The Untethered Podcast™

When looking into tethered oral tissues, it is easy to focus entirely on visual structural appearance. However, judging a restriction by looks alone frequently misses the true clinical picture. Real progress happens when healthcare providers shift the diagnostic paradigm away from what a tie looks like and focus entirely on how it affects dynamic function over a patient's lifespan.

In this episode, Hallie sits down with Dr. Richard Baxter, DMD, MS, FAAPD, a board-certified pediatric dentist, founder of the Alabama Tongue-Tie Center, and lead author of the bestselling book Tongue-Tied. Dr. Baxter shares his personal and professional insights into the complexities of identifying oral restrictions, moving past basic anatomical definitions to explore how a tiny string under the tongue can alter systemic, long-term health.

Dr. Richard Baxter is a board-certified pediatric dentist, a Fellow of the American Academy of Pediatric Dentistry (AAPD), a Diplomate of the American Board of Laser Surgery, and the founder of the Alabama Tongue-Tie Center. As an internationally recognized speaker and creator of the Tongue-Tied Academy, he has dedicated his career to educating healthcare providers and parents on the structural and functional impacts of oral restrictions. Having experienced a tongue-tie himself and treated his three daughters as infants, his dedication to the field is deeply personal. He resides in Birmingham, Alabama, with his family.

• Symptoms Over Appearance: Why a visual exam never tells the full story and why diagnostic protocols must prioritize symptom functional profiles over pure aesthetics.
• Groundbreaking Research in Complex Profiles: Dr. Baxter shares fascinating insights from recent research surrounding oral restrictions and their structural correlations to cerebral palsy.
• Buccal and Lip Ties Exploded: Clarifying the distinct functional impacts of cheek and lip restrictions, and how they play a role in infant feeding dynamics.
• The Interdisciplinary Standard: Best practices for post-operative care, follow-up timelines, and maintaining clear, collaborative communication lines across the therapy team.

"Common does not mean normal.

" "Digestion starts in the mouth."

"Untie the shoelaces for proper function."

• 00:00:00 – Intro Hook: The Shoelace Analogy breakdown.
• 00:01:03 – Guest Welcome: Dr. Richard Baxter joins the show.
• 00:02:43 – Clinical Debate: Treating oral restrictions based on symptoms vs. appearance.
• 00:06:51 – Collaborative Care: How a therapist should present a concise, one-page case review to a doctor.
• 00:09:13 – The Post-Op Rule: Why myofunctional therapy is essential (The knee surgery comparison).
• 00:11:51 – Clinical Truths: Why "common" does not mean "normal" when tracking snoring or mouth-breathing.
• 00:13:08 – Complex Case Study: Dr. Baxter's landmark research on tongue-tie releases in children with Cerebral Palsy.
• 00:20:27 – Digestion & The Nervous System: How poor swallowing mechanics trigger chronic fight-or-flight states.
• 00:26:49 – Emerging Research: Survey insights on identifying and treating Buccal (cheek) ties globally.
• 00:32:24 – The Bed-Wetting Link: The surprising connection between airway stress, heart peptides, and nocturnal polyuria.
• 00:48:28 – Reclaiming "No-Man's Land": Why releasing ties between 6 months and 4 years old is critical for core brain development.

• Read the Best Selling Book: Tongue-Tied by Dr. Richard Baxter
• Explore Clinical Resources: Visit TongueTie.com
• Watch and Learn: Tune into Dr. Baxter's YouTube Channel

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Episode 200: Functional Impact: When A Tongue Tie Is ACTUALLY A Tongue Tie
• EP 348: Tongue Ties, Sleep Apnea & More: The Patient-Centered Approach to Airway Dentistry

STAY CONNECTED & GROW YOUR PRACTICE

Join the conversation: Get behind-the-scenes insights, clinical pearls, and real conversations over on Substack.

Hosted on Acast. See acast.com/privacy for more information.

Making the leap from a school-based setting into a specialized pediatric feeding niche is an incredible professional transformation. But what happens when that career pivot collides with your own deeply personal parenting journey?

In this episode, Hallie sits down with Aerica Walsh, M.S., CCC-SLP, CPFT™, an ASHA-certified speech-language pathologist, pediatric feeding therapist, and the founder of Thrive Therapy Solutions. Aerica opens up about her unique path into the world of pediatric feeding—a journey that took a profoundly meaningful turn when her daughter was born with tongue and lip ties that impacted their early breastfeeding dynamic, followed by her son being born with Down syndrome and diagnostic feeding challenges.

They dive into the common medical misconceptions surrounding low tone and special needs, the reality of balancing deep grief with profound gratitude as a parent, and the heavy advocacy needed in hospital and NICU settings. This conversation is an invaluable mix of raw personal storytelling, actionable clinical advice, and a beautiful reminder of why compassionate, holistic, family-centered care always trumps generic medical protocols.

Key Topics & Takeaways

• The Leap From Schools to Feeding: How Aerica navigated the transition from a traditional school-based SLP caseload into the highly specialized world of feeding therapy.
• A Diagnosis in the Middle of Training: Aerica shares the emotional and clinical impact of receiving her child's Down syndrome diagnosis while completing her specialized CPFT™ program.
• The "Low Tone" Misconception: A close look at why low muscle tone is so frequently misunderstood in children with Down syndrome, and how to look past a label to find functional solutions.
• The Power of Pre-Feeding Skills: Practical strategies for supporting vital pre-feeding motor skills long before a child with special needs ever takes their first bite of solids.
• Advocacy & "The Mama Gut": Why clinical reasoning and motherly intuition should always come before generic medical timelines in hospital and NICU environments.
• Building Thrive Therapy Solutions: The challenges, rewards, and exact mindset shifts required to successfully launch your own specialized private practice while parenting children with additional needs.

Soundbites

"Low tone is often misunderstood in Down syndrome" 

"Trust your mama gut over medical protocols" 

"Find your niche and dive deep into it"

Timestamps

00:00 – Intro Clip

00:20 – Welcome to the Untethered Podcast

00:57 – Meet Aerica Walsh, M.S., CCC-SLP, CPFT™

02:10 – How Motherhood Led Aerica Into Feeding Therapy

04:35 – Pregnancy Expectations vs Reality

07:15 – Parenting a Child With Additional Needs

10:25 – NICU Experience & Early Feeding Challenges

13:40 – The Overwhelming Amount of Parenting Advice

15:00 – Identifying Feeding & Development Concerns

18:20 – Tongue Ties, Breastfeeding & Early Intervention

21:45 – Navigating Medical Professionals & Parent Advocacy

25:00 – Hospital Experiences & Emotional Impact

28:15 – Why Standardized Feeding Support Matters

30:00 – Gaps in Pediatric & Feeding Education

34:10 – Supporting Families Beyond Clinical Care

37:50 – The Emotional Side of Motherhood & Therapy

40:00 – Learning to Trust Your Parent Instincts

43:25 – Helping Parents Feel Seen & Supported

46:40 – Balancing Family Life & Professional Growth

50:00 – Building a Career in Feeding Therapy

52:30 – Advice for Clinicians Entering Feeding Therapy

55:00 – Investing in Education & Mentorship

57:00 – Final Thoughts & Outro

Links & Resources

• Connect with Aerica: Follow her on Instagram https://www.instagram.com/thrivewithaerica/

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• EP 343: Inside a Mission-Driven Pediatric Feeding Practice
• Episode 361: Why Two Therapists Get Different Feeding Outcomes (And How to Fix It

STAY CONNECTED & GROW YOUR PRACTICE

Hosted on Acast. See acast.com/privacy for more information.

Navigating the world of tethered oral tissues (TOTs) can often feel like wading through murky waters. With so much conflicting information out there, it’s incredibly easy for clinicians to fall into the trap of letting a visual anatomical structure dictate their entire treatment plan. But looking at a tongue or lip tie doesn’t tell you the whole story.

In this solo episode, Hallie Bulkin dives deep into the complexities of diagnosing and treating tethered oral tissues during feeding evaluations. She pulls back the curtain on why presence does not automatically equal cause, and why a systematic, function-first approach is the only way to truly help your pediatric patients.

Whether you are feeling the pressure from families to provide quick answers or trying to differentiate between a primary and secondary driver of a feeding challenge, this episode is a crucial masterclass in clinical decision-making. Tune in to learn how to move past the anatomy trap and build ultimate confidence in your functional assessments.

• The Murky Waters of TOTs: Why diagnosing and treating tethered oral tissues has become a clinical minefield, and how to navigate it safely.
• Presence vs. Cause: A critical reminder that just because an anatomical tie exists does not mean it is the primary driver of the family's feeding struggles.
• Common Clinical Traps: How relying solely on visual anatomy can lead to incomplete treatment plans and poor patient outcomes.
• The Function-First Framework: Why evaluating dynamic feeding function is the only way to give structural anatomy its true meaning.
• Primary vs. Secondary Drivers: Learn how to decipher when a tie is the root cause of a feeding issue versus when it is simply an incidental finding.

"Don't let anatomy lead your feeding plan."

"Presence does not equal cause."

"Feeding function gives anatomy its true meaning."

• 00:00 – Introduction to Tethered Oral Tissues and clinical challenges.
• 01:24 – The murky waters of diagnosis and the role of anatomy.
• 02:32 – Understanding feeding challenges as multifactorial.
• 03:02 – Limitations of relying solely on anatomy.
• 04:22 – Common clinical traps in tethered oral tissue cases (Traps 1 & 2).
• 05:11 – Trap No. 3: Treating the restriction instead of the feeding pattern.
• 07:13 – Trap No. 4: Skipping a full feeding assessment because the tie feels explanatory.
• 07:50 – Pressure to provide quick answers and the importance of function.
• 08:15 – Shifting focus to feeding function over anatomy.
• 09:21 – Feeding function as the key to meaningful anatomy interpretation.
• 10:00 – Primary vs. secondary drivers of feeding difficulties.
• 11:50 – When ties are incidental and not the main issue.
• 12:10 – Assessing functional impact and developing confidence.
• 13:30 – The value of structured feeding assessment training.
• 14:37 – Empowering clinicians with feeding function knowledge & final wrap-up.

Links & Resources

Dive deeper with Tongue Tie Bootcamp

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Episode 348: Tongue Ties, Sleep Apnea & More: The Patient-Centered Approach to Airway Dentistry
• Episode 363: Tongue Ties, Oral Habits & the Future of Airway Health

STAY CONNECTED & GROW YOUR PRACTICE

💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips on

Instagram | Facebook | LinkedIn

If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

Hosted on Acast. See acast.com/privacy for more information.

If you’ve ever felt like you were "guessing" your way through a feeding session, you aren’t alone. In fact, many clinicians enter the field with a passion for OT or SLP, only to realize their foundational schooling barely scratched the surface of pediatric feeding.

In this episode, Hallie is joined by Courtney Lewis, MOT, OTR/L, CPST, a pediatric feeding specialist and owner of NOSH Pediatric Feeding Therapy. Courtney opens up about her "long and winding road" to feeding—a journey that began with an 8th-grade project and evolved through home health, clinics, and hospitals.

They discuss the pivotal moment when Courtney realized she needed more than just general experience to truly help her families. From the "regulation lightbulb" moment that changed how she views patient behavior to the deep empathy she brings as a former "picky eater" herself, this conversation is a masterclass in why specialized training and clinical reasoning are the keys to professional confidence.

About the Guest: Courtney Lewis, MOT, OTR/L, CPST

Courtney Lewis is a pediatric occupational therapist, feeding specialist, and the founder of NOSH Pediatric Feeding Therapy. With over a decade of experience across various settings, she specializes in transforming mealtime struggles into joyful family experiences using a holistic, play-based approach. Courtney is a Feed The Peds® graduate and a dedicated mentor within The Pediatric Feeding Hub™.

Key Topics & Takeaways

• The Accidental Specialist: How pediatric feeding "found" Courtney and why every previous setting—from home health to hospitals—was a necessary stepping stone.
• The Missing Link in Education: A candid look at why most therapists feel underprepared and how to fill the gaps that grad school leaves behind.
• The Sensory Lived Experience: Courtney shares how her own history as a picky eater allows her to advocate for her patients with a unique, firsthand perspective.
• 44,000 CFA Points: The story behind Courtney's "Regulation Lightbulb" and how understanding the nervous system changes everything in the clinic.
• The Power of "The Hub": Why having a community of mentors and peers is essential for preventing burnout and ensuring clinical excellence.

Soundbites

• "I didn't choose feeding therapy; it chose me. Every setting I worked in was leading me here."
• "You go from feeling like you're guessing to actually having a clinical 'why' behind what you're doing."
• "When you understand the nervous system, you stop looking at the behavior and start looking at the child."

Timestamps

• 000:00 – Overcoming imposter syndrome and the "stuck" feeling in feeding therapy.
• 02:22 – Courtney’s Journey: How pediatric occupational therapy "found" her.
• 05:47 – The Confidence Catalyst: Helping a breastfeeding infant transition to solids in 10 weeks.
• 06:34 – The Foundational Gap: Why standard courses like SOS and Beckman sometimes leave therapists wanting more.
• 23:40 – How Feed The Peds® provided the framework to finally "connect the dots."
• 29:10 – Lived Experience: How being a former "picky eater" shapes Courtney’s empathy as a therapist.
• 38:20 – Mentorship: Transitioning from student to leader within The Pediatric Feeding Hub™.
• 42:15 – Closing thoughts and where to find NOSH Pediatric Feeding Therapy.

Links & Resources

• Visit Courtney’s Website: noshfeeding.com
• Follow Courtney on Instagram: @NoshFeeding
• Feed The Peds®: Join the 3-Day Screen The Peds to Feed The Peds Challenge
• THE HUB: Become a part of The Pediatric Feeding Hub™

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Episode 369: The 4 Layers of Feeding: How to Finally Know Where to Start
• Episode 361: Why Two Therapists Get Different Feeding Outcomes (And How to Fix It)

STAY CONNECTED & GROW YOUR PRACTICE

💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips on

Instagram | Facebook | LinkedIn

If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

Hosted on Acast. See acast.com/privacy for more information.

In this solo episode, Hallie Bulkin dives deep into a common pitfall in pediatric feeding therapy: treating red flags as a diagnosis rather than a starting point. Many clinicians feel the pressure to jump straight into treatment the moment a concern is raised, but skipping the foundational steps often leads to stalled progress and clinical uncertainty.

Hallie clarifies the critical distinction between screening, assessment, and treatment. She explains why red flags should be viewed as "decision points" and how a structured screening process can transform your clinical decision-making. Whether you are navigating complex sensory issues or safety concerns, this episode provides a systematic framework to help you move forward with clarity and intention.

Hallie Bulkin, MA, CCC-SLP, CMT®, CPFT™, is a pediatric feeding and orofacial myofunctional therapist and the founder of Elevation Movement. With years of experience in pediatric feeding, myo, airway, and tethered oral tissues, Hallie is dedicated to empowering clinicians with the tools they need to provide life-changing therapy for children and their families. 

• Red Flags as Decision Points: Understanding why a red flag is a signal for more data, not a roadmap for immediate therapy.
• The Power of Structured Screening: How a checklist removes the guesswork and identifies specific risks.
• The Clinical Sequence: Why the order of Screening → Assessment → Treatment is non-negotiable for successful outcomes.
• Avoiding Common Pitfalls: Why relying solely on parent reports or mislabeling limited variety as "just sensory" can hinder progress.
• Building Confidence: How a systematic approach reduces "imposter syndrome" and helps you know exactly what to do next.

• "Red flags are decision points, not treatment plans."
• "Screening answers the vital question: Is further assessment even needed?"
• "Jumping straight to treatment skips the assessment phase entirely."

00:00 – Red Flags: The Doorway to the Next Step

00:36 – Introduction: Meet Your Host, Hallie Bulkin

01:52 – The "Now What?" Moment in Feeding Therapy

02:54 – Why Structured Screening is Not Optional

03:48 – Screening vs. Assessment: Solving the Sequencing Issue

04:22 – Mistake #1: Treating Parent Concern as the Only Data Point

05:27 – Mistake #2: Equating Limited Variety with Sensory Issues

06:17 – Mistake #3: Skipping the Safety & Airway Layer

07:22 – What a Strong Feeding Screening Checklist Actually Does

08:24 – The 3-Step Sequence: Screening, Assessment, and Treatment

09:34 – Case Example: Moving from Red Flags to Clarity

10:30 – Building Confidence & The "Screen The Peds" Free Training

👉 Join the free 3-day Screen The Peds to Feed The Peds training

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Why Two Therapists Get Different Feeding Outcomes (And How to Fix It)
• The 4 Layers of Feeding: How to Finally Know Where to Start
• 
  

STAY CONNECTED & GROW YOUR PRACTICE

💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips on

Instagram | Facebook | LinkedIn

If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

Hosted on Acast. See acast.com/privacy for more information.

In this interview episode, Abigail Kemp shares her honest journey through her Clinical Fellowship Year (CFY) and into the world of pediatric feeding therapy. Like many new clinicians, Abigail quickly realized that academic knowledge alone wasn’t enough—especially when faced with the complexity of real-life feeding cases.

She opens up about the challenges of navigating unclear expectations, limited mentorship, and the pressure to perform early in her career. Through these experiences, Abigail discovered the power of self-advocacy, continuous learning, and finding the right support system to grow as a clinician.

This episode offers a grounded and relatable perspective for therapists who feel overwhelmed or unsure—reminding you that confidence isn’t about knowing everything, but about learning how to think, adapt, and take action.

Abigail Kemp, M.S., CCC-SLP, is a speech-language pathologist who began her clinical career in 2024, gaining experience across pediatric clinics, preschool and daycare settings, elementary schools, as well as adult outpatient and acute care.

While she had strong academic exposure—particularly in dysphagia—her early clinical experience in pediatric feeding therapy presented unexpected challenges. During her CFY, Abigail was faced with feeding cases that pushed her beyond her comfort zone, often without the level of mentorship and guidance she needed.

Abigail continues to expand her expertise in feeding therapy and hopes to further specialize in the field. She encourages new clinicians to advocate for themselves, ask questions, and trust that growth takes time—but is always worth the journey.

The Reality of CFY Challenges:

Why many new clinicians feel unprepared—and how real growth happens after graduation.

The Power of Mentorship & Community:

How the right environment can accelerate your confidence and clinical development.

Building Confidence in Feeding Therapy:

Why confidence comes from action, not perfection.

Self-Advocacy in Clinical Practice:

How speaking up and seeking support can transform your career trajectory.

Individualized Feeding Therapy:

Why no two clients are the same—and treatment must reflect that.

“I realized how little I knew about feeding.”

“Treatment strategies must be individualized.”

“Support and mentorship are crucial in our field.”

00:00 – Introduction to Abigail Kemp

01:43 – Early Career and the Clinical Fellowship Year (CFY)

03:39 – Navigating Expectations in a New Pediatric Clinic

05:39 – Challenges of Remote Mentorship and the First 4 Months

06:56 – Finding a New Setting & The Power of Self-Advocacy

08:21 – Facing the First Pediatric Feeding Client (approximate transition based on the flow of setting change)

10:58 – Discovering "Feed The Peds" and Pediatric Feeding Courses

17:16 – Balancing Practice in School and Clinic Settings

21:38 – Navigating Ethical Dilemmas and Professional Integrity

25:20 – Practical Application: Using Clinical Knowledge at Home

47:24 – Final Advice for New Clinicians & Closing Remarks

If you’re feeling unsure where to start in pediatric feeding, Screen The Peds to Feed The Peds is the perfect next step.

Join me for this free 3-day training, where I’ll show you how to screen feeding cases clearly, confidently, and with intention — so you know what to do next.

👉 Join the free 3-day Screen The Peds to Feed The Peds training

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Why Two Therapists Get Different Feeding Outcomes (And How to Fix It)
• When Imposter Syndrome Shows Up in Pediatric Feeding Therapy (and What to Do Next)
• 
  

STAY CONNECTED & GROW YOUR PRACTICE

💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips on

Instagram | Facebook | LinkedIn

If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

Hosted on Acast. See acast.com/privacy for more information.

In this solo episode, Hallie Bulkin dives deep into the "noise" of complex feeding therapy. When a child presents with multiple overlapping issues, it’s easy for clinicians to feel stuck. Hallie explains why the secret to better outcomes isn't working harder or using more strategies - it’s prioritization.

By breaking feeding down into four essential layers, Hallie provides a framework for identifying the "primary limiter" and building a treatment plan that actually moves the needle. Whether you’re a seasoned therapist or new to the field, this episode will help you trade confusion for clinical confidence.

Key Topics & Takeaways

• The Four Layers of Feeding: Understanding the hierarchy of physiological stability, oral motor skills, sensory processing, and behavior.
• Cutting Through the Noise: Why treating every issue at once often leads to plateaued progress and clinician burnout.
• Identifying the Primary Limiter: How to determine which factor is actually holding the child back from reaching their next milestone.
• The Foundation First Approach: Why skipping foundational stability for high-level skills is a recipe for failure.
• Clinical Confidence: How mastering decision-making skills changes the way you show up in the therapy room.

Soundbites

"The problem isn't effort, it's prioritization."

"Not everything is equally urgent. If we treat everything like a priority, nothing is a priority."

"Clarity in your plan builds confidence—not just for you, but for the families you serve."

Timestamps

• 02:09 – The Real Problem: Effort vs. Prioritization
• 03:19 – The Confusion Loop: Why Feeding Cases Feel Complex
• 04:22 – Identifying the Primary Limiter in Feeding
• 05:05 – Layer 1: Physiological Stability
• 05:54 – Layer 2: Oral Motor Skills
• 06:25 – Layer 3: Sensory Processing
• 07:01 – Layer 4: Behavior and Learned Patterns

If you’re feeling unsure where to start in pediatric feeding, Screen The Peds to Feed The Peds is the perfect next step.

Join me for this free 3-day training, where I’ll show you how to screen feeding cases clearly, confidently, and with intention — so you know what to do next.

👉 Join the free 3-day Screen The Peds to Feed The Peds training

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Why Two Therapists Get Different Feeding Outcomes (And How to Fix It)
• Why Pediatric Feeding Therapy Feels So Hard and What’s Been Missing

STAY CONNECTED & GROW YOUR PRACTICE

💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips on

Instagram | Facebook | LinkedIn

If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

Hosted on Acast. See acast.com/privacy for more information.

In the ever-evolving world of motherhood, the journey through breastfeeding can often be fraught with challenges. In this episode, Hallie Bulkin and Tamari Jacob (CLC, founder of One With The Pump) share their personal experiences with exclusive pumping—a path less traveled but deeply impactful for many moms.

Moving beyond traditional nursing expectations, Tamari opens up about the reality of the "hot mess express," from the initial confusion of latch struggles in 2017 to the emotional weight of grieving the nursing journey she thought she’d have. 

Whether you are a parent feeling isolated in your feeding choices or a professional seeking to provide more compassionate care, this episode sheds light on the emotional and practical pivots required to navigate infant feeding when the "natural" path doesn't go as planned.

• The Unforeseen Challenges of Nursing: Why we must normalize the shift from nursing to exclusive pumping when reality doesn't match our expectations or a baby struggles to latch.
• A Community of Support: How connecting with others—through online groups and social media—provides the validation and specific pumping education that is often missing from traditional healthcare.
• The Shift to Creating Change: How a personal project during the 2020 pandemic turned into a global platform to fill the gap in pumping-specific resources.
• The Emotional Toll of Feeding Struggles: Addressing the grief, guilt, and "triple feeding" trauma that occurs when feeding becomes a source of stress rather than bonding.
• The Professional Gap: A look at why many training programs fail to provide adequate lactation education, leaving parents to "drive the boat" in their own advocacy.

"I assumed that I would nurse because why wouldn't I? But when it didn't work, I found myself on the 'hot mess express,' grieving the journey I didn't have."

"Exclusive pumping is essentially a second full-time job. We didn't just need the equipment; we needed to know we weren't alone in the middle of the night."

"We have to stop chasing a 'perfect' ideal and start aligning our feeding choices with our values—bonding, flexibility, and mental health."

00:00 – Introduction: The Ever-Evolving Journey of Motherhood

03:15 – The "Hot Mess Express": Navigating Latch Struggles and Confusion

08:42 – Grieving the Goal: Processing the Emotional Toll of Feeding Challenges

14:10 – Finding Your Village: The Rise of the Exclusive Pumping Community

21:30 – COVID-19 & The Content Gap: Creating the Resources You Needed

29:45 – Advocacy & Education: Why Compassionate Support is Non-Negotiable

38:20 – Aligning Values: From "Perfect" Feeding to Mental Health Sanity

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Episode 164: Lactation Consultants Journey Into Tethered Oral Tissues
• Episode 82: Bottle Refusal Is Not Always A Feeding Disorder With Jill Rabin M.S. CCC-SLP/L IBCLC

STAY CONNECTED & GROW YOUR PRACTICE

💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips on

Instagram | Facebook | LinkedIn

Connect with our guest, Tamari Jacob: 

Follow One With The Pump on Instagram | TikTok | YouTube Visit onewiththepump.com 

If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

Hosted on Acast. See acast.com/privacy for more information.

Is a thumb-sucking habit just a "phase," or is it a survival mechanism? In this episode, Hallie Bulkin breaks down the often-misunderstood world of oral habits in infants and toddlers. 

Moving beyond the traditional "just make them stop" approach, Hallie explores how frequency, duration, and intensity act as a roadmap to a child’s underlying airway and developmental health. Whether you’re a therapist or a parent, this episode will change how you look at pacifiers, fingers, and oral fixations forever.

• Decoding the "Why": Why we must stop viewing habits as behaviors to be eliminated and start seeing them as symptoms to be investigated.
• The Compensatory Connection: How thumb sucking often masks underlying airway issues or tongue-tie restrictions.
• The Triple Threat: Understanding the "Frequency, Duration, and Intensity" framework for assessing when a habit becomes a developmental red flag.
• Sleep & Behavior: The hidden link between poor sleep quality and the "behavioral" concerns that often land children in therapy.
• The Professional Path: Why specialized credentials in pediatric feeding and myofunctional therapy are non-negotiable for lasting results.

"We have to stop asking how to stop the habit and start asking: What is this habit trying to tell us about this child's system?"

"If a child is biting through a pacifier or sucking their thumb aggressively, they aren't just seeking comfort—they might be seeking an airway."

"Frequency, duration, and intensity. If you don't look at all three, you're missing the full picture of a child’s development."

• 00:00 – Introduction to Oral Habits: More Than Just a "Phase"
• 02:29 – Defining Oral Habits: From Pacifiers to Fingernails
• 04:30 – The Red Flags: Identifying When a Habit Becomes Problematic
• 07:50 – Why Credentials Matter: Finding the Right SLP or OT
• 10:25 – The Airway Connection: Is the Habit a Compensation?
• 12:19 – Root Cause Resolution: Moving Beyond Habit Elimination

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Ep 363: Tongue Ties, Oral Habits & the Future of Airway Health (with Dr. Casey Jones)
• Mouth Breathing in Toddlers: Why It Matters 

STAY CONNECTED & GROW YOUR PRACTICE

💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips on

Instagram | Facebook | LinkedIn

If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

Hosted on Acast. See acast.com/privacy for more information.

The world of myofunctional therapy is currently seeing a surge in "preformed appliances"—ready-made mouthpieces designed to guide dental growth and improve breathing. But are they a silver bullet or a systemic shortcut?

In this episode, Hallie Bulkin is joined by the legendary Autumn Henning to pull back the curtain on these tools. From hygiene concerns like mold growth to the physiological risks of "cookie-cutter" treatment, this conversation is a must-listen for any therapist or parent considering an appliance-based approach.

They dive deep into why a multidisciplinary team and a holistic view of the "Integrated System" are the only ways to achieve lasting functional outcomes.

Key Topics & Takeaways

• The "Cookie-Cutter" Limitation: Why a one-size-fits-all appliance can lead to compensation rather than correction.
• The Hygiene Factor: A frank discussion on mold growth, dyes, and sensitivities in pediatric appliances.
• Airway First, Always: Why comprehensive imaging and evaluation must precede any device being placed in a child's mouth.
• The Multidisciplinary Team: Understanding the roles of SLPs, myofunctional therapists, and airway-aware dentists in a successful "Integrated System."
• Financial Reality: Assessing the cost, durability, and true clinical value of these devices versus functional therapy.

Key Soundbites

"Kids can bite through these appliances in 24 hours. We have to look at the durability and the 'why' behind that force."

"We can't treat in silos; the system is integrated. If you move the jaw without looking at the airway, you're missing the big picture."

"Don't dismiss treatment based on a diagnosis alone. Early intervention and the right team can change a child's entire facial development trajectory."

Timestamped Chapters

• 00:00 – Introduction and Guest Credibility
• 01:54 – How Preformed Appliances Work vs. Case Selection
• 06:16 – The Hidden Issues: Mold Growth and Appliance Hygiene
• 10:01 – The Necessity of Comprehensive Evaluation and Imaging
• 16:34 – Building a Multidisciplinary Team for Holistic Success
• 27:20 – Sleep Disordered Breathing and Neurodevelopmental Impacts
• 41:26 – Autumn Henning’s Program Updates: TOTS Gold & Feed the Peds

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Why We Can’t Ignore the Airway in Pediatric Feeding Therapy
• Episode 309: 5 Airway Health Tips for Children with Hallie Bulkin

STAY CONNECTED & GROW YOUR PRACTICE

💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips on

Instagram | Facebook | LinkedIn

If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

Hosted on Acast. See acast.com/privacy for more information.