The Power Of Breathwork In Our Function with Erin Browning

Hi, and welcome to Real Life Momz. I'm your host Lisa Foster and Real Life Momz is a podcast that's all about connecting moms through real parenting conversations. I believe that moms has so much insight and knowledge, and together we are powerful. On this podcast, we give moms a voice to tell their stories, share their expertise and resources through real conversations. And this week we are joined by Erin Browning. She's a speech and language pathologist for more than 20 years, she owns her own private practice, Evolve therapy, where she treats both adults and children. 

And today we are discussing calming our nervous systems, using breath work, and hitting on hot topics such as tongue tie and sleep apnea. 

Hi Erin, welcome to Real Life Momz. I am really excited to have you here today because you're a speech therapist and you have expertise in oral malfunctional therapy and you use breath work to help kids calm their nervous system. And I'm just a huge fan of breath work. I use it a lot in my own private practice, and I feel my clients really benefit. So I'm excited to have you on the show today to learn more about your expertise and how you can work and help kids and their parents. 

Thank you for having me, Lisa. I'm excited to be here and talk with you. Uh, typically when I do podcasts, it traditionally has been more of my personal story. People are more interested in our challenges than in our accomplishment. So my professional life has been a bit of an accomplishment. My personal life has been a bit of a challenge. Um, and I will tell you just a little about that to get started. 

Does that seem, 

That sounds good to you. Sounds wonderful. Yes. Tell us a little about yourself. 

Yeah, so I am not a mother biologically. I am a stepmom. Uh, my, I met my stepson when he was nine years old and he is now 18 getting ready to graduate high school next week, which is a huge accomplishment. 

Congratulations. Yeah. 

Yeah. Thank you. Um, and I am actually not even a traditional stepmom at this point because, uh, almost two and a half years ago, my partner, his father Dave died. So I had been a very involved stepmom. I will tell you that Dave gave me incredible amounts of leeway that many parents would not. Dave's ex-wife gave me incredible amounts of leeway as well. And partially because of my professional background, they knew I knew mm-hmm. 

<affirmative>, if that makes any sense. So my stepson has a D H D and he has always been a, a very energetic child, <laugh> a very, um, engaged child or needed to be engaged. Mm-hmm. <affirmative>. In fact, the day that I met his father or the day, hi, I met him through his father. We had a date, and Connor ended up at his dad's house like a day early on the visitation schedule. 

And Dave looked at me and said, I know how this goes with 30 year old women who don't have children. I will probably never see you again, 

<laugh>. Oh. 

And I said, what are you talking about? And he said, well, let's just put it this way. Uh, he needs to be engaged a hundred percent of the time, or we're gonna have a mess on our hands, it will be trouble. 

Yeah. 

And, um, and I fell in love with, obviously with my partner and then with his son separately. So my perspective is one that is a little bit different as we talk about breath work and what that looked like, uh, as a stepmom mm-hmm. <affirmative> and how that worked in our family. And then also, you know, just through grief how my perception of breath work and how I even worked with clients has changed in the past two and a half years. 

It's drastic, drastic difference. 

Well, and I love this so much because I know I, you know, I'm a pediatric physical therapist, and when before I had kids, the amount of stuff I would be giving to parents was ridiculous, honestly. And it wasn't until I became a parent did I realize what was really realistic. So as much as like this whole medical side needed to be, you know, filled for the client, there is something about coming from a mom perspective to be able for like the parents actually handle the information and be able to perform all the exercises and things too. 

So I love that you had this experience with your stepson on breath work and then being able to bring that into your practice as well from a mom point of view, because I think it makes a huge difference in how we handle our patients and our parents. 

Yeah, it does. And you know, I also think another added layer of that that I had not thought about until this moment is as a stepparent, I'm not his biological mother. And I would tell his mom and his dad, you two have bias. You see this kid differently than anybody else in the world, including me, who loves him dearly, including the therapists who are giving recommendations, including the teachers who are telling you all the things that are going wrong. 

You see your child differently. And even as a stepmom who loved him very, very much, I think I had just like one step removed. So if you had him and his mom and his dad in the nucleus, I was in that one outer layer of the cell, and then you had the rest of the support, right? Mm-hmm. <affirmative>. But it was a really great way to build a bridge, and it helped me tremendously learn how to build a bridge between professional world and personal world in the clients that I see for feeding therapy or speech therapy. 

Hmm. 

So can you talk a little bit about, since you're talking about breath work, um, about breath work and how you use that with your stepson as well as with your clients? 

Yeah. So if you would've talked to me even just maybe a year and a half ago, I did more of a, what I'm gonna call a woowoo breath work, <laugh> <laugh>, where I would work with people to breathe. This was not something I did as a speech pathologist, but, uh, as an Ayurvedic health counselor, that's the c certification that I have. Uh, and I would have people lie down and breathe. And a lot of times it opened up, uh, emotional pathways, uh, somatic sensing, it shifted the brain into more of a parasympathetic state. 

So, and I, should I explain this? Would that be helpful? Yes, 

Yes, please. I don't think everyone knows what a parasympathetic state is. Yes. 

So our nervous system has this automatic function. It's actually called the autonomic nervous system. It, it is not the thinking brain that is working. It is your brain. It is innervation in the spinal column. It's the autonomic nervous system. And the autonomic nervous system has two functionalities. It has parasympathetic, which you might hear as rest, digest, connect in everyday speak. And then there is sympathetic, which is that fight flight freeze. 

So what I would do was work with people to get to a more parasympathetic state, more rest digest. And then oftentimes they would, they would find healing. They would find emotional experiences, spiritual experiences, all this connection. When I experienced deep grief after Dave died, it was all I could do to just catch a breath, much less do breath work. It took me probably two years before I was able to breathe in the way that I was trying to guide clients into breathing. 

So it taught me a whole lot about the vulnerability of our nervous systems. And I'm a pretty resilient person. Mm-hmm. <affirmative>. Um, I don't have any Neurodiversities myself. I don't face any of those challenges that many of the clients I was seeing do. And so I was able to win that grief, hit empathize in a different way and say, oh, wait, maybe I need to teach breathing differently. 

Maybe I need to slow this process down. Maybe I need to get more physical about it. Uh, meaning where's the tongue in the mouth? Where is the jaw? What is the airway doing? How do we just get our bodies to feel comfortable and safe and secure before we start stirring up a bunch of breathing <laugh>? 

So true. Yes. 

Yeah. And I'm sure you've seen this as a cranial sacral therapist that mm-hmm. <affirmative> that the body has so much wisdom in it. And when it is in any sort of a compromised state, we don't, we don't make the same gains functionally. Mm-hmm. <affirmative>, you can't. Yeah. 

So my stepson, <laugh>, he's so funny. He learned that I loved to breathe, right. He knew this was my work. Um, I would frequently coach him to slow down to take a breath. Uh, and by the time we hit the teenage years, you could watch him do certain things automatically. Now, even at 18, I will, if he were to listen to this, he would probably argue and tell me none of it makes any difference, <laugh>. However, when you have an interaction with him, if things were to get heated, I could watch him. 

He would often mimic me. I could watch him move his body and almost like huff to expel that air, um, activate that vagus nerve, which triggers the parasympathetic system I just talked about. And that exhalation or that noise making would, would change the state of the nervous system and often change the entire interaction that we would be having with a teenage boy who was struggling through school, number one. 

And then his dad died and he was struggling through school cuz that didn't go away. And struggling with grief with an added layer and coaching from me was not super effective. But modeling was, even at age 16 when his dad passed, he was able to watch me and I could see him imitate behaviors, imitate my, my methodology for healing, but not necessarily when I told him to do it. 

So what I'm visioning is that you would just start doing some of this deep breathing or 

Yeah, maybe 

Not so deep if you can actually breathe deep, but, um, and he would just kind of copy it just naturally just watching you. 

Yeah. Um, it was often, honestly, it was often in our personal world, it was more of like sighing releasing in that way because of what we were dealing with. It was much more of like a vocalized sigh or moan, even something that we would, and we would sing. This was another one which activates the vagus nerve. Mm-hmm. <affirmative> beautifully. Mm-hmm. <affirmative>. And that was one of our longstanding traditions is that I would let him listen to whatever he mu music he wanted in the car with me. 

Whereas his, his parents often had that control. So when he got in my car, we listened to whatever bad language, I didn't care, we just did it, whatever he was into. And it was a connection point for me and him. But then it became a moment where we would have like singing parties in the car and it would shift everything. 

Yeah. Every single thing about the interaction. It is one of my primary tips for families. Um, and I've used this with my stepson a lot. I would say, we need two songs mm-hmm. <affirmative> and then we can revisit this. Yes. Whatever was happening. And that's how we would sometimes like, break the cycle of whatever negative thing was happening. And uh, I don't know how old your children are, but teenagers mm-hmm. <affirmative> are difficult. <laugh> teenagers can be difficult. And we would do, you know, we would start listening to this mumble rap or whatever music he was interested in at the moment, and just sing and, and listen and not be involved in the interaction, in the problem solving in the, the situation that required us to use our frontal lobes, our executive function. 

Cuz we just weren't in a space where we could do that sometimes. Mm-hmm. <affirmative>. 

Yeah. And I, I recommend singing and humming. That's another one that will stimulate the vagus nerve as well into that parasympathetic, like you said. But I also not, I recommend this a lot with, especially with kids and adults with anxiety. They're very anxious. I always recommend, I'm like, do they like to sing? Put 'em in choir, you know, 

<laugh> Yeah. 

Is one of the recommendations I say a lot and it does, it makes a difference. I mean, yes, you feel good because you're singing, but it is stimulating that nervous system to go from fight or flight to rest and digest. And I even hear my daughter who's pretty anxious, like when she has a lot of test taking and things Oh yeah. The, the singing that comes out of her room is huge because she just, she doesn't know to do it, but it just innate, you know, that she just starts doing it. So I, that's such a great recommendation for those that are listening for kids that have anxiety or need to calm down or go down into that more parasympathetic state. 

I love that. 

Yeah. So the breath work wasn't traditional breath work, like I said, it was much more practical mm-hmm. <affirmative>. And I feel like that has bled over into my, my practice with clients that I see as well. 

Great. Are there any other, I mean, I love this thing. Is there any other kind of breath work that you use now within your practice? 

So one, uh, that I use a lot with children, uh, and this actually originated with my stepson as well. We called it horse breath <laugh>. 

Oh. 

Um, and I'm gonna try to do this while we're talking, but I don't know if you'll be able to hear, but you puff your cheeks up with air and release. 

Oh yes. Okay. 

So it's almost like a lip trail, but forceful and the cheeks get puffed up with air and the diaphragm is activated. And so what the reason we call it horse breath was, um, at the time that we discovered, he and I discovered this way of breathing. I was working with a nonprofit in West Virginia where we were located that did work with equine therapy. So they saw kids with that were on the spectrum and they brought them to the barn. 

And one of the, the professionals working there told me, this is one of the things the horses do to regulate themselves. You know how horses shake their head and make that Yeah. 

Noise. Mm-hmm. <affirmative>, he told me that's what the horse was doing, regulating himself. And I thought, oh my gosh, I do that all the time nowadays, <laugh> <laugh> because I was in such a state of fight or flight, a chronic state of fight or flight for a while, and sometimes life throws us there mm-hmm. <affirmative>, right? Mm-hmm. <affirmative>, sometimes life throws us into those states. And even when we know every single trick, it, our body doesn't allow us to come out as quickly as we might like. 

So we have to keep doing those resets. That's another one. And it's a great one to use with kiddos because it's fun and you can pretend to be a horse or you can talk about horses. So that's another really good one. I've found that that type of releasing breath works quite well with young people, especially to do before you introduce deep breathing or calm breathing or, um, a more controlled type of breath. Something that just releases allows them to reset a little bit. 

Yeah. Oh, that's really cool. The animals just know, they're so in tune to regulation and healing. You know, you, you see like dogs sitting out of the sun to get sunlight that heals their bodies. I mean, they just know. And I just think of like, we are constantly, honestly in fight or flight whether you have a big event or not. Yeah. Just we have gotten to this point in our lives that just go, go, go. And we never are able to kind of come down to fully reset. 

But animals, when they go into fight or flight, you know, they kind of shake it off, you know? Yep. If they're being chased by some, you know, predator, they like curl into a bowl and freeze or whatever. And then as the predator leaves and they're still alive, hopefully they, they see it, they shake their whole body so that Yeah. Releases everything and then they're reset. But as humans, <laugh> and people, we don't do that. We don't have this reset mechanism like that. So I love that this breath work can, can get you down that way too. 

Or I, I'm assuming even just shaking your body out too. 

Yeah. Yeah. And so for me as a speech pathologist, I've started a private practice and part of why I started private practice was I wanted to be able to incorporate some more non-traditional methods into my therapies. And if you have ever put your child in speech therapy, say they can't pronounce their sounds properly or they are having language delays or, uh, a pediatric feeding disorder, which might look like picky eating, um, I would say the majority of these kiddos have some level of underlying stress in the nervous system. 

Hmm. Oftentimes there's some underlying stress in the nervous system, and if you can't breathe, and I don't mean like literally can't breathe, but if you can't properly breathe, if you don't have a patent airway, if you aren't using that diaphragmatic so, uh, supported breath and you don't have an imbalance system, you are not gonna be able to speak or eat very effectively. Mm-hmm. <affirmative>, um, yeah, that's my belief. And, um, and so for me, this is something that the sensory and the breathing component I incorporate with every single person I see in speech therapy 

Because That's great. That's great. Yeah. There used to be a chorus back in my PT days of, you know, taking classes like that and was called, uh, if you can't breathe you can't function. 

Oh, yeah, true. Which 

Was, was so right on because Right. It is, if you can't breathe, you don't have the energy level to do all these things. You don't have the speech, you can't eat, you can't do anything really. Yeah. So, yeah. So, so important. 

Yeah. So the work has led me to learn more and more about myofunctional therapy, oral myofunctional therapy, um, and I've been at it for 20 years mm-hmm. <affirmative> and working with kids who can't eat and swallow easily. Um, could 

You actually just explain what myofunctional therapy is, just for the listeners that may not know? 

Yeah. So myofunctional therapy is a, a muscle based approach, which actually, uh, works with the nervous system as well. But it is a way that we look at the airway and we look at the mouth and the position of the jaw, the cheeks, the tongue, um, what the palette looks like, and the structure that supports your ability to breathe, eat, and speak and, um, perform or prescribe. 

So traditionally it would be prescribing a set of exercises to support good muscle function, um, muscle mobility, muscle strength, so that the airway is open. Um, this, we see this a lot with kids who need orthodonture, that their pallets don't develop properly, their pallets are high and arched. Uh, they might have crooked teeth. We see this with kids who have tongue ties or adults who have tongue ties. Um, and so the therapy is prescribed to basically get the muscles to have full range, full function, good, adequate strength, and be able to breathe number one and swallow number two and speak. 

Yeah. Yes. Well, being that you also mentioned tongue tie<laugh>, I'm just gonna bring this up because this is a hot topic, I think with parents. Yeah. Because there's a lot of, like, should we, shouldn't we, um, do a release? And so I don't know if you can a, maybe just talk  about what tongue tie is for those that don't know, and also then discuss like, yeah, what are the signs that you would recommend something like a release? 

So tongue tie is when the tissue, you have a tissue, um, that is tethered under the tongue. So if you feel under your tongue, and you can do this right now, you can put your tongue up to the roof of your mouth. Um, if you can do that <laugh>. Yeah. So sometimes you discover you can't actually do that, but put your tongue up to the roof of your mouth, take your finger and sweep the floor of your mouth under your tongue and see if it feels like a band, like a, a cord or a band there. 

If you feel a cord or a band, you may have some tethered oral tissue. And there are different degrees of this. So one of the common misconceptions is that you can take a picture and show it to your mom's group on Facebook and they'll tell you <laugh> the, the degree to which the tongue is tied. 

This is not how this needs to be happening. Um, there's also such a thing as a lip tie and mm-hmm. <affirmative> buckle ties, lip ties, super easy to identify for people who have gaps in the front of their teeth. There's often a lip tie that accompanies, but it's the same thing. If you pull your lip out a little bit, take your finger and sweep there, you may see or feel that there's a, like a cord of tissue mm-hmm. <affirmative>. Now some people have complete function, great range of motion, great ability to chew their food, to swallow their food with no problems. 

Um, and some people do not. So in my opinion, the best thing to do is get a full, um, myofunctional assessment or at least an oral MEC assessment from a speech pathologist. Mm-hmm. Hmm. <affirmative>. Um, I mean you can also, hygienist can do, can do myofunctional therapy too, but I, I personally would say find a speechy because they're gonna have that feeding and swallowing expertise as well. 

Mm-hmm. <affirmative>. So if there's any kind of concern with the tongue tie around the feeding, swallowing, I mean, lactation consultants often do this too, and some OTs will do this as well, but get a good thorough assessment. Cause what you wanna see is not just, is that tongue tied, present is the tissue tight and tethered, but what can the muscles do in spite of the tissue? Mm-hmm. <affirmative>. So some people still have good function, um, and some do not. My recommendations around <laugh> around release are, uh, very individualized. 

There's a nice window when babies are very small that the release is easier to do. They're, the babies are easier comforted, the recovery is easier, they're nursing or using a bottle. This may make nursing much, much easier if you release, but you also wanna have support afterwards. So don't just get a release and then don't do anything else. 

Find a speech pathologist to work with you and coach you on how to get the muscles to work properly. Because basically you have this baby who's been in utero and their tongue has been connected to the floor of their mouth. It didn't have full range of motion and they have sucked that entire time in utero. So they've learned kind of, um, a modified suck pattern. You get the tissue released, it doesn't just know what to do mm-hmm. <affirmative>, but a therapist can give you a few simple strategies to help, uh, improve that, to help the muscles learn what to do. 

Um, and, and I love that you're a craniosacral therapist too, cuz that's often one of my biggest referrals is Yeah. Yeah. If you're gonna have the tongue release done, you probably wanna see a cranio sacral therapist as well. Cause the whole body mm-hmm. <affirmative>, you know, just kind of gets outta whack. That fascia is pretty important in our world. 

Yep. Yep. The tongue, the tongue is connected to so much. Right. Yeah. Its, you think it's just that floor of the mouth, but no, that fascia is connected all the way down. Yes. Especially we find a lot of tightness around their diaphragms. Yeah. Yeah. 

So, so breathing, right? Mm-hmm. <affirmative> 

Breathing again. Yes. Yeah. Well, well, and it's interesting, um, because I have seen both infants and adults who have and had have tongue tie. Some have released, some have not. Um, what the adults say after a release is that they can breathe. Yeah. They always talk about like, it's a, it's immediate how they can breathe. So it's interesting. 

Yeah. One thing I've found recently is that some providers with adults are doing releases. If they have a complete tongue tie, they are doing the releases in stages because this person has spent a lifetime with their tongue tethered. And from a nervous system standpoint, so not physically, but from their nervous system standpoint, when they do a complete release all at once, the person has a huge emotional response. So some providers are doing release in two part in two parts now. 

Wow. That's interesting. I have not experienced that, but yeah, it does make me re see some, some infants Right. That have had the release are are pretty dysregulated and Yeah. Afterwards, honestly. And so I, I tend to see those kids because it's cranial psychotherapy and that helps rebalance the nervous system mm-hmm. <affirmative>. Um, but it, it makes me think, I almost wonder if that's partly why. 

Yeah. I think that's 100%. Why, because they've spent, you know, 40 weeks in utero mm-hmm. <affirmative> be learning how the say let's suck the sucking mechanism is comfort. Mm-hmm. <affirmative>, that's what babies do to find comfort and they've done it in a modified way, and then we change the way they are sucking and their system doesn't know how to handle that. So I think body work is fabulous. And I also think finding a speech pathologist or a lactation consultant or a combination of both actually, because there are different perspectives that come in. 

Yes. 

Mm-hmm. 

<affirmative>, um, to help regulate from the oral perspective as well. And this is like one step further that I do wanna talk about <laugh>, because what often happens is in, during this hap the babies get released in infancy, the tongue tie gets released or doesn't, but feeding levels out and nobody's unhappy. And then a couple years down the road, we start to see a kid who eats only a handful of foods and most of the foods are mushy and processed or crunchy and processed, but not foods that require, uh, that fine jaw control to tear meats or to tear fresh vegetables. 

And so we find kids with really limited diets or that only wanna suck from pouches, which are a speech therapist nightmare. By the way, <laugh> <laugh>, we do not, we do not love the pouches. Um, <laugh>, they're not great for oral motor development. Mm-hmm. <affirmative>. Um, and the, the oral structure just supports so much the development of the jaw, the development of the tongue. It supports nervous system regulation, not just speaking and, and eating. 

Right. Cuz there is something about the tongue actually reaching the roof of the mouth Yeah. That helps calm the nervous system. Is that correct? 

Yeah. That's where our tongue should always be. <laugh> is on the roof of the mouth and if you work with a myofunctional therapist, you'll learn about the suction exercise and they want your, we want your tongue suction to the roof of your mouth. And this helps with your airway. I mean, sleep apnea or sleep mm-hmm. <affirmative>, just even if your kid doesn't have apnea, if they just have sleep disturbances and difficulty sleeping, you might wanna see what's their airway doing. Mm-hmm. <affirmative>, um, is their tongue in the bottom of the mouth and if it's in the bottom of the mouth, is it falling back? 

Right. And they, and they snore. They're a noisy sleeper, you know, um, bedwetting often goes hand in hand with this, um, thumb sucking all of these, uh, kind of, kind of the experiences that we think the kids will just eventually grow out of, but don't, don't necessarily always address as we as we could. 

So just wanna clarify, so snoring is might be a sign of like poor airway, is that what you're saying? And kids? Yes. Yes. 

Well, it could be poor, poor oral muscles, oral and facial muscles and poor airway support. Mm-hmm. <affirmative>. So the muscles aren't where they need to be and they don't have the tone that they need to have to support that open airway for breathing during sleep. 

And thumb sucking as well. Could possibly, yeah. It could also be calming. Right. But could possibly also, okay. 

Yeah. It's gonna well, thumb sucking keeps the tongue in a lowered position. So if you have a child who's sucking their thumb or using a pacifier for a lengthy period of time, they don't develop that tongue up posture that we need for that healthy airway. 

Wow. Okay. That's good to know. Did not know that. 

Yeah. 

Well, and you've brought up sleep apnea, so I do wanna put a plug for this because Yeah. You know, as adults, as parents, we are constantly taking care of our kids <laugh>. Yeah. But this type of therapy is, is also good for adults, especially if they have, which a lot of old, you know, older adults have sleep apnea. Um, and instead of just putting on a CPAP, there's actually some therapy you can actually do as well, which is this myofunctional therapy. Is that correct? 

That is 100% correct. And it actually works quite well for apnea. It works quite well in adults because with kids we have to find interesting and fun ways to do this therapy mm-hmm. <affirmative>. Uh, whereas with adults you just do a prescribed exer set of exercises. Uh, we don't have to have a bag of tricks to get you to do it mostly. Yeah. And, um, and it works really well. And the one thing I wanna say about this too, so there's more, the more recent research looks at the, um, the connection between lack of sleep and or sleep apnea and attention and ability to, to function with adequate executive functions. 

So if you are the tired, exhausted parent who can't seem to stay focused or to get everything done that you need to get done, how, what is the quality of your sleep? Um, that's a good question to ask yourself and to look at. Um, and what can you do to, you know, modify that sleep routine and do this therapy to help improve your airway during sleep and decrease some of that snoring. 

So if your partner is snoring too, <laugh>, 

Send them to see Erin <laugh>, this 

This, yeah. This might be something for both of you, right? Because you're probably not getting good night's sleep either if they're 

Too loud. It's actually really common that I get a referral for a child who has these problems and then you see the parent and you say, oh wait, but look at your jaw <laugh> and look at your tongue and look at all these things. And they need the therapy as well. Yeah. It's very, very common. 

And some of this is hereditary, right? Yeah. Because there's a lot of, like if a child has a tongue tie, usually you can look at one of the parents and find one too. Yeah. So that's a really good point. And of course, you know, nowadays I think there's more out there that maybe when we were younger they didn't have or didn't notice, so Yeah. So this could be helpful for your child as well as, as you <laugh>. 

Yeah. Yeah. And don't think that because you go to a provider now there are some providers who might not be on this camp, but as a provider of speech therapy services, I would never say you must get that tongue released. Mm-hmm. <affirmative>, there's always progress to be made. Um, I, I mean personally if it were me, I would absolutely have the tongue released. If it were my child, I would absolutely have the tongue released mm-hmm. <affirmative>. However, if there's also a window of time, if you have a two-year-old, um, that might not be the ideal time to have the tongue released because the aftercare, the stretches you need to do, they will bite you, right? 

Mm-hmm. <affirmative>. Yeah. Um,  and it depends on the severity. So there are so many things that are individualized with regards to release, don't release. Mm-hmm. <affirmative>, how do you treat it? When do you treat it? I think the best advice is really get involved with a professional and have them assess where your individual child is and where your family is and the ability to provide that aftercare. 

Yeah. Cuz the aftercare is, and 

It's intense. 

It's intense, it's intense and you know, and the way I look at at least tongue tie is, you know, is there an issue, right? Are, is breastfeeding hard? Is feeding hard, you know, as far as when they're an infant, you know, are your nipples getting sore because they're not sucking the way they should be and that's causing an issue? Or are they gaining weight? Things like that. And then also like later on are like you said, are they eating multiple types of food? Can they move the food around? And then taking a look at speech, how's their speech as they get older? 

So sometimes none of these things actually are a problem <laugh>, right? Correct. And so, so, and 

Then it doesn't matter <laugh> 

And then it doesn't matter. But if there is a problem then this is a step to say, well there might be something that you could do, whether it's a release or just even some therapy, it's good to, good to know that there are choices out there than just struggling along, especially when it comes to feeding. Cuz that's such a, it's so hard on the parents to not be able to feed their child. 

Yeah. And you know, I work with a lot of younger toddlers and preschoolers that are deemed picky eaters. Mm-hmm. <affirmative>, and I'll tell you that the majority of those picky eaters have some sort of an underlying oral motor deficit mm-hmm. <affirmative> that once you start to get some of those skills in place and they have a bit more confidence about what they can do in their mouth, it doesn't feel comfortable to them to eat the different foods. So there is a sensory standpoint from that, but there's also just a level of discomfort that they don't know what to do with it in their mouth. 

Yeah. 

Um, and so you can get some of those foundational skills in place and some of the pickiness starts to go away. I have a client that I'm working with currently, he, we do telehealth. I've never seen the kid in person. We do telehealth. He was deemed a picky eater and, um, within, we've had three sessions, three 30 minute sessions online. And his parents were like, he requested Turkey and cheese and put it in his mouth. 

This has never happened in his four years of life. Right. Wow. Never happened in his four years of life. He eats a very limited diet and it's because he's starting to have more comfort with his mouth. Yeah. He's beginning to understand what he can do. You know, I think like if I think about this physically, you know, until your kid learns they can climb up the stairs, they don't always try, right? Mm-hmm. <affirmative>, they don't, they get, they get leery about that. Until they have that experience, it might be something fearful for them until they have that experience that, oh wait, I can do this, I can climb up these few little stairs now I'll try a ladder on the playground and mm-hmm. 

<affirmative> and the, the level of difficulty increases with their practice and with the support we provide for them to have success. 

Yeah, that makes total sense. Total sense. Yeah. Yeah. So where, where can people find 

You evolved-therapy.com <laugh>. Yeah. And I'm based out of Boston, Massachusetts, but I do telehealth as well. So, um, I'm open to to virtual clients and actually have found that there is great, great success and, and carryover works quite well in virtual clients too because the parents are directly involved in those treatment sessions. Um, I feel like it's almost a way that I can empower families to be in charge of their child's treatment in a different way than we tend to do. 

Or at least I tended to do with in-person therapy where I would almost take over mm-hmm. <affirmative> and I would do some things, whereas now, I mean, I will tell a three year old here, you do this to your own mouth. Mm-hmm. You put your fingers here, you rub here, uh, and let them be in charge of that for themselves. It, it changes the autonomy for the family and the child. 

Yeah. I mean I think one of the good things that came over out of Covid was we started doing more virtual visits. Yeah. And how much, yeah, the carryover was almost so much more with some of the virtual visits because they did have to be accountable and do the work themselves. So yeah, I think it's great. 

Yeah. I love hearing a therapist say this, a PT say this because often I feel like I get a lot of kickback from other speech pathologists and OTs and PTs that they really want to be, that this direct care in person has to be the thing. And I think that might have been the thing and now we have a new thing, <laugh>, 

I mean I definitely saw an improvement in just the carryover. Yeah. Because cuz parents needed to do it or kids needed to do it for themselves. So that was, that was nice actually. I think that was an eyeopening experience for myself. So is there anything else you'd like our listeners to know? I 

Think the biggest thing is pay attention. Just pay attention to what your breathing is doing. Pay attention to what your child's breathing is doing and know that there is support out there if you are, are struggling with any of these things we've talked about with the anxiety, attention, sleep, breathing, eating, there is support for you and you don't have to do it on your own. There is a lot of support out there. So that's the last thing I want your listeners to know. 

And I also wanna say thank you to you because this is a great, uh, shift for me personally of not speaking only about grief, which I have done ad nauseum for many year, couple years now. I've just talked about grief and grief processing, which is lovely and wonderful and necessary in the world, but this is really nice to kind of have a fresh take on things that's not that it all ties together, but it's not the focus, you know? 

Yeah. Well I'm glad I could be a part of that shift for you. 

Oh, thank you. Yeah. 

And thank you for coming on and just sharing everything with us. Your expertise, your personal story. Yeah. You know, I think it's nice for parents to know that there is help out there. Yeah. And I think it's some services that we don't think about getting the help for. So I think this is great 

And really informative. 

Yeah. Wonderful. Thank you so much for the conversation today, Lisa. 

Thank you for listening to this episode. If you or your child is struggling with any of the topics that we share today in this episode, know that there are resources out there that can help you. If you'd like to learn more about Erin and the resources she provides, visit her website evolve therapy.com. And thank you for your support of the Real Life Moms podcast. Please share, rate and review this podcast and continue helping us connect with moms worldwide.