
And I say and I'm really nice and like look like we just got to work on this and like but their brain is becoming imbalanced from this.
And then I think people kind of get it a little bit. You know and I get it everyone's tired they just want another kid to be relaxed.
And I just watch something like I really I don't have kids if I try to understand as much as I can pick a book pick anything like do something but just not that because these brains are literally forming in an imbalanced way.

(54:25):
And then you expect them to like right like it's like it's a lot.
And kind of to your point you know when we were younger it was okay we'd eat dinner and then the whole family may go watch shows together or you know and you all hang out on the couch together very different than now.
Your child had the stimulant all day. So now to come sit as a family and watch TV. It's a it's a different world.

(54:50):
It's like different.
Yeah like I was just in the elevator today and like I my hands were full carrying a bunch of stuff and like I didn't have my phone on me but everyone who walked in was on their phone and I was like wow.
50 years ago like these people would have said good morning or said hi to me but like they didn't because like they're everyone's like on their phone.
And to this like it's literally like a hand grabbing you it's like pulling you out and people do parallel screening I mean I'm like scrolling right couples and don't engage with one another and it's just there's so many like missed opportunities for like social kind of engagement because of it and it's like you know I like I you know try to advise my family

(55:29):
and say okay just have one tablet then your kids have to share it and it's like yeah it's gonna suck for a bit but like at least they're watching the thing together.
Pause it make them talk about what they just watched like trying to do anything to like kind of create a little bit more of like a balance the balance use of the tool and like look there's times you're just going to need to use it and that's fine but like it really I think people really don't realize how we don't know what the long term effects of this are at all.

(55:56):
We really don't. Right because this is Gen Z is the first group that will have this from birth everybody else but we didn't have it.
The Y's got it halfway through Z's and the first one to have it. And look at the like look at what you the stat you mentioned of the suicide rate of teenagers and depression.
Yeah. Yeah.
It's not looking good.
It's not.

(56:17):
It's really not and it's like it's it's it's such a like I said before it's a very different world post iPad it's a very different world post COVID it just is.
Yeah.
Yeah.
That's true. That's true. And so you kind of mentioned this a little bit earlier so for our parent audience that's listening that they don't live in LA how can they access this kind of care for their child?

(56:43):
Specifically like OT and Mayo or.
Or with the sleep and airway. I mean like I said from the beginning that was part of what intrigued me so much about your website.
Yeah.
Because it was so different because you do talk about.
Yeah. And I you know I will be really honest like there's not a lot of people doing it at the level that we're doing it at and that's the within more OT and integrative approach like it just not it's not out there and from I know this because other people have interviewed me or research and stuff.

(57:10):
I would say like trying to find a no T who does my I was your best bet airway airway circle is a great resource for that.
If not I would definitely like if your kids in OT, you should have your child your I believe your child should be screened for airway stuff and you should be looking at a malfunctional therapist.
And I and then an ideal world they'd be working parallel together if you can't find an integrative clinician. I say this because.

(57:36):
And I and I this is with no, like disregard to my OTs or to my parents who have been in OT or anything like that but if you're taking a kid OT, they're usually there's a regulation thing going on.
You want to make sure that the OT that you're doing is penetrating well, and that's how it needs to be breathing well and sleeping well, because if not the swinging and the crashing and the jumping and all the things.

(58:00):
It's just not going to hit like it's supposed to it just can't like a kid for ventilating on a swing.
How regulated are they getting of course will be more regulated on the swing you might see a more regulated state or adaptive response for a little bit but is it going to carry like it should.
Again biology and physiology before neurology.
And I am like if you can't find an integrative clinician who does both.

(58:24):
And I would definitely do parallel of like my own OT and because when you start to work with the mile then your kid won't need that their sensory needs like typically will go down in intensity and severity, because they're more regulated we have so many kids who buy scratch hit drop
like we've had some really intense behaviors here older kids we work with a lot of kids with AC devices who are nonverbal. So this is why I know a lot of what the nonverbal community communicates to me for through their body or through their devices some of literally said mouth hurting.

(58:56):
He's 16 is wisdom to this coming in like somebody get this kid of the dentist right yeah like the like if there's a regulation component you have I really truly feel like you really need to roll out sleep or airway issues and if your OT is not
trained in that find a malfunctional therapist who is or speak surface who is and have them evaluate and assess and treat that side, because you really that's to me, how you have more of like an integrative more kind of just whole picture assessment

(59:28):
of what's going on, because now, you know, I'm looking I'm trying to find kids that are brought to my clinic who don't have airway stuff or don't have something.
And so many of them do. I'm like there's none that come here and like, I'm known as the mile person so yeah like statistically like I'm going to get all the mile kids and I get that and stuff but like all my colleagues and friends like they're like, oh my god,

(59:51):
I know that I know what you said like, okay, I'm gonna refer them to you and I'm like, yeah, you're right like this kid's got this going on right like it's it's a thing and something that I think parents. It's not easy, but it is something that like doing your due diligence of that will be
really helpful wherever you are and you can usually find my over through someone now. Thank goodness. And you can usually go to but that's what I would say is the best route.

(01:00:16):
Yeah, that's a good way. Yeah, yeah, for now. So at the end of every episode I always hand it back to our guests because you are the experts after all, for the final thought to leave with our parents.
That's a good one. You know, I think person foremost like parents need to like trust their gut, and they need to understand that if you're probably listening to this or if you're down this rabbit hole, it's, you're probably on to something.

(01:00:48):
And you're doing yourself and your child a great deal of service to really start getting more into the deeper root causes of what might be going on. And I would also say with that is that you want to develop a team but you also don't want to shop everywhere,
because you want to write, you want to ask the right people the right questions. You're not going to come to me for an ear infection, your pediatrician who has no training in airway, you kind of don't want to ask them something because they might derail your thought process and I love

(01:01:17):
pediatricians don't get me wrong, but we all have our they we need to be educated in some ways and they need to be educated in ways to but like those and those are like when the sleep city comes back with mild sleep apnea and someone just tells you it's mild but you hear your kids stop breathing 16 times in an hour.
You're like, I'm good and you're like fire alarms are growing off like you should trust that people don't let someone talk you out of what your experience is, find the clinician who will validate that and dig with you is really what I think is really important.

(01:01:49):
Yeah, it might not be easy to find that person but keep searching because we're out there. We've been digging for a while and we're on there with you but like it's, I find it just as a human and I'm sure parents can feel this way too maddening when someone
validates with their experiences. And I think as a healthcare professional that's like one of the worst things you can do. And I just, I really want people to understand how. Yeah, this is really complicated but it's also really simple.

(01:02:20):
Like I kind of don't have any tattoos but if I think I got one it would be like biology and physiology over before neurology and psychology like truly like it's, it is, it is complicated but it is also simple like we need to breathe you need to sleep you need to eat
poop. And theoretically things should start working and can't breathe. You're not gonna sleep you're not gonna eat you're not gonna poop.

(01:02:43):
Yeah, and it's time and I can't tell you time and time again how I see this. Right. And it's like we people want to come to me about like selective eating and I'm like let's talk about the sleep first and everyone's like what and then I explain it and they're like,
okay, I'm like we'll touch sleep. I mean, eating in like a few months or nine months or whatever the case is and also like, I also want people to also kind of understand that this is like a marathon and not a sprint. A lot of cooks in the kitchen.

(01:03:13):
This is one of the most complicated parts of the body like I said in the beginning, other than a female's reproductive system. That's why you have an ENT is why you have an ortho this is why you have a dentist this is why you have the tongue type specialist this is why you have a
dental therapist maybe you you're lucky and you get a two for and your mile person is a speech therapist, combined with a mile or an OT combined with mile, or you have to have two separate people because you live in a more rural area and that's just kind of the way the cookie crumbles but like, you need these

(01:03:43):
people because we all are complementary to each other and we all have different roles. I can't tell you what the best appliances for your child like I can tell you kind of my experiences but like that goes back to the dentist and the ortho right.
I mean, I do but like, are they gonna be able to the dentist going to give you like your myo exercises probably not. It's too much as this is such advanced training and it's so it's so complex there isn't a one size or one program fits all.

(01:04:14):
It's something that of course we all wish there was not magic bullet or magic pill for that, but it just isn't. And you just remember if like it takes a while because you have to kind of as long as much as you want to like recreate something you also have to undo the
pattern that has happened. People kind of dismiss that a lot because parents are like I want to know how long I'm going to be here and I'm like well like, I don't have a crystal ball and I'm a clinician on a magician like I don't know, but like, also, don't forget how long it took to get here.

(01:04:46):
And don't forget that this is very pattern half the battle is un-patterning things. And if there's a sensitivity now there's a bigger battle with the desensitizing and un-patterning because the desensitization process is not fun for the kid or anybody when they're uncomfortable, right and you try to make it as comfortable as possible but, you know, if
your tongue and your palate haven't touched for a really long time then all of a sudden you're trying to get your tongue up to your palate you think that's going to feel good? Feels weird. It's a load of mouth breathers. Super high-arch palates never get touched.

(01:05:18):
You think they're going to touch it with their own tongue? So many kids don't gag. They don't like it. And so you have to kind of give your clinicians and your team grace too because like this stuff takes a while to un-pattern and then redo the
team. So, I mean, that was a lot longer than like one phrase but it's kind of like full circle way of like from like the perspective of the parent of trusting themselves but also from the clinician side of like why this is so, so at the same time like simple but complex.

(01:05:51):
Yep. And we say this all the time you've got to collaborate. It takes community and airway mama bears. You've got to trust that gut.
Yeah. And it's unfortunate because like there's no longer that like tribe for people and stuff like that. It's like so long ago but I feel like the airway community and I feel like different communities and pediatrics are starting to become that tribe for so many people which is like a really beautiful thing to see.

(01:06:15):
And like a lot of parents tell me that, you know, they're like, oh, I've come to you for like every question, you know, because like, well, so they're going to go to like their like five, 13 minutes. I see them weekly for an hour. Right. So yeah, it's different.
And that's kind of to that point is I'll put a link to the airway huddle on here for parents too because there is a community that we're trying to build and foster parents can talk and collaborate and share and

(01:06:40):
totally not walk this alone. Totally. Absolutely. Which is great because this wasn't like, it wasn't as like, no, not long ago, you know,
I cannot thank you enough for coming on today and sharing so much amazing info. And again, parent link is in the show notes. Check out the website.
Yeah. Thank you so much for having me. This was a blast. Love chatting with you and can talk about this stuff all day. So thank you so much.

(01:07:06):
Same. Thank you. Yeah. Awesome. All right.

(01:07:37):
Children's airway first.org. Today's episode was written and directed by Rebecca St. James video editing and promotion by Ryan drawn and guest outreach by Christie Bojikin.
And finally, thanks to all the parents and medical professionals out there that are working hard to help make the lives of kids around the globe just a little bit better.

(01:08:00):
Take care, stay safe and happy breathing everyone.

(01:08:30):
Yeah.