Trish: [00:00:00] Welcome back to another episode of The Birth Experience with Labor Nurse Mama, where we empower and educate you on all things birth and motherhood. This is Trish, and today we have an incredibly insightful episode for you. We're gonna dive deep into a topic that affects us all. So many new mamas and their babies tongue tie. 


Joining me today is a leading expert in the field. Literally like one of the few Lisa Palladino, and she has dedicated her career to understanding and treating this often missed or overlooked condition. And she has helped countless families navigate these challenges. She also trains experts. So, I'm going to talk about how to get the right treatment and help parents navigate tongue tie, which is huge and necessary. 


In this episode, we're going to talk about what tongue tie is, how it can impact breastfeeding and oral [00:01:00] development, and what you can do if you suspect that your baby has this condition. So whether you're an expecting mama, a new parent, or someone who supports women through the journey of tongue tie, this episode is for you. 


And we have more links in the show notes if you need more information. So Let's welcome Lisa to the show. 


Hey everyone. We have a great topic today. The guest that I have on today is an expert and I am so ready to dive in. We have with us a Lisa Palladino. Lisa, I'm just going to let you do the honor of introducing yourself. Just tell everyone who you are and how you got started doing what you're doing. Sure. 


Lisa: And thank you so much for having me, Trish. This is a thrill. As I started out as a labor and delivery nurse and talking to any labor and delivery nurse is an honor because [00:02:00] we're a special breed. Nobody else understands the role of an L and D nurse unless you've been one, right? So yeah, I was an L and D nurse and I always knew that I was drawn to. 


pregnancy, childbirth, and everybody always said, Oh, it's just because you want to have babies. And that wasn't exactly the case. I knew that's where I wanted to be. If I had known before I went to nursing school, that there was a such thing as a nurse midwife, I would have gone straight there. 


But at the time it was just really being, I'm old, so it was just being established as a career. So I didn't even know about it. So I go to school, I go work in, first I had to work in the medical floor as most RNs don't start out in. Medical, allowed quote unquote to work in maternity. 


And then I had to work in the nursery for a while and the postpartum floor, which at the time it was totally separate nursery and postpartum. And all the while just [00:03:00] wanting that chance to be in labor and delivery. And finally after a couple of years, I was allowed to work in labor and delivery and I have to tell you, I was disillusioned. 


It wasn't what I thought it was going to be. And that's why I said most of us have no idea what it is. And I thought birth was going to be different than it was. I expected a more natural experience. I learned a lot about how to work a monitor and IV drips and all this stuff. But I was always a touchy feely I wasn't running to triage. 


I wanted to be the handholding nurse. So I feel like you're telling my story right now. 


Trish: Like I could predict the outcome. 


Lisa: So yeah. So then these two very brave women who were nurses with me decided to go on to midwifery school and they were my inspiration. I couldn't believe that this was a thing and they did it. 


And they came in charge of the patients, which to me was like awesome. Cause as an L and D nurse, for those who are listening, who don't know, We do everything. And then the doctor would run in and get the [00:04:00] glory of, Oh, I caught the baby. That's the easy part. So I was like, I can do this. So I started going back to school. 


They inspired me. I started going back to school part time. Cause I had only had my associates. So I went back to school and little by little, I got my bachelor's degree in nursing, and then I went off on my master's in midwifery, did an internship at the hospital I worked at, which is great. Interesting because one day I was working as a nurse and the next day I was working as a It's 


Trish: interesting. 


Yeah. 


Lisa: I would have to like So no one I did things to differentiate myself. Knew your role for the day. Yeah. Today I'm the midwife, or today I'm the nurse, different color scrubs or a white jacket when I was the midwife or whatever. But I, at that same point, I started realizing what I didn't know about breastfeeding and how little we learn in our education about how to support women breastfeeding. 


We learned it's important. When I went back to when, when I was first in school, it [00:05:00] wasn't even that important because this was going back, in the eighties, it wasn't that important. But as we went on we still learn that it's important. We learn that it's best, whatever the heck that means. 


But we don't learn how to manage breastfeeding, and we don't learn beyond the simple things. Besides forcing moms to do it. Forcing moms to do it. If mom's got pain in her breast, it must be mastitis. The simple, Silly things. And if anybody's got to take any medication, they have to stop breastfeeding. 


That's what we learned. And so we started a breastfeeding initiative. I'm in Staten Island, New York, and we're part of New York City and Staten Island started a breastfeeding initiative based on New York city was having a major, there was a major grants program to New York city hospitals, but they didn't include us. 


We weren't in the we're not in the heart of the city. So a friend of mine and myself rallied, like politically, we became political activists nothing like a labor nurse to get shit done. [00:06:00] Uhhuh. . We forgot to tell the person in charge of the hospital and they got a call from the mayor's department and they're like, what is going on down there? 


Who's making these calls? Who's sending these letters? But anyway. We got a grant, the breastfeeding initiative was established, they needed somebody to run it. And this happened concurrently with me graduating from midwifery school. My boss at the time, who became like one of my best friends and mentors she said, Lisa, do you want a job? 


If you want a job, it's yours, you'll be in charge of the breastfeeding initiative. You have to write the job description. What I did was part time midwife, part time, like halves. I split it in half and I was for eight years, that's how I worked. And we were trying to make the hospital baby friendly. But the only problem was I was the only person trying to make the hospital baby friendly. 


Nobody else really does it 


Trish: work. Yeah. So it 


Lisa: didn't really work. And after eight years, I threw out the wave, my white flag and said enough, but getting back to what I do right now. So I left there [00:07:00] in 2015, started my private practice. I'm in private practice now. And as I, so at that point when I was in charge of the breastfeeding initiative. 


It's like I better get more breastfeeding education. So that's what I did because I can never stop going to school. After midwifery school, I started training in lactation, got my IBCLC and started getting, people were sending babies, mommies and babies who wanted to breastfeed and were having struggles to me because they just associated me with breastfeeding. 


And then that went, that, that was great. So when I started, when I left the hospital, I was doing like a mixed kind of practice with breastfeeding, GYN, whatever. And then all of a sudden I had a bunch of babies that I couldn't help. So I did all the tricks I knew to get these. This is why I'm so 


Trish: excited to have you here. 


Lisa: Yeah. Yeah. So it was like, I'm doing all the things they taught me. What the heck is going on? And I started hearing about tongue [00:08:00] tie and honestly, I was a midwife. So I was like zero interventions. Why would we need to do something to a baby's mouth to help them feed? They should be able to feed. So I tried to ignore the issue of tongue tie and I had three babies in one week who could not latch and I couldn't get them to latch and then one of those moms said. 


I think my baby might have a tongue tie and she on her own found someone to release the tongue tie and came back to me and showed me, she taught me. Now my baby can feed, she was very lucky that baby, it was a simple case because it's not always that cut and dry. 


Trish: No. 


Lisa: Yeah. And so I said, I better start learning about this stuff. 


And because of where I live and because there wasn't a lot of lactation and there was nobody that knew about tongue tie. Everything I learned was more than anybody else knew. So I [00:09:00] started being seen as the person to send to for TongTi. So I went in that direction and I started learning about it, going to all the conferences, joining all the organizations. 


If there's something to learn about TongTi, I've done it. And now I run my brand is TongTi experts, but. I like to always say, and I know you introduced me as a tongue tie expert, but I like to say it's not me, that's the expert. I 


Trish: really didn't. 


Lisa: Yeah. 


Trish: I let you introduce yourself because I don't know that I've ever seen a CNM who's an IB, CLC, who's also a tongue tie expert, who was a labor nurse. 


You're a unicorn. 


Lisa: Yeah. It's it's a niche. Oh, for sure. Yeah. A hundred percent. But I like to say I'm not the expert. The people that are the experts are the people that The parents, first of all, because the, as I just told you, I learned from a parent. And the people I interview on my, whether it's on Instagram or on my own podcast, they are the experts and I like to bring together the [00:10:00] experts and bring them to other fam, bring them to parents. 


So my following and my world is parents and professionals who are. Curious or need to learn about tongue tie for whatever reason. And we learn together, and I have parents courses. I have professional courses, which I think is probably the most important thing is to teach other professionals. 


Trish: I am just. I don't even know the words to say because here, let me tell you my little bit of a journey to finding you because I reached out to you is that I have my birth classes. My birth classes include weekly hangout, weekly support call on zoom with me or one of my doulas. And then we also have a membership. 


AKA our family ship, I don't know what to call it, but we're like a family. My girls can also opt in. They get 30 days free when they buy the. Birth classes, and then they can choose to stay. It's 19 a month. It includes our [00:11:00] monthly mindset coach. We have weekly postpartum hangouts. We've experts come in and do workshops. 


I do. Workshops. Our doulas do workshops. We have the most incredible. And I'm going to be doing a chat text message going on a group text with our girls, both postpartum and pregnancy and waiting for baby. I'd love to have you come in and do a workshop. And here's why I got to the place where we were looking for someone who could. 


educate us more on tongue tie. Because as a labor nurse, and you'll understand this, I've never spent a significant amount of time with postpartum moms, minus the few of my friends in my own life. But you know, When you're in the midst of postpartum yourself, who has time , to actually learn for one another because you're surviving. 


So for the last couple of years, every Thursday, I hang out with my postpartum mamas, my students, my members, beyond them having their baby. And it's given me this other side of, perspective from [00:12:00] postpartum mental disorders, like rage and sadness and fear. We've talked about abuse. 


We've talked about relationships. We've talked about sex. We've talked about fears in laws. Your own parent problems, but it's also allowed me to walk, their journey with them and their babies. And I have learned so much, but I kid you not, when I say that probably 60 to 70 percent of my mamas, their babies have one form of tongue tie. 


or other, like it's blown me away. And I'm wondering to myself, has this always been the case? Are we just aware of it now? 


Lisa: Yeah. Maybe not. I can address that if you'd like. I would 


Trish: love that. That is a huge thing I want to know. 


Lisa: Yeah. I get this question all, yeah, all the time. And from the great minds who I have learned from, I didn't make this up. 


There's a dentist named Kevin Boyd. Look into his work. He's actually an anthropologist and a [00:13:00] dentist. So he has looked at, I'm going to write this down. Yeah. Yeah. Kevin Boyd, B O Y D. I'm sure he'll love me shouting him out. And I've actually had him on my podcast. But he lectures about the epigenetic changes that have happened to the face and jaw, right? 


So now this gets us down a rabbit hole because tongue tie isn't an isolated problem. It's a, an aspect of the changing faces that we have. If you think about the tongue not being able to move appropriately, or the tongue being able to move appropriately and lift appropriately against the palate, the top of the mouth, is what starts the formation of the shape of the whole face. 


So babies with tongue tie often have high palates, which means they're going to have narrow sinuses because the top of the mouth is the bottom of the sinus. So fast forward that [00:14:00] to adulthood, think about the amount of sleep apnea we have in a, it's an epidemic. Now people cannot breathe when they sleep. 


That's all related, not to say, not to scare any mom whose baby is having trouble breastfeeding that there's someday going to have sleep apnea. That's not what I'm saying, but there is a trend towards a. Changing shape of the face. So is there more tongue tie? Possibly, but is it related to well for a few generations? 


There was breastfeeding. 


Trish: We had no information either When you and I were breastfeeding our babies, we didn't have information like this. We had to go to the library and who has time to go to the library and look things up with other babies. 


Lisa: And there was no community. There was little Leche around here, but it was very like hippie and a little bit. 


And excuse me, any La Leche leaders that are [00:15:00] listening, but at the time it was a little militant. 


Trish: Yeah, I went to La Leche with some of mine. I liked it to a point. It's like Bradley instructors. And sorry if you're listening because I know some amazing Bradley instructors, but part of my story and why I do what I do sounds a lot like Bradley instructors, your story in the beginning. 


But when I was having baby number four, my Gavin, I wanted to do something a little different. I already had unmedicated birth, but I wanted to have a peaceful unmedicated birth. And so I took a Bradley course. And for any of you guys listening, we go off on weird tangents, but this is one of them. Anyway. I became what I thought was very good friends with my Bradley instructor. 


We got our kids together, here I was this really young girl. Cause just so you guys know, I had all four boys by the time I was 25, I was a young mom from Florida, total city girl, not country living girl, but I'm living in Tennessee making bread with this Bradley instructor, all the things she had chickens. 


And I remember being like [00:16:00] chickens anyway. Long story short, Gavin ended up turning breech and my midwife was like, Hey, let's do an ECV. If you don't know what that is, that's an external cephalic version for those of you guys listening. If he doesn't turn, I'll induce you and we'll still do the delivery, a breech delivery. 


Like she was going to deliver me vaginally breech, but she didn't want me to go to full term because. My, according to like palpating and even ultrasounds, which are often wrong, but according to my own body for my fourth pregnancy, I knew he was a bigger baby and he was, he turned out being eight something at 38 weeks. 


So who knows what he would have been if I went full term. And I made the decision for myself that was what I was comfortable with and I loved my midwife. I picked her well. I loved her and I trusted her. So we go in, we did a successful version. I had a beautiful, unmedicated induced birth because when he went head down, I decided to let them induce me. 


But that being said, my Bradley instructor [00:17:00] like never spoke to me again because I didn't do what I was told. And I am not like, like that in any way with my students. You don't impose what you think is right on someone else. You give them the education. And this is why I do what I do. This is why I left the bedside and I'm pursuing this is because I don't want to be the one bullying and coercing. 


I want to lay it out. My students say that I'm crunchy with a side of medical and then I lay it out for them like a s'mores board or a buffet and I let them choose what's best for them. And then I support them because it was so hurtful to me that I didn't as a young mom. Then she 


Lisa: wasn't a good friend. 


No, 


Trish: she wasn't a friend. No, that's the whole point of that. 


Lisa: I like, I just, I know another tangent, but the way you say that you lay it out and you educate and you let them decide, I'm the same way about that. Because, there's no absolutes and I firmly [00:18:00] believe that every mother knows what's best for her baby. 


And with that's the only absolute there is. And I think that with the right education and support, every mother will make the right decision for their baby. So if I tell you your baby appears to have an oral restriction or tongue tie or a lip tie, I'm not saying you have to have a procedure. I'm saying, this is what you need to learn about it. 


This is the symptoms that I see. Let's see what we can do without release, if that's not what you want to do. And you take all that information, and even if you said, you know what, Lisa, you're crazy, I don't want to do this. You need to know, I give them what we know in nursing as anticipatory guidance in, if you don't do this, look out for this, and this. 


And even if you do that, still look out for this and this, because chances are, I'll never see you again. And other people may not. Look back at your history or the baby's history of [00:19:00] poor breastfeeding as a red flag for some of the things that could come later. And more and more I am looking at breastfeeding as like a vital sign, or if it's not going well, a red flag that something is up. 


because babies are supposed to breastfeed. Whether we choose to breastfeed or not, babies are meant, they're born to breastfeed, right? That's survival. We're mammals, we feed our babies at the breast. And when that doesn't work, something's up somewhere. Now, sometimes it's just, as an L& D nurse, all the interference that can go in. 


To birth, right? All the things that we do to women that interfere with the natural process can affect the baby, can affect the mom. Sometimes there's lack of education. Sometimes there's I've had women in my office who have no idea how to hold a baby. 


Trish: No. Yeah. That was shocking to me. When I first started as a labor nurse, I always tell my girls that I walked in there like I had already breastfed five babies. 


Oh wow. I was like, [00:20:00] I'm going to be the queen of breastfeeding help with my people. They're never going to need a lactation consultant. And then I never have sweat so bad as I have when you can't get a baby latch and a lot of times it's just simple mechanics of her body or baby's mouth and holding the baby. 


Yeah. Yeah. And even her anxiety can really interfere. Absolutely. 


Lisa: So yeah, so I even bring in like breathing exercises to my patient care. Let's, baby's screaming, mom's freaking out. We do skin to skin, calm the baby down. And then I tell her take a deep breath. And this is great for anybody listening. 


This is like something that I don't know where I got this from, but it works. Take a deep breath. And when you exhale, drop your shoulders. And I tell them to do that three times when the baby is on them, near them, about to come on, because you will not have let down if you are not breathing, right? It's just biologically important, impossible. 


Your stress response [00:21:00] holds back the milk. So your stress, every time the baby cries, if you clench and stress, it's going to prevent anything good from happening in the baby picks up on that stress, right? So those breaths, that breathing really helps. That's all of the Most of what I suggest in my practice, in my, online, whatever, in my classes is really simple and basic. 


Like I said, so far, trust your instincts, take deep breaths. 


Trish: I love that you say that because one of my most powerful free classes that we do as an introductory, so people can like, get used to my teaching style and my community and get a glimpse and want to join us. And, so if someone's going to join me, I want them to be like, yeah, I want to join her. 


I like her. I like how she does it. I like her teaching style, so I do this class. It's all about the pain of labor. People forget we're mammals. And there was a time and a place when we didn't rely on hospitals and houses and our bodies were designed in a certain way. And when you get anxious, when you get afraid, whether it's a nurse coming in at you really fast, not [00:22:00] explaining what she's doing and you get scared. 


Or, you're out in the wild and another animal's attacking you. Your body produces the fight or flight response that is amazing out in the wild. If an animal is attacking, you need to run and fight because it will slow down or even stop your labor. And I tell my girls all the time, I am a hundred percent that this is a huge reason why so many women end up in the OR is that staff does not think outside of the box, they do other things besides what we're taught. 


and our bodies. It just makes so much sense. And, 


Lisa: and how many 


Trish: labors 


Lisa: stop in the triage room. Exactly. And that's normal. 


Trish: Because it doesn't feel like a safe place. and our bodies. It makes so much sense because our bodies are designed so beautifully that of course if you're out in the wild and a tiger is going to attack you and your labor needs to stop, your labor needs to stop. 


Yeah, and your milk to stop flowing so you can take care of business. Yep. Because when you're being chased by a lion, you're not going to stop to feed the baby. No, so it [00:23:00] all just made such logical sense. But what doesn't make sense is that most medical providers, lots of labor nurses, lots of OBs, and I call them med wives, do not understand. 


You're the problem. Make her feel safe. Right. Support her. Yeah. 


Lisa: And the scary the scary things that we say to women. And I say that I actually have PTSD from my labor and delivery days where I did things that I now regret. I spoke in ways, I touched in ways that No, I know. I had, I didn't know about asking permission. 


I It's terrible. And I really, I regret it. And I apologize. Like every time I talk, I'm like, if I took care of you, I'm sorry. But the sad part is that most women don't even understand they're not getting treated well. 


Trish: This is the part that's hard for me. And that is what makes me sad. it difficult to even sell the birth classes because I also do business coaching for women in the perinatal mom space. 


And I tell my clients all the time if they [00:24:00] know the pain problem. So let's say you're a sleep consultant. They know like these parents coming to them. No, I'm not getting sleep. I need help. They know they need help. Super easy. But in the birth space and birth education, Women do not realize how detrimental it can be to walk into the hospital without the right knowledge. 


And I am 100 percent not a fan of hospital birth classes. I've been asked to teach them over the course of my years, and it's very intertwined. With policy and procedures and that I'm not a fan of. Sorry, if you're listening to teach one, but I'm not a fan. This isn't about what the hospital or the doctor wants. 


This is about what she wants and what she needs and what her body is capable of. I'm getting fired up right now. Same go back to one of my early episodes and listen, if you're listening right now, it's about coercion. It's so freaking prominent and it's a problem, but it's really hard to be like. Listen, don't get the Mac Daddy stroller. 


I know you want it. Take this freaking birth class [00:25:00] because you don't want to be traumatized by your birth. It changes everything. You only get one shot to birth this 


Lisa: baby. And you know that, so every, almost everybody I see is postpartum, which is sad because I wish they came to me prenatally, but I, in my intake forms, there's a question You know, did you experience and it's a checklist and almost, I'd say 90 percent of women check off birth trauma. 


Yes. And sometimes they don't even know what that means. And that's the first time they've seen that term. And then I unpack that with them and I say, you know, this is a safe space. So I'm still doing midwifery in that form, because nobody's unpacking that and most people 


Trish: are. 


We are. And that's why I hired a mindset coach that specializes in releasing trauma. She works with my pregnant mamas inside my membership and my postpartum moms once a month. She comes in, does a one hour or longer depending on the need. That's great. She meets [00:26:00] with them. She works on releasing childhood trauma that maybe, like you're bringing into your parenting experience. 


or any kind of trauma. She works through postpartum mental health disorders and the loneliness and all of it because it's not really, maybe I should work with her to deal with my labor and delivery day trauma. Yeah. And then she works with the postpartum moms because here's what I want everyone to listen to. 


You're the one who decides if you have birth trauma, no one else, not your mom, not your sister, not your labor nurse, not your doctor, not your partner. If you feel traumatized in any way. Then you've been traumatized. And I have students who have taken my class and have felt traumatized maybe by their labor nurse who was condescending or rude or a family member or maybe their partner didn't rise to the occasion. 


I had a provider that walked in on one of my students, laughed at her birth plan, ripped it up and threw it away. Yeah. 


Lisa: Yeah, on the other side of it, I was the midwife. I hope none of my former colleagues are listening. I was the midwife [00:27:00] that would come in with my patients. And have to argue with my former friends who I used to work with as a nurse and get them to let her just have an IV lock, not an IV. 


Get her, let her walk around the room. Why? 


Trish: That's just, it's maddening to me because Yeah, and here I was their colleague. And also they're the boss. But you know what I'm saying? Like, I mean, I love labor nurses. I agree with you. We're a breed of our own. And I think they are the most amazing breed of nurses. 


Sorry to my other nurses, I'm partial. But there is a subset of nurses who really think that what they've been taught in the hospital is birth, but it's not. It's policies and procedures. The birth side of it is the natural side of it. Birth is a natural process. One of my friends and students, she's on Instagram, Kim Perry. 


If you guys aren't following her, Kim Perry fit. She's amazing. She just delivered this morning. If you guys are listening to it may have been a [00:28:00] while. Her fourth baby, she was having a home birth. She was like 42 weeks, I think, in one or two days. I could be wrong on that, but she went in yesterday for an anesthesia. 


She posted in her stories that the nurses were really being jerks and like trying to get her to stay and get induced. And it's like the baby passed her NST flying colors. NST is a non stress test for those of you guys listening. You would get hooked up to the monitor and we just see how is baby doing. 


Baby was doing fine. 


Lisa: Good for her. 


Trish: And this is what I teach my students. We're not going to just refuse everything because we can, but we're also not going to just go wildly into saying yes and yeah, I'll do this because out of fear, this is where I'm medical at the sight of crunchy. I still want my students, if they're going over 40 weeks, if they're going over 42 weeks, you're doing NSTs, you're doing BPPs, you're following up with your providers, you're paying attention to your body and what the baby is doing. 


You're not being stupid, right? You're being smart. But you're also not falling into, I have to do this because I'm [00:29:00] told. 


Lisa: Out of fear. It's all fear based. So the, let's get back to a little bit about the where do we start? Are there more tongue ties? Are there more tongue ties? Okay. 


So the one thing that I like people to understand or that I feel like it's necessary to understand about tongue tie is it's not just, it's not just a diagnosis or an assessment that can be made based on looking in the mouth. It is a functional diagnosis. So if everything is working and it looks like your baby might have a tongue tie, but there's no symptoms with you or the baby, then it's not a tongue tie, right? 


We all have frenum. So in the groups that I run, I don't let I have two Facebook groups. One is for the professionals in my course, and one is for anybody, parents and professionals together, and it's a great group. But I don't let anybody just post a picture and say, does this look like my baby has a tongue tie? 


[00:30:00] Because this is a functional diagnosis. The, the tongue tie world has gotten a lot of bad press, but even before that, we have to be very careful that we're not doing procedures on babies that don't need it. So if it's not broken, don't try to fix it. 


Trish: One thing I would love for you to share is what are the steps that a mom should take if she thinks that her baby is tongue tied or someone has said to her or she's having difficulty with breastfeeding. 


Let's say it might be tongue tied, like not just difficulty breastfeeding. 


Lisa: Yeah. I think that every woman who plans to breastfeed should have a relationship with an IBCLC before she delivers her baby. That's the ideal world, right? Because we were just talking about the postpartum trauma and all the things that happened postpartum. 


It is so hard for somebody to try to even make an appointment with me. And I know [00:31:00] that for a fact, like I've gotten people reach out and I answer them back and then I never hear from them again. And it's not because they don't want my help. They can't figure out how to pick up the phone. Like they're that overwhelmed, especially if things are going badly. 


And especially if their primary medical providers aren't the ones that suggested they see me. So now this is outside the box. So I've had patients say, Oh, I can't come to see you. I have to go to the pediatrician. I'm like, no, come to me first. Come to me first. And the ones who do say, why did my pediatrician teach me this? 


So it's, so if that's ideal world, you make a relationship with an IBCLC. As soon as you're having trouble, call the IBCLC, text her. Most of us are texting with people we've had a, we've had one visit or maybe a class or even just a contact. Guess what, Lisa? 


I'm having a baby and I want to see you after the baby. I will answer that text with hints as far as I can [00:32:00] generalize. Hints if you're not my patient. If you are my patient already, all bets are off. I'm giving you all the help. I'll jump on the phone with you. Even, I've even had people come straight from the hospital to my office, for helping out. 


So breastfeeding should never hurt. If it hurts, there's something to be done. If It's not selfish. I just did a whole episode on this. It's not selfish to accept, expect breastfeeding to be comfortable. And the main reason for that is if it hurts you, that means the baby's having a hard time. So breastfeeding needs to be comfortable for you and the baby and efficient. 


And it's, if it's not comfortable for you, It's not being, it's not efficient. The baby's not getting what they need. So those are things that get a little fuzzy in the, I've heard people called selfish for wanting to do a procedure so that they could breastfeed as if, the breastfeeding was just for them. 


Which is really [00:33:00] 


Trish: well. And I think we have to really acknowledge that the older generation of a lot of these mamas, like I was told, my oldest son, I had him really young. I was pretty much told that your nipples are going to be sore. It's going to hurt. You have to grip it. Just deal. I remember grabbing the chair every time he would latch on for the first few seconds. 


Like this is a pain I will never forget in my life. It's the worst pain ever. 


Lisa: Yeah. And I say all the time, my second daughter literally took my nipple off, literally. And now I know she had a tongue tie because she still has a tongue tie, but I didn't know anything about it back then. 


Trish: But the older generation will just tell you, and I preach this from the rooftops. 


We, we tell our moms too, part of the course is preparing for postpartum and you have to have your resource list ready. And that includes a pelvic floor specialist. We want them to see during pregnancy, a chiropractor for you and baby ready to go, preferably Webster certified, have your IBCLC. And a mental health specialist that your insurance covers or someone you can afford or a free resource in your [00:34:00] community, have it already because you're right. 


Sleep deprivation, your booty's falling out, you're miserable, you're trying to learn this brand new human, your brain is telling you all these things, and it's really difficult to just stand up and look up a resource. So have it ready. 


Lisa: So now the other thing to realize is just because it hurts doesn't mean the baby has a tongue tie. 


So we talked a little bit about positioning. So seeing the lactation specialist will help you to make sure that yes, you are positioning the baby. Sometimes, I've had women sit down at it on my couch and and she'll go to latch them and go, what if we just did this? And I just moved the baby's head like a centimeter and they're like crying. 


Cause it doesn't hurt. So it doesn't necessarily mean there's a tongue tie, but if it hurts, you need to investigate because it's not going to get better. And that's the other thing I hear, Oh, I'll get used to it. What is that? And I feel so strongly that I wrote a little book [00:35:00] about this called it shouldn't hurt to nurse your baby all about healing nipples. 


Cause I was sick of saying it shouldn't hurt to nurse your baby. It shouldn't hurt to nurse your baby that I made it the title of my little book that I wrote. Other things. So now, all right, it hurts, but you can get comfortable. But other things that happen early on is sometimes the baby like doesn't seem to be transferring milk or that either the baby can't latch or they latch and they're nursing constantly. 


And they never seem to be satisfied. Neither of those is normal. It's hell on wheels. I love that you 


Trish: said that. You definitely 


Lisa: want to reach out for help. And if your IBCLC tells you. This is what you should do. And I think there's a tongue tie. I don't recommend going straight to getting it lasered or released. 


I like a laser release personally based on experience. And do the 


Trish: parents have a choice in that? 


Lisa: Usually in most places, especially in the U S in most places, there is a laser dentist who is [00:36:00] trained. 


Trish: So that's an important part because that's part of why I've had so many students that have realized that it's a tongue tie issue. 


We had a pediatric dentist come in when I first started the membership and we have that expert workshop in the recording. So when our members get their first 30 days free and then in the membership, they have access to over 70 recordings, including this workshop, which so many of my students have watched two years down the and realize they have a tongue tie issue. 


And it's one of our most popular ones, so I'd love for you to say that. So I want you guys to hear these steps. You need to connect with an IBCLC while you're pregnant. Doesn't hurt to even have, one if things are going well for you to connect with her afterwards. And then if you have any problems step one, see your IBCLC, not your pediatrician. 


Lisa: Of course you want to see your pediatrician, just, because of the things. Maybe controversial, but don't be surprised if your pediatrician says there's no tongue tie without even looking in the baby's mouth. 


Trish: We've had [00:37:00] plenty of our students have ended up too, and now they're going to chiropractors, they're getting tort stuff, like all of this, and their pediatrician was like, baby's fine, this is normal. 


This is what, yeah, this 


Lisa: is what I like to arm parents with if they're brave enough. And now, Postpartum women tend to be very vulnerable and not feeling very brave, but every once in a while I get somebody that uses this for me. If you don't think my baby has a tongue tie, what do you think is stopping my baby from breastfeeding? 


Because there's gotta be a reason, but typically it's, you'll hear things like your nipples are too small or too big. The baby's mouth is too small. The baby's too small. The baby's too big. Like your milk must not be good. Whatever the heck that means. Your milk isn't enough for your baby because he's big or because he's small. 


I've heard it all. I've heard it all. Your pediatrician is not in [00:38:00] charge of your baby. You are. Getting back to instincts. If your pediatrician ever tells you something that doesn't go along with your instincts, follow your instincts. Unfortunately, many of the families that come to me never tell the pediatrician they got a tongue tie release and it doesn't matter because they never look under their tongue anyway, which is a shame because I've had pediatricians miss cleft palates because they didn't look in the mouth. 


Which is crazy, right? How is that even 


Trish: possible? We checked that in the labor 


Lisa: room. Nurses do most of the time, 


Trish: but shouldn't it be charted and they know 


Lisa: it, please. You can have a, you can have a not easy, not obvious submucosal cleft that can easily be missed, but with a thorough oral exam. 


Trish: This is why. I'm not a baby nurse. The babies are just too complicated. They don't tell you what's up. They can't say, Hey, I've got this problem going on. 


Lisa: Yeah. They do. That's why you said nursing, not being able to nurse 


Trish: is a red flag that [00:39:00] something's up, right? I like vaginas. I like babies coming out of them, but I'm not a baby nurse. 


I was a travel nurse most of my career. And if it ever got floated to the nursery back when there was a nursery, I'm like no. I'll go anywhere. 


Lisa: See, I was okay. I would. I was okay with regular nursery. Put me in NICU and I break into, I just, I like start sweating, thinking about it, those little, I was floated to NICU a couple of times. 


Those little stinkers don't tell you enough. And I was like no, I don't do this. I do, like I said before, I do hand holding, cushy, nice, emotional support, not all the monitors and beeping. Anyway. So now even when you are pretty sure because you've done your research and you're a mama, you've done your research and you've. 


Spoken to your IBCLC and she says, yes, there's a tongue tie. Hopefully you have an IBCLC who is trained properly. And that's why I'm doing what I do by training professionals [00:40:00] to understand that doesn't mean treatment does not always equal send for an immediate release. And most of us who have been doing this for a long time, are going slower and slower every year with that recommendation, because we want to be absolutely sure. 


Number one, it is a tongue tie causing the problem because you can have a tongue tie, but there's other things causing the problem, like low milk supply or Scheduling feedings or, there could be other things that cause difficulty of breastfeeding, even if there is a tongue tie. So you want to try and correct everything first. 


And then on the baby side of things, you want to make sure there is no torticollis, as you mentioned the word, because if a baby cannot. Tilt their head back or turn side to side comfortably. Their tongue is automatically going to be pulled back or to the side when they try to extend for breastfeeding. 


So any tightness. I like to say it this way. If there's [00:41:00] tightness anywhere, there's tightness everywhere and it restricts movement. So we want to work on that if possible before the tongues are released. Most well trained experienced IBCLCs who are the go to people in this field, have a list of providers they will recommend for you depending on what they assess in the baby. 


So my tongue tie resources include chiropractors, occupational therapists, craniosacral therapists speech language pathologists who are trained in infant feeding depending because sometimes I'll feel muscle tone issues and those babies need some work before because we could release the tongue. 


That's not going to teach them how to move Their tongue, right? You take out the phrenom, they still have to learn to use their tongue. And the person that you're going to should also be giving you a plan of care for what are we going to do after the phrenotomy and how are we going to be ready for it? 


If that's necessary. [00:42:00] So I have a lot of free handouts on that. Oh yeah. I would love 


Trish: to link to some of those in the show. Yeah. How to 


Lisa: prepare for phrenotomy. How do, how to, I even have had to select a provider. So there's a list of questions to ask the dentist you go to, do you have a network that you recommend? 


Because if they don't, something's up, right? Because those of us who do this know that we have to work in teams. If you have a dentist that says, Oh, or an ENT who says, I can do this today. And no, you don't need to do anything else. Yeah. That sounds really tempting to the parents. It sounds like, Oh, quick fix. 


I'll just do this. Yeah, because the other side sounds exhausting. Yes, but I've had parents come to me, hundreds of parents come to me after having that quick snip with the ENT or pediatrician who still have a tongue tied baby, whose baby was never. Able to use their tongue efficiently who may now have an oral aversion because [00:43:00] they weren't prepared for it. 


So we start doing exercises before the procedure. We get mom and dads or whoever's going to be working with that baby. Get them used to touching inside the baby's mouth, get the baby used to oral play. And. Make sure their red, their nervous system is down regulated. All of them are ready. There's analgesia bought before. 


So you don't want to wait until you're on your way home to stop at this, wherever you're going to stop to get the thing that they may not even have. So prepare, preparing ahead of time is key. And I even go so far as to tell parents. When you're preparing for this, plan a little like staycation, like you wouldn't want to have the procedure on Friday and say their, baptism is on Sunday or the other child's birthday party or, Oh, I'm going to Bahamas. 


I've had all kinds of stories. Oh, we're leaving for Bahamas. So we're going to do it this week. No. [00:44:00] You want to be able to. Give time and relax and be in a like kind of huddling in kind of state with the baby, just in case that baby isn't a baby that bounces easily. Right? 


So things like afterwards, things like taking a bath with the baby is helpful. Low lights calm. If there's other children else Yeah. Not running around and errands, 


Trish: stuff like that. 


Lisa: Right. Maybe somebody else can run, take care of the other kids. You're not gonna be, you're not gonna be doing the things that you usually do that night, the next day, maybe the day after. 


Now, that being said, some kids, no problem, they're back to it. No, I know. Everything's fine. But some take a little longer, and we want to have that opportunity. And my goodness, we don't rest enough anyway. So we should be postpartum, postpartum 


Trish: women do so much, right? We definitely try to encourage ours to at least follow the 5 5 5 where it's five days in bed, five days on the bed, five [00:45:00] days near the bed. 


But longer is even better. Oh, that's so grateful that you came today. And I'd love to invite you into the membership to do a workshop because these moms, as you were talking, I'm thinking, gosh I've cried with so many of my postpartum moms that are going through all of these different modalities and therapies and they're running here and there while they're trying to heal their body. 


They're already feeling so inadequate for this baby. So for those of you guys listening, I know it's a lot. We know that it sucks and I just want to put that out there that it's okay. It's okay to feel like this sucks because it's a lot it's motherhood. It's hard. We gotcha. If you've already delivered, you want to be a part of our family ship or membership, you can try it out for free and then hang out with us for 19 a month. 


You will never find such value. So click the link in our show notes. 


Lisa: Yeah, but also it's also okay. Okay. to decide not to do anything. 


Trish: Yeah, 


Lisa: I agree. You know, It's also okay to make [00:46:00] that choice. Because this is your baby, right? And you know what you can handle and keeping in mind that everything always seems like an emergency and urgent, most things aren't. 


So if you can't handle it and you want to pump for a couple of weeks and, Feed the baby that way. If the baby will take a bottle, cause sometimes this isn't just about breastfeeding, I've had plenty of babies that can't take a bottle because of their tongue tie, including my own grandson. Um, there's no right or wrong. 


There's no absolute right. There's just honor your feelings about it. Do the best you can get the best support. And education and there's lots of people that are doing the same work I'm doing. I often say I don't want to be that busy in my office. Like I said, I mentioned my grandson. 


I'm a grandma. I want to hang out with him. I love to teach. I love to lecture. I don't want to be that busy clinically, but it's really sad because I should be because [00:47:00] there's. There's not a lot of lactation consultants around me. So most people are not getting lactation care. And that makes me sad. 


Not that I want it to be me. I want it to be someone. Yeah, I agree. 


Trish: Thank you so much for coming on today. Can you tell everyone exactly where to find you? Sure. The 


Lisa: best place is actually Instagram tongue tie experts on Instagram. And my website is tongue tie experts. net because. com was already taken. 


Okay. There you have it. And yeah, and I'm all over Instagram and if you're on Facebook, the Facebook group is breastfeeding tongue tied babies. And that's a, most of the Tongue Tie groups are very like Wild West, and this is very well moderated. You have to answer questions to get in. 


There's no, no nonsense is allowed and we have parents and professionals supporting each other with learning from each other and supporting each other, which is really nice. And I think we're up to 3000 people. It's pretty cool. That's 


Trish: awesome. Yeah. I love that so much. Thank you again for coming [00:48:00] today. 


Oh, thank you, Trish. This was a blast. And I feel like we could talk, we could 


Lisa: talk forever. 


Trish: Thank you so much for listening to today's episode. I hope you found our chat with Lisa on Tongue Tie as enlightening as I did. If you want to dive deeper and get access to more amazing experts, and exclusive healing hangouts and mindset coaching. Be sure to join our mama membership. It's a supportive community where you can get personalized advice. 


You actually have access to me and my doulas connect with other moms on this incredible journey. You are not alone. The link is in the show notes or go to labor nurse mama. com forward slash C M S until next time you keep empowering yourself. Bye for [00:49:00] now.