Hi everyone, and welcome back to Airway First, the podcast from the Children's Airway First
Foundation. I'm your host, Rebecca St. James. My guest today is Michelle Emanuel.
Michelle has more than 27 years of experience as a pediatric occupational
therapist with a specific focus on posture, movement, and connection for the pre-crawling
baby. She has a background in NICU, PICU, SICU, and outpatient population. She has a unique
and interesting way of blending traditional and complementary forms of therapeutic applications,
with her main emphasis being on facilitating healthy nervous system functions.
Michelle is an international board-certified lactation consultant and a national board-certified
reflexologist. She has advanced training and extensive experience in a wide array of manual
therapy and body work techniques, including craniosacral therapy, myofacial release, reflexology,
baby facial massage, and more. Michelle developed a unique curriculum of manual therapy, utilizing
therapeutic skin movement for pediatrics and nervous system regulation. The Tumming Time Method
was developed to address the rising number of babies affected by sleeping on their backs,
developing tension patterns, torticollis, and flat spots. Developed around 2005, it was the first
and still the only program developed directly addressing Tumming Time issues and has been
learned by close to a thousand professionals worldwide. She also developed BabyMayo, a novel
curriculum of oral, habilitation involving optimal strength, endurance, range of motion,
sensory processing, motor patterns, reflexes, oral, and pharyngeal phases of breastfeeding
and bottled feeding for newborns to pre-crawling babies. You can find out more about Michelle
at TummingTimeMethod.com. And now, let's jump into my interview with today's guest, Michelle
Emmanuel. All right, great. Thanks so much for joining me this afternoon, Michelle. You're welcome.
Thanks for having me. I'm very excited to be here. Yeah, I'm super excited. So let's just,
let's jump right in. We're going to come out of the gate talking about the Tumming Time Method.
So let's just start there. What is the, exactly, and why is it so important for infants?
Okay, the Tumming Time Method is a specific sequence way to do a whole body movement,
including tummy time for pre-crawling babies. Now, I developed this many years ago, and it was
specifically for babies I was working with who had all of the symptoms that our babies right now have,
such as persistent asymmetries, meaning looking one way more than another, who were having a
difficulty balancing their postural muscles and having stiffness and imbalance tension, and maybe
even were crying a lot and didn't really want to do it at all. And we all know Tumming Time is
important. So anyway, it's a specific way of doing Tumming Time and problem solving it, etc.
Now, what I do is, and how I learned to do it was really just working with babies and noticing
what was natural for them. So it is based on natural development, and it's very, what we call
co-regulated in the sense that we're working with the baby to stay. We're going to make it
intense a little bit because that's what we all need to develop, but we're not going to make it too
intense. It's not torture time. We make it so that it's actually doable and enjoyable. And I think,
you know, it's important for babies because we live in a culture that doesn't really support
Tumming Time that much and doesn't give us a lot of support around that. And we know it's so important
and our babies are sleeping on their backs. And that's fine for back to sleep, but we need to
really balance that out by doing enough during the day. And that's difficult to do for a variety
of reasons. And so having a way to do it helps us get her done and knowing that we're doing it well
and feeling good like, hey, I did that and that mattered. Right. You know, for a parent, I think
is really important. I remember back, you know, just being a young parent myself like, I'm willing
to do this. This matters. I can see changes. It's really important. And so many of the babies that
we see have problems with their posture, their tongue, or their mouth, or their breathing, or their
GI, or their airway. And so it's working all those muscles to balance it and really mature the nervous
system in a really good way that does that from a naturally development perspective.
How many times a day should we be doing that with our babies?
That's a good question. I mean, tell me how many times we talk about, we like to do it for,
we like to do it for very short, frequent times. So like three to five times a day or so. And
really what the American Academy of Pediatrics recommends is time. You know, so many times
that they say break it up and it's good. But I think the most important thing and what I've seen
over time, babies be successful is just not having a big expectation that they do it for a long time,
but just do it really frequently for short periods of time. And even like if a baby is at the maximal,
like not having a good time in tummy time, what we usually say is do it every day or change.
So we'll say every diaper change you lay them down, just roll them over for five, six seconds,
pick them back up, snuff them. And that's a good reminder is we do a lot of diaper changes.
That's a great way to get a ton of tummy time in with very little adding extra to our day too.
And babies get used to it when they know, hey, I don't have to be here forever. And these little
bitty bites throughout the day help so much. That makes sense, man. I wish I'd known that.
Yeah. We could say that about, I think. Right. Yeah.
I thought it was fun about these conversations because we can pass things along and grow our
network in that situation. Absolutely. Absolutely. So and I'll put the link to all the things we're
going to talk about in the show notes. But on your website, you talk a little bit about
compensatory and is it, I don't know if I'm supposed to be saying novel or no novel novel?
Novel. Okay. So what are they?
That's a great question. Compensatory movements are things that we do because we couldn't do it,
how we were going to do it. So for example, if you have restrictions of your tongue and the tongue
is supposed to do so many different things and say it's inhibited by a tie or some other type of
muscle dysfunction. And so we still need to eat and breathe and do all those things. So the other
muscles and other parts of the neck and the shoulders will compensate. So they'll help,
they'll jump in and they'll lend a hand and do more to compensate for that. So what we see is that
if we stay in our compensatory strategies and we don't ever do anything new, which is what novel
movements are, making new movements, then that's what persists over time as oral dysfunction.
And that's where we see kind of a lack of progress or plateauing type of thing. And novel
movements are new movements. So a lot of times for babies in the pre-crawling period where I really
work with babies is sometimes that's eliciting reflexes because reflexes require sensory input,
such as putting your finger into the palm of the baby grasps. This grasping is a reflex,
but there is a stimulus to that. So we will provide the right stimulus and input to make sure
these reflexes are working. But the other thing we're trying to elicit novel movements is for
volitional movements. And that means these are movements that are the baby does on their own,
autonomously, in generation with engagement in the environment. And yes, babies have volitional
movements. Okay. Okay. Like what? Well, it could be anything, swiping, reaching, orienting, grasping,
you know, and so they're exploring a texture or something on there in their personal vision.
Yeah. And they're not the most sophisticated movements that babies have, but they are there.
And that's what is increasing as they mature. So for example, when we're born, we have a small
repertoire of volitional movements, but by six months, we have a large repertoire. And reflexes,
at birth, we have a large repertoire. And by six months, we want to have very few working for us.
But integration process, using those, and they go into the foundational nature of our brain and
our neuromuscular development, but they're not as like stimulus response that, you know, we switch
over the two volitional systems. So it's really important when it comes to not just the tongue
and the lips and how we maintain our upper airway patency, but our posture and how we move in the
gravitational field and how that actually that experience feels to us and how that stimulates
for babies. We got to put ourselves in this thing, that curiosity, the burning desire to
explore the environment. Right. That's everything. Put it in your mouth, of course, right? Because
that's what they do. Yeah, exactly. Get into it. Put it all in your mouth. Make sense of it.
And that's what they're doing, right? And is this really at the core of why tummy time is so
important? Because I now I'll totally come clean. I did it because I was told to do it. I didn't
understand why I was doing it, but I did it. It's not just for this this oral. I mean, is it for
brain development? And what is that why we're doing tummy time? Well, and that's a good question,
because there's a little bit the difference between general tummy time and tummy time method. So
tummy time method is this really specific sequence. It's actually a whole sequence of movements and
transitional movements. Yeah. And a way of doing it that follows the baby all the way until they're
crawling and versus tummy time itself is just being in the position of prone. So what would still
good and but they're different. This is more intentional. Yeah. And it's like a specific way.
And, you know, it's not just prone, which is another word for tummy time. But you could it's
time to time still an important of prone is still an overall important position for baby all babies
to assume and to achieve. And so we have been focused and we because we knew with the back to
sleep that came out in 1992 ish. And at the same exact time tummy to play came out because they
were they had the foresight and the wisdom to say, Hey, if we're going to do back to sleep,
we need to counteract that with tummy to play. They just didn't foresee the difficulties that
babies were going to do. And I was a young occupational therapist. I graduated in 1996.
I started working in Peds right away. And I had a baby in 1998. So that was a big, you know,
eye opener for me and then another baby in 2001 and another baby in 2003. And so all along growing
and I was working in the NICU at this time and an infant developmental follow up clinic.
And all of these, you know, this was being saturated into me is development from every level
over time, long trajectories, high acuity, etc. So I knew that it was more about sensory processing,
which I'm getting way around to your question now. Yeah, I think a little long winded, but about
processing. And that and I'm occupational therapist. So as what is sensory processing mean,
I think a lot of us know a little bit about it because it's it's gotten out there into social
media and other outlets and a lot of really good blogs and a lot of good therapists putting things
out. But that's how we have all of our senses and how we perceive them. So it's not just eyesight
and smell and here, but it's balance and orientation and it's movement directionality and it's,
you know, our feeling of our insides and it's all these different things. So vestibular is our
kind of balance and orienting. And that is where things can really get a baby having difficulty
with tummy time. So that's why it's really good to work it out with someone because just trying to
get through the tummy time thing without really working through it or avoiding it. We're not
really avoiding the problems. We'll meet them a little bit later. Okay. And this is something
all babies should do. I say should, but it would benefit all babies or is it just a specific
group of babies that this would benefit? Yeah, it benefits all babies and mainly because what I
think is cool that it's also developed tummy time method to be sort of play therapy. So it
organizes the activity and that's how, you know, we kind of play and just relate. And I know I enjoy
sitting at the piano and just, you know, plunking along, but it's so much more enjoyable when I've
learned the notes and where to place my hands and how to move them on the keys and a little bit. I
don't have to be a professional, but I can sort of connect the music to my fingers and just know
a little bit more about it. And so that was where I was going with it, with developing this specific
technique. And I think as another thing about occupational therapists is we love to break
down activities. We call it activity analysis. And so we'll take something and look at it and do
an analysis. And sometimes it's about ergonomics and about how could we do this so that it's better
for your body. It's for, you know, even to the point where we can serve our energy or our joint
protection, et cetera. And or how could we do this so that you can build more strength or have more
challenge and adapt and modify that. So that's what's also built into it because every baby's
different. And even though it's kind of like a little cookie cutter-ish in the way that we do it,
it's individualized to each baby because of their response to it. And that's why I think every baby
can benefit from it. And I've trained a bunch of people. So, you know, we try to, and I try to
keep up with getting them listed on the website. But... And this is, and it's something that
if a parent comes in and they start working with you, obviously they're going to sit and do it
with their baby at home. But then they would have just check-ins with you periodically or how does
that process typically work? Yeah. My favorite way to do this is in groups. To do it like a group
of four, you know, meet weekly as a, with several babies and parents coming and doing this together,
which is that's the most exquisite. And I did that for so, so many years here. And I do,
even from time to time, but I did it like every Thursday at 9.45 for eight years. And it was on
a solid for me. And it was like breathing. And I was so rewarded from that learning about the
benefits of it. Because I thought, oh, this is going to be great for parents. And it really was.
They became friends. And you could see them supporting each other. And I didn't have to do
much supporting because they did it themselves. And I, you know, this is going to be good because
we're going to get, you know, parents doing the hands-on thing. Because I know therapists,
we train to be good with babies. We practice to be good with babies. We have a lot of experience
with it. But the reality is, is like parents need, you know, want to know how to do things with their
babies expertly and well. Right. You know, and that's just the height of really good parenting
and simple things. So I thought that was, but I did not, I underestimated, I did not count on how
the babies would love each other, would look for each other. Yes. And what they're doing.
During tummy time, because, you know, we're a class of what, always in a circle.
And they, I did not. And so that has always touched my heart, you know, over the years,
seeing that in different age groups, because, you know, we'll do sometimes an older baby group
and then a younger baby group. And I see it across the ages. And it's very exquisite. And all of those
things are really good. But then you can do it one on one. And what's really good about this,
you can also do what we call teletummies. And you can do it online and meet like we're doing,
you know, now, right? Because the deal is we work with our baby doll. Okay. And we'll show you with
our baby doll. So when we're teaching tummy time method, you know, we, we should have our baby
doll. And about what age do they start typically? Well, I mean, we do, we have a prenatal program
where you can practice with a doll baby before. And then the first two weeks after birth, most of
it's right here. Okay. All the tummy time is up on the chest. And we're doing it here. And then
after that, so about two weeks, we want to start thinking about the firm flat surface and beginning
to explore other gravitational field a little bit different. Yeah. And again, it's these little
short periods of time, they're super sweet, and always dialed into what the baby needs. And I,
if I ever, if I do, if I am ever able to reach parents in a way, and I love this is a great way
for me to reach parents. But if I get ever like get my point across, is that what our babies really
need is this movement prolific life. They need to struggle in the gravitational field, they need
to be able to move their head anti gravity, they need to be able to turn their head easily.
Side to side. Most of the time, because that turning side to side and also organizing around
the midline here, it's going to be dependent upon what's going on with the tongue and the airway.
Got it. Got it. Because most of the time when you like head turning preference to one side,
it's because of the airway patency. Well, and I guess that kind of leads into another question
that I had, you know, because we talk a lot about tongue ties and things like that on here and
airway and jaw development, but how specifically does the tummy time method help with tongue ties
or lip ties in those kind of restriction? Well, I appreciate all this opportunity to talk about
tongue ties method, but really it's because it's a whole it's specific to getting cranial nerves
moving the muscles of the cranial nerves with the face and the neck and the tongue and the head
and the shoulder girdle, but it's also whole body and it's eliminating compensatory strategies and
eliciting those novel movements, the new movements that take over that are more functional, that
generate suction that have efficient milk transfer that keep the tongue up and keep the airway nice
and huge. So the breath comes in and out and that the tongue feels like it can float to the roof of
the mouth and it doesn't have to be bunched and humpy and retracted in the back as a compensatory
strategy, right? And we need that to happen. Now, one of my other things I'd like to touch base
with parents is because there's a lot of talk about tension and eradicating tension and I just
want to understand tension a little bit more. Okay. And we need tension in the body.
Tension is movement, so we don't want to ever eradicate tension. What we're noticing is imbalanced
tension, tensional imbalances in the body and a lack of soft tissue integrity,
okay, but their compensatory nature, such as these persistent asymmetries in pulling to one
side that has body wide effects and it's felt as tension, but it's really the baby's nervous system
struggling for stability. It doesn't have it on the kind of both sides, right? And in the three
dimension. So it's pulling and it's overacting, over holding because these compensatory muscles,
again, they weren't really supposed to be doing all of the tongue's work.
So,
you're listening to Airway First, the podcast from the Children's Airway First Foundation.
You can find out more about CAF and our mission to fix before six on our website at
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Parents are also encouraged to join the Airway Huddle, our Facebook support group,
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You can access the Airway Huddle support group at facebook.com backslashgroups backslash airway
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As a reminder, this podcast and the opinions expressed here are not a medical diagnosis.
If you suspect your child might have an airway issue, contact your pediatric airway dentist
or pediatrician. Thanks again to today's guest, Michelle Emmanuel, for sharing her medical
expertise. And to each of you, for listening to today's episode.
So it's really complicated too, because just like
whole body movement is individualized, babies temperament and even their ability,
even how their GI feels, because some babies don't have a lot of GI issues, even if they're
maybe burping up a little bit, they're not really upset. Some babies are really feeling that and
having significant dysregulation. And that's what I call interoceptive disruption.
There's a fancy word for, I feel like my GI tract is disgruntled. There's
got it. Chaotic signals coming out of our belly. And sometimes that's because of bowel motility or
reflux or trapped gases or air from air swallowing or improper sexual breath coordination.
And are there movements and things that we can do with our babies when you're to help with all of
that? Yeah. And that's where you say like any tummy time, if you get the baby relaxed on the
belly, that will help with some of that, because it gives the optimal, but also that's where keeping
them upright against your body. But again, they're putting a little bit of pressure on the front of
their body, which would be sort of like tummy time on your chest. But I think that
movement in general is important, but babies will often have difficulty with, say, burping.
So even if they're swallowing even a normal amount of air, which would be minimal, hopefully,
but all babies burp just a teeny tiny bit. And it's really difficult to get it up. And for some
babies that causes significant reflux. And for other babies, they just twist their bodies and
can tour and kind of hold their breath a little bit. And so all these different ways are how the
baby then learns to respond. And it becomes a habit. So how we balance all of these intentional
problems is to really equip the baby with new movement. That's the novel movement. So that
they are then equipped with this other thing. And all of these other compensatory strategies can
sort of just fall away. Because it's more balanced. Because we can organize around the midline.
Because we can turn both ways. Because we can keep our airway open by elevating our tongue to the
roof of the mouth. And for babies, it's particularly, I mean, it's their, it's their neural developmental
challenge, just the appropriate thing. But you got to remember their developing head control. We
have developed head control. So we don't remember even what that's like, that they're working on
keeping their upper airway patency at the same time that their head is the heaviest part of their body.
And they don't have head control. Right. So that's why it's perceived as tension. But we want
tension in the body. We just want it to be balanced. We want it to be optimal.
Okay. And that a lot of times means we need to equip with a new movement. We need to get the
baby moving in new directions, equipping with strength, let the muscle tone really inhabit the
muscles. Also working with, you know, from the standpoint of airway and breathing, slowing down
usually the breathing rate. Okay. Slow down the baby's breathing. Exactly. And guess what the best
way really to do that? Singing having parents singing. Really? Right. Because everything in
like the polyvagal and all of the parasympathetic talk is about the lengthy exhale is what lowers
our heart rate. The lengthy exhale lowers our respiratory rate. And so when we're singing,
we're exhaling. And so we are calming down the sense of our physiology. It's as simple as our
physiology sometimes to lower our heart rate and respiratory rate. And the baby does as well.
Yeah. And then when the baby's breathing slows down, then you can feel that sense of tension.
A lot of times we'll be gone in many areas. Like, well, where did that go? Well, that's because
the what you perceive is tension is just the nervous system over recruiting. Got it. But it
almost has to over recruit if you're breathing fast. That's a fight or flight. Yeah. It's a safety
thing. Right. Right. All right. Well, let's let's shift gears just a little bit. And focus on
breastfeeding specifically. I just, you know, we've talked about it on some other podcasts,
but you know, just I would like to get your take on you why it's so important for infant
development and what are some of the options available for new moms, especially those that
are experiencing issues with breastfeeding? Well, the number one thing I want to say is
please work with an IBCLC or the highest train lactation expert in your area. Because it's
it really is the one on one support and problem solving and collaboration and really teamwork
and counseling. It's worth it. And honestly, our insurance companies should be able to reimburse
that. That's one of those things. So that's my number one thing to say. You know, there's other
tips and tricks that we could say, but that is the absolute most important thing. But breastfeeding
itself is it's beyond sleeping, okay, which is the baby's primary occupation and activity of daily
living. Eating and feeding and receiving human milk is the biggest thing they've got going. It's
their activity of daily living. It is their primary occupation behind sleeping again. So when you say
this is that primary occupation, again, the occupational therapist observes this and says
how efficiently is this working? How is this going on all the different levels?
And so it's reflective of reflexes, spontaneous movements, innate biological urges and powerful
forces that drive the baby to connect at the deepest level extra urine, but again becomes one
with the mother's body through nipple, nipple real or complex. And there's lots of really good
products out there to mimic this human nipple real or complex. There really are really some great,
great things. But nothing is like this human tissue thing to the point where it's very unique.
Every woman is a little different. And so it's really neat. So it's also when you look at, hey,
what do babies have reflexes for a lot of them around the mouth? And so that's licking, sucking,
herning the head and licking and sucking, suck searching, tongue darting, snap response,
gaping, all of these different elaborate perioral and even proprioceptive field instincts to feed.
These are urges that are coming from the nervous system and who this little baby is as a human.
It's very sophisticated. And so it is the exact perfect activity to notice where the
vulnerabilities, where are the strengths? Because every baby has both. And sometimes a baby is
nursing with someone who has experienced nursing, has a great supply and doesn't have any pain and
the baby's gaining weight. And other babies have trouble with lots of different things with supply,
with latch, maybe GI stuff, and they may even have the same level of restriction going back to tongue
ties, lip ties and buckle ties. It's variable. You can compare two babies with the exact classification,
which remember, classification is really just where they're attached. It's not a functional
hormones, but and there's a completely different symptomatology list. Now the pattern recognition
is there. This is kind of the same genre, head turning preference to one side, postural pulling
to one side, a distended abdomen, you know, these different things that we can see feet curving in
or the toes clenching. Okay. I thought about looking at their feet. Yeah, I got so excited about the
feet that I actually literally became a national board certified reflexologist, which was not a
waste of my time of any stretch of imagination and became an expert at it. And then I developed the
baby reflexology program. So I also train professionals to do reflexology, you know, with babies. It's
very simple and very gentle, but it's a great adjunct. And it's amazing how much is connected there.
Well, yeah. And we talk about the tongue to the toes connection. A lot of people have heard about
that. That's a physical, you'll think about musculoskeletal. But when we talk about reflexology,
and we talk about, you know, the feet and the toes, that'll make sense how like the tendons and that
and the fascial structures are connected, but how, you know, the whole body is represented
on the bottom of the feet and how that really can be seen or kind of read on the feet. And we can do
certain points and techniques to help a baby, especially with relaxing the nervous system
and also helping the GI systems really reliable for that. And some babies are quite sensitive on
their feet as well. So it's good to know because if we're sensitive on our hands, our feet, our
soles of our feet, a lot of times maybe our mouth can be sensitive too. So when we work with the hands
and the feet that will help optimize sensory processing in the mouth. It's interesting. Yeah.
And it's funny too, because I learned it with my oldest daughter when she was little. Now I was
taught where to rub on her feet to help her relax for nap time and things like that. And so I just
kind of started doing it after she ate when she was little so I could zip her off to sleep.
And it's so funny to me because even as they got older,
anytime I would sit and do that on their feet, you could literally, I would just watch them,
they just kind of turn into this little pool of just jelly. And it was one of those
kind of mom flashback things. You do it when they're little and then you forget about it.
And then you do it when they're older and you have that moment of, oh, I remember that.
But you forget the impact they couldn't have on it.
Right. Yeah. And it's sort of a whole body treatment because we're giving sensation
to the feet. It's picked up by large nerves and taken back up to the spinal cord,
up the spinal cord, into the processing centers of the brain, perceiving it, interpreting it,
doing something with it, and then coming down.
So we do have the largest nerves on the bottom of our feet as well.
It's a powerful way. That is powerful. That is amazing. Amazing. Well, and that's kind of the
funny thing because if you relax them when they go to sleep, sometimes it's like they might not
be sleeping enough. Right. You want to be able to get relaxed without falling asleep.
Yeah. That's true. That's very true. That's very true. One of the things, and I honestly
can't remember if I saw it in the video or if it was on the website or where it was, but the sleeping
tongue posture. So I would love it if we could talk a little bit about what this is and why is that
exercise beneficial. Yeah. So that's a baby myo exercise that I designed many years ago
to address the open mouth, low tongue position that we keep seeing in the face of breathing dysfunction,
tongue tyliptyte, buccal ties, and other symptoms. And what I really like to do is work when babies
are doing what they're supposed to be doing, which is when they're asleep, the tongue should be up
and the lips should be sealed. So it's really working towards that happening while they're asleep,
but it's also a strengthening activity and a, you know, the tongue pulling away from the floor of
the mouth activity and a jaw activity that does generalize over to awake states. So it's done
when the baby's asleep. Okay. And a lot of times held in arms, but it can be done in other positions.
And it's so it's designed to strengthen and really get the tongue away from the floor of the mouth
and to get it elevated up in the roof of the mouth while the jaw is maximally open as possible.
And when babies are asleep, that's the time when we're working with the autonomic nervous system.
It's not their muscle tone isn't really the big thing. They're not moving around. Right.
And so this is the primitive parts that we work with that coordinate sucking,
swallowing and breathing. So it's a really powerful way to make some big functional changes.
And then also it can be used for as an adjunct for wound care, prep and wound care after frenectomy.
Oh, okay. Wow. Awesome.
Yeah. So it got, you know, I, instead of like keeping all these things, you know, I was like,
let's spread this out and get this in parents' hands because it's simple to do. And I'm really reluctant
as both an occupational therapist and an international board certified lactation consultant to say that
I would say the same thing for every baby, but this is one exercise I would do for every single baby.
Oh, wow. Okay. Yeah. Because it can, it will benefit every single baby regardless of what's going on.
And so I could, you know, do a little example of it myself for the baby sleeping.
Now there's two different things you could come upon. So the baby's sleeping and let's say the lips are sealed.
And that's what we want to see, but we can't really just trust that. So what we're going to do gently is use this,
the pad of your finger and pull down on the skin of the chin and check to see where the tongue is.
We look in and we see that the tongue is up. So what we do is then pull down.
You can see I have quite an impressive friend on there myself. Hold down on the skin of the chin to get the tongue away from the floor of the mouth.
And you can see how much range that would take and how much extensibility of the friend on it takes and how we want the floor of the mouth to stay down.
And so it, it strengthens those exact neural patterns to do that.
Now let's say this is a second scenario. We come up on the baby and their mouth is open and we can see the tongue is down.
So what we do is use our finger behind the chin and it's really soft underbelly, press up and then pull down.
And sometimes it takes some repetition because those times sometimes are good to the floor of the mouth.
But I promise you I'm very good at it. And you know why? Because I'm persistent. I do it three times, four times.
And sometimes it's on that fourth time it finally goes up there and me and the parents celebrate in the session.
And then it's so exciting. Yeah.
Because it really truly works at the unconscious level.
Which supports all. Yeah, exactly. Exactly.
And how often would you do it? Would you just do it every time they sleep until you start to see it's just there? They're doing it on their own.
And this is really where it's individualized. You know, some babies are going to need it a bunch because of X, Y and Z.
Other babies are, you know, have more milder symptoms and maybe they only need it one time a day.
Just doing it one really good time a day because we're busy parents. It depends on a lot what's going on.
It depends on how your baby sleeps and what that is. It's a lot easier if you're someone who sleeps with baby in arms all day long.
Not everybody. It's not most people. Yeah.
It's exactly. And so it really depends on the baby's needs at this time.
But I don't think you could overdo it. I think not doing it is something more to worry about than how many times.
Yeah, I would just like parents, you know, to really try it.
And we call it the sleeping tongue posture.
Because it helps us to understand a lot. The baby is sleeping and that we're holding what the tongue should be doing all the time.
It's just like saying, Hey, our posture is upright. We hold our head upright. We stand upright. That's our posture.
Well, the posture for the tongue is we cling to the roof of the mouth.
Here's my little head will go inside. Here's the whole tongue starting at the front of the tongue in the back.
The whole thing needs to be really up. And this is the hard palate where the white bone is. And then this is the soft palate.
And you want this really strong elevation of the whole tongue, which helps to keep our airway open and our upper airway patent from the nose all the way to and through the larynx and lower.
And a lot of times when we see the baby's mouth is open and the tongue is down, it may take some practice to get this to change with the sleeping tongue posture, but it will if you just persist just a little bit.
And there are some videos on my YouTube which are under Michelle Emanuel.
Yeah, and we'll put links to them.
Good. And like lots and lots of people have taken my classes and learned how to do it and even learned from social media.
And it can't really is one of those things that you can't really do it wrong. You might not be doing it fully.
The way it could be helpful, but it's not. You can't mess it up.
Can't hurt a baby doing it anyway. And how it becomes part of the frenectomy wound care.
If there is a tongue tie that needs to be released is that you do this and it pulls the wound bed open as much as you can't replace your wound care.
It's a way to add to your wound care. It doesn't replace what your team is recommending, but it's something you can add pain free because all the other things you're not putting your fingers in there either.
No. And this is comfortable because we don't have pain when we're sleeping and because you're not pulling it open.
It's the tongue. It's the natural opening itself and the wound bed can separate and it can feel like gently pulled because I know when we're doing wound care, it's like we have to sort of pull against the baby.
I can be really challenging and also cause some sensory processing differences in the mouth.
Sure. Yeah.
So at the end of every episode, I always like to hand it back to the guests for the last word is y'all are the experts.
So what final thoughts would you like to leave with our parents?
Wow, I feel so honored to be asked that. Thank you so much.
Yeah.
Well, one, I'm a parent myself and it's my youngest is 20. My middle is 22 and my oldest is 25.
And I felt I felt supported in different ways that I think new moms may not have support.
So what I want to leave it with is to find a little corner of the world that you can get support that you can connect with people who are in the same lifestyle as you.
You're having babies. You're all nursing. You're all working on this. You're all working on that because there are local groups that you can find.
And you just need to ask around, ask doulas or lactation consultants and really get engaged in community because you start feeling normal for your dysfunctional stuff.
And you do it used to and when you realize that, hey, we worked through these problems together that raising children is, you know, it's, it's challenging.
And we, you know, especially if we're dealing with something like tongue ties, lip ties, buckle ties or airway compromise, breathing dysfunction or some sort of, you know, even just GI issues.
So I think that is the wisest thing I can say and what I've learned in 28 plus years of working with babies and also trust yourself.
Now, that doesn't mean we know everything as a parent, but you get the idea that feels right for my kid. This doesn't feel right and really trust that because that's coming from the in that inside sense of the gut feelings.
And we can trust, we can really trust that.
And so once you lean into that and realize that you really know what's best for your kid and you're going to lean on experts to give you advice.
You'll feel what's right for them.
And one last thing is thank you for wanting to optimize your child's health.
Because I think it can be really easy to just want to coast along and not pay attention. But, you know, if you're listening to this podcast, you're thinking about optimizing your child's health about what can I be doing intentionally, mindfully, respectfully, and
you know, really helping your child blossom in a holistic way from their physiology and who they are as a human being. So that's amazing.
Yeah, it's beautiful. Like I said, thank you.
Well, and thank you so much for everything that you've shared today. Truly appreciate it.
Thank you. Appreciate it. It's been really fun.
Yeah.
Thanks again to today's guests, Michelle Emanuel, for sharing her medical insight into each of you from listening to today's episode.
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