Ep 95: How the Birthing Process can Impact Infant Feeding

In this episode Dr. Shannon and Doula Rachael discuss the impact of birth trauma and stress on infant feeding (nursing and bottle feeding).  There’s lots to unpack in this episode:

• What baby’s body goes through during the birth process
• What is “birth trauma” 
• How normally physiological birth carries a certain amount of stress and strain
• Interventions that can cause more birth trauma
• Other events that can cause birth trauma
• How birth impacts the nervous system of baby
• What does birth stress and nervous system dysfunction in the baby look like (specifically for feeding issues)
• How chiropractic care can help and what a proper and thorough nervous system assessment for baby looks like 
• Other providers who can help

Inspiration for the episode:

Pathways to family wellness podcast: decoding the effects of birth trauma on feeding

Resources discussed in the episode:

Episode 69: Benefits of pediatric chiropractic care

Episode 65: How to have a gentle induction

Episode 63: Breastfeeding tip and resources

Episode 57: Pediatric Chiropractic Care and Cranial Adjustments - Interview with Dr. Martin Rosen

Episode 55: Tips for optimal fetal positioning

The 'Your Health. Your Story.' Podcast
The future of medicine and the healing stories behind them.

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Transcript

0:00

Line birth Podcast. I'm Dr. Shannon, one of the host doula Rachel is here as well. One of the other hosts and together with the team of the line group podcast where we talk about all things, birth, and we talk about all things post birth. And so today, we're going to be talking about birth, and how giving birth can impact the feeding aspects and nursing breastfeeding aspects of newborn as well. So we're basing this a little bit off of a podcast that we had both recently listened to, we'll go into that and a little bit as well. But we've talked about this on the show before and several different manners in several different ways as far as lactation, you know, support breastfeeding support how the cranial bones in the skull relate to infant nursing and feeding, but we want to kind of look into how the normal physiological aspects of birth can also impact nursing and feeding. And so that's what we're going to talk about today. So we've got lots of things like going through the birthing process and what baby goes through there. We are going to touch on the the aspect of birth trauma, but we're going to define trauma a little bit differently, and we're going to use some other words to to help make that a little bit more understandable. Some of the interventions that can lead to some of the traumatic birth events. And then yes, babies are resilient and are able to deal with that birthing process, but there might be some dysfunction, some nervous system dysregulation that occurs in a baby from the birthing process. And so we want to go through some of what that dysfunction can look like. So yeah, I'm excited to chat about this today with you doula Rachel.

1:53

I'm very much looking forward to this conversation, as I always am. And I think the thing that I'm most excited to talk about today is sort of understanding what is quote unquote, normal with the normal physiological birthing process and the impacts on the baby through the like actual event of passing through the birth canal or being born via Cesarean birth, versus like things that are interfered with in that normal process that cause additional trauma to the baby as they navigate birth. Whether that be a medical induction instrumental delivery, more of a hands on type of like pulling the baby out, or, or a subsidiary of birth, where they have to also work really hard to get the baby out like all of those like it was like outside of the normal physiological range that creates stress on the baby's nervous system, and how so many of those things like it's not like an outward facing it injury as you can't see it, but yeah, it might manifest in other ways. As in one of the things that we're gonna focus on today is feeling and how the birth process impacts that and so define kind of really understanding and looking at your birth and being like, did I experience some of these things? How is my baby acting? And have they had that thorough evaluation, assessing everything to make sure they're functioning optimally? I think that's what I'm most like, this is kind of got me lit up about

3:34

No, I, and even when you were talking to I was thinking of, you know, hearing, I can hear some people comments as far as like, Well, I had, you know, my a vaginal birth, everything was fine. It wasn't dramatic. There wasn't a lot going on. Why would I need to have you know, they'd be assessed or looked at or whatnot, but there really are mechanical forces during the labor and birth process that yes, are within normal limits and normal ranges of what mom and baby can deal with. But it's still a lot. It's still a lot that happens. And when we talked even in our tips for optimal fetal positioning, why did we talk about that because there is an optimal position for baby for it to, you know, come out the birth canal, and it's not a straight shot. It's not like a slip and slide. And that's where all of those degrees of movement all play a part in that cranial molding. And it doesn't take much for just one little thing to be off and it doesn't have to mean that it's so it's a big issue, but those little things can impact nursing in a way that we don't have right and left jaw alignment. You know, just very, very minor things that may not take much to fix but it definitely set you up for successful breastfeeding, but then also successful. I'm looking at brain development milestones like you know, not to freak people out but it is all connected. So yeah, that's, I like talking about this aspect of things, to see the bigger picture of it as well.

5:13

Yeah, and I think sharing with people who are about to have a baby or just had a baby or planning a pregnancy in the future, about this, like sort of the whole body care for a new baby. And so just like, you know, pediatricians are amazing. They look at certain things. They don't always look at the things that someone like a chiropractor would look at, and I think it's really important to consider adding that in and viewing that as well care, because I think a lot of people think, Oh, my baby's brand new. They don't have low back pain, like I have low back pain. Their neck doesn't hurt like my neck hurts, you know, but maybe it does. They're not able to communicate their

5:58

talent in a different way because that's telling

6:00

you in a different way. And any sort of like challenges with feeding that arise because there's a subluxation in their neck and make a birthing person feel like there's something wrong with them. They're not making enough milk or they're, you know, baby's not able to latch when it's just maybe maybe it's uncomfortable at the brass because of what's going on inside of their mouth jobs, gold neck body that isn't you know, setting them up to be able to efficiently and comfortably nurse and then that has the downline effects so kind of seeing that whole picture. And while most babies come out just fine and ready and able to latch you know, when there are challenges it's kind of sooner rather than later saying, can we have everything assessed here that that could be assessed? You know, to make sure baby is functioning as optimally as possible. And

6:55

I guess I wrote a little note while you're talking because sometimes too, we look and look so much of like, oh, well mom wasn't producing enough milk, you know, and I'm like, Well, maybe that's not the problem. She is producing enough milk but it's the transfer of milk. That's not optimal. And it may not be you know, mom's nipple shaver. This is the slacker boob or, you know, there's all of the things but I think when you look at all of it, so sometimes too, we have this like wait and see or that's not a problem yet. In I guess sometimes in the medical world, not everybody. I hear that a lot though, in the office when some moms come in proactively, or their referral from a lactation consultant. When they say okay, these these issues I'm seeing now let's go ahead and get this taken care of rather than well, let's just wait and see you know, they'll grow out of it or the nursing will just get better. You just got to keep trying, you know, like, yes, but there could be some other things to look at that are super non invasive, you know, very gentle. It can be very, very effective. In helping that in that nursing experience. So yeah,

8:08

and I think part of this conversation and our goal was to help people learn more about the interventions, or or things or events during labor that might occur that increase the risk of trauma to the baby's nervous system, meaning their skull, their spine, you know, all of that. And again, babies are designed to withstand a certain amount of pressure on their body through birth, because there is already a certain amount of pressure that comes from birth that is within the range of normal. But some things that might happen that change that would start with something like Pitocin where it's a medical induction, and the Pitocin creates these extra strong extra long contractions that are not what your body would produce on its own. It's saying we need the contractions to be stronger and longer in order to move baby down and out in an effective manner for one reason or another. Now that's we have a whole conversation about induction whether it's necessary or not, but so definitely we'll link that in our notes because that's an important conversation too. But let's say you do have Pitocin understanding that it does put more pressure, longer pressure on the baby and if it goes up too fast, or too high of a dose, you know, we're is this outward function or thing that is interfering with the normal physiological process that can either move baby down too fast into a position to where they're there weren't ready, so maybe they become a sim clinic or who knows there's a number of positions.

10:02

And all I can think of when you're saying is, is that so many times you hear when you've got this cascade of medical interventions, oh, I spiked a fever, baby's heart rate drop, my heart rate got you know, all of those things that is the nervous system, like telling you, I'm freaking stressed out, you know? So that's what you were. I mean, that's exactly what you were just saying as far as really looking at that nervous system function and the body trying to balance working within that outside

10:31

forces. So now you now it's no longer the normal physiological birth process. So if you have just Pitocin alone, you know, then then you need to say okay, my baby experience birth in a way that's outside of normal so maybe I need to look at this in a more holistic way. And like we said, I think at the beginning as even what we consider the straightforward, low intervention, non medicalized birth, like there's still a degree of force and stress and trauma on the baby, but that's usually within like, a manageable amount of stress for the baby and that they typically do just fine. But again, what we'll talk about later is if your baby did go through something in the birth canal or something that you can't see like how are they acting? What's the dysfunction that's being seen? So that you can say, okay, maybe there is a problem here. So there's Pitocin. And then there is like prolonged Well, that was in my next section. So there's, there's Pitocin and then other things that might interfere and cause more pressure would be something like forceps. So instrumental delivery, so forceps are used, they kind of like big salad tongs, and they go up into the birth canal and wrap around the baby's head and help all the baby underneath the pubic bone

11:56

salad. It really they really well that's what they look like. Yeah,

12:00

yeah. And so this is when you had a long pushing stage. Or there are some distress with the baby. The baby's really like pretty low in the birth canal so that they can get help. Use the forceps to pull the baby under the pubic bone once you're in the pubic bone. Typically people can push the baby out with a little bit more ease. So if forceps are used, again, that's putting a degree of pressure on the baby's skull, and then pulling them through versus letting the like normal normal push and pull process happen. So understanding what what additional pressure pressure is put on the baby using forceps, and then there's the vacuum. So that's where they do like a suction cup. Same thing. They're trying to help bring the baby's head under the pubic bone and so they can use a vacuum and that puts a lot of pressure on the baby's head. And there's a certain number of times that they're like if they put the vacuum on, and then when you start pushing, they're polling, kind of like a plunger and the goal is to get the baby's head on the pubic bone they finish pushing your baby out and if it pops off right, that's theirs. That's a kind of like, we can only do that like two times three times. And then they say, We can't do this anymore because there's risk of, you know, too much pressure, too much pressure on the baby's head and it can cause these like, big bruises and hematomas Yeah, the top of their head. So there's a lot of pressure there. Again, sometimes they're necessary sometimes like, you know, for a number of reasons, or you might be in a position where a vacuum might be necessary. So it's not this is not necessarily talking about right or wrong. It's understanding that these are tools are used. It's really important that you understand the pressure that's going on the baby's body. It's above and beyond what's considered normal. And then there's the Syrian birth and Cesarean birth sometimes can cause additional trauma to the baby's nervous system when if the baby was really wedged down in the pelvis, and the, you know, you've been in labor and the baby has descended into the pelvis, then you end up needing necessary and they have to really pull the baby out of the pelvis. And that can actually is a lot of pressure pulling the baby out, wiggling the baby out. You know, a lot of people just think, oh, they just come right on out. More times than not, I mean, the baby's still being born and being manipulated out of the mother's body. So, again, talking with your provider about what did they have to do to get the baby out? So that you can have that picture painted? Some are easier than others. And then the events that aren't necessarily like medical, but that can occur for your baby that can cause birth trauma is like a prolonged pushing stage. So you know, if you've been it's think it's considered normal, healthy, low, respecting person to push for, there's really no time limit. It can be three hours or longer, so long as everyone is handling it fine. But, you know, that certainly is if you've been pushing that long. Again, a lot of pressure on the baby's nervous system, even if it's not been induced by Pitocin. And they're still like, that's something to be considered and what position were they in when they came out? Are they were they acing clinic was their head slightly tilted while they were in there? Were they posterior because we have posterior your your more like flex like this versus touch like this. So you know how your baby navigates the pelvis and or sits in the pelvis a lot of times a synthetic baby's when, when they're just slightly tilted this way. It's really really really hard for them. So if they do come out there for neck within this position, and then if if it's determined they're not going to finish coming on any of this area, they were still in that position for a long time in the water pressure being applied. So yeah,

16:06

I was so good. I'm just like, yeah, now obviously, you saw me I'm just like naughty naughty naughty because I did all I can't think of two and that is thinking of my two births that I had that were so very different, but I want to hit home, how there was still stress and both both of them because I would say I did end up with an unscheduled emergency cesarean birth with my first that I would deem that it was traumatic, just is traumatic in all aspects. It was lots to handle there but he was engaged and I was pushing we did use the vacuum I had the internal fetal monitoring it was you know, everybody's stressed out and then it became okay, can't do the vacuum anymore. We're gonna have to do a C section. So he was already engaged, and then pulling him out. So and I will say, he's 13. Now, I will say, and I don't know maybe one exam to all episode is just looking at. I think that stress is unresolved and undealt with from birth can definitely can definitely stick around. I'm just gonna, the Body Keeps the Score. I'm just gonna say that but that birth process compared to my second which I was able to have my V back. He both of them were sunny side up. So occiput posterior, but they were able to help my second like, twist and do that. Gets like super long term to come out. But he was born vaginally and I just remember that difference. So they were they were both stressful, right? Like, but looking at the word sometimes the word trauma can be traumatizing, as far as you know. Really, a whole lot of different feelings from here's a lot of different feelings. Yeah. So like, yeah, I would say my first birth was traumatic, but my second birth, I mean, it was still birth. There was still a lot going on, you know, there was still he didn't need a little bit of assistance there. He may not have been in the optimal position that presents you know, a different set of things to look for. But I do really want to hit home that aspect of when you say trauma, it doesn't necessarily have to, is that trauma to the nervous system. It's not necessarily maybe the thoughts feelings and emotions with it when you're looking at like the newborn as well. And that is why in my I say I do a detailed health history for my newborns. Yeah, they don't have a lot, right like we've got, you know, 40 years of, of health history to go through, they don't have as much. However, I ask all these questions, I want to know where they head down, you know, what was the optimal position? How were they born? Because all of that clues me into what am I looking for and the neck and the skull and the cranium and the spine because structure determines function and if we have this structure that is misaligned, then our function our nervous system function can be impacted as well. So everything you said there

19:19

was yeah, thank you for also sharing about your experiences because I do think that's super important to talk about and it looks different for everybody and being aware of of your work experience from start to finish and like you know, if you need to be induced, like what's going on there, if what happened throughout the course your labor asking for them to if you're getting vaginal checks during your birth, like, can you help me learn? Tell me more about what position the baby's in, they should be able to tell you that so that you can know what your baby's going through during the process of birth. And then when they come out, you can either watch or ask about which way their head was facing or they posterior or they anterior. The other thing I wanted to bring up about the delivery of another thing that can come up that can cause more stress and trauma on the baby's nervous system is how the baby is delivered. So there's a one stage or a two stage delivery. And if you are so at one end of the spectrum is like your birthing at home with one arm a hands off midwife, and maybe you deliver your own baby like you weigh like say maybe the head comes out and you wait for that next contraction, then you reach down and pull your baby up. Like that's all normal. This is more if a provider the health care provider is delivering the baby. How hands on are they and this is something really important to talk about prenatally is asking them how they support the birth. So one stage is where like once the head out, I help health care provider might force that last shoulder to turn like they grab the head like this. And they turn it in and they pull the baby out. All like all one movement versus letting the head be born, assessing everything and then waiting. So in that time of weight the baby's shoulders turn and this is for like a normal like not a posterior baby, right sometimes because your babies do need help making that turn. But so letting the head come out and if you didn't touch the baby, their head, they turn they turn their shoulders navigate and then you're just supporting like the perineum or supporting the head as the as the baby is born versus forcefully and unnecessarily turning and tugging on the baby's head that creates trauma so you can talk to your healthcare provider beforehand about that. And they may have some like hesitancy like my Doula partner was at a birth one time and was asking the provider about it and they seemed completely confused about what she was asking about which was concerning. That they didn't understand. They basically did it all. On one stage like as soon as they come down and know their errands or their options. Their hands are on the head. They're manipulating the baby and forcing the baby out like they are they're delivering the baby versus like letting it do for ya. And then in that process, they're missing out on like the big squeeze that helped get all the fluids out like it's rushing the process. It can increase tearing, all these things. So

22:32

that's good. I'm glad you mentioned that. I'm glad you mentioned that. Yeah,

22:37

yeah, it's just another way that stress can come. I mean, they've even like they've even we've witnessed like, hands on the baby's head. Like, up, down, up, down poll. Could you not tell me that something's undue stress on the baby. Now with that, I'm sure there are lots of scenarios and providers that can explain when that's necessary, but, you know, rushing that process doesn't feel necessary and if it is, so be it then you need to know and be able to like say my baby went through a lot. So under the birth canal and coming out like we need to look at their nervous system closely.

23:15

Now and you know, we have on here, yes, babies are resilient. But again, to there's you know, there's limitations to matter. There's understanding kind of within those normal limits, but even within the normal limits, and I tried to get home this that there is that degree of stress and strain and so and that's where it comes into if I'm seeing in Benton it's like care plans. I love when people like I'll have to venue to be seen if I'm doing console on the phone. I'm like, wow, I don't know. Like I need to have no idea because there's just a lot of things at play there when you're really looking at that birthing process. And so

24:10

until yeah

24:12

and it is I do feel that it is very different than a pediatrician well checks and visits so I do ask you know, like I do want to know are they gaining weight I has the you know, did they lose a little bit at after birth and then start gaining again like I you know, I am assessing those. I like to see who they've seen and what kind of issues have come up and was there jaundice? You know, all of those things was their time in NICU? I mean, all of that. Yes, but then my exam or when you're looking at it from a nervous system function. It's very different than the than a pediatrician visit as well. So there I hear more often of that goes into that common versus normal aspects of things when you hear Oh, my baby hasn't pooped in nine days pediatrician says. You don't tend to think so.

25:15

Is it common?

25:18

That's neither. That was common, but it shouldn't be common either. I don't know. Oh, my gosh. Um, so there's it's looking at it through a different lens. And so I've definitely never want to be like, Oh, you shouldn't go see this provider. You shouldn't do that. I'm more of like, how many people can we get on this team to help in this manner of things as well too. So

25:46

it sounds like when we're talking specifically about birth, the stress and trauma from birth on the baby's nervous system. In regards to feeding. I definitely want to say that you should live in a lactation specialist. ibclc like having them on your team, assessing or all the ties looking at everything working with them on latch and effective milk removal all the things if you're if you are breast or chest feeding, but I think that's a it's a it's a coke care situation, because they can help with certain things. So definitely moving in my patients specialist or IV CLC is going to be very, very important. Regardless of if you have issues

26:31

thank You that are just had someone to and I was like I still want you to go see like they should. Yeah side of the hospital. I'm talking outside of that room for sure. 24 hours after birth. We have no idea what the hell's going on. They said the latch was fine we don't know like Have we really assessed any of your milk even come in like right

26:48

go there's no way to do that. Like I

26:51

love that. Yes, that's great. Yes, but we do need we do need a little bit more and I

26:58

recommend AHA Yes. And I would

27:00

recommend insurance coverage. Companies are covering up to six visits. Let's use that if you're a pediatrician there I work for I just I have a wonderful referral network with lactation consultants and it is one of the most things I am grateful for with their activities and knowledge as well too.

27:20

Yeah, because it is I mean, that is a while again, just like you know some things about feeding as a doula I know some things about feeding, but having that train specialist again, pediatricians have a lot of training. They don't give up on one of their focuses is not on the biology and anatomy and physiology of breastfeeding. So it still seems like

0:02

specialist lactation counselors, our recommendations for all of our clients is to align with one do a pre natal visit. So before you give birth, have one visit, get, you know onboard with them so that afterwards you can check in with them have a follow up regardless of if you have issues. You already have done the research and figured out who you you know what your insurance will cover, where they're located, do they do virtual visits do they do in home visits, which definitely I recommend. And in conjunction, so that is something we recommend. We obviously recommend chiropractic care, but those things go together but I would like if you could share with us a little bit about on the chiropractic side of things, but the mechanical muscular things that are going on inside or could be going on inside the baby's neck, skull jobs spine that could affect breastfeeding.

1:01

Yes. So there's there's a wide variety of issues that come in and can arise and I'm trying to gather my thoughts and think how to go about this. And so I'm just going to start thinking of babies in the office. So when there's the aspect of someone coming in, and we're having problems latching you know, for whatever reason, so that's what my thought when we go through the questions, and I'm always asking one of my first ones and a lot of times when they come in and they're in the infant carrier, the exam has already started to parents just don't know it, because I am looking at like, how are they in that infant carrier? So that you know head tilt head rotation? Or the fists really clenched? Like are they screaming crying already? Are they sleeping like Ah, how are they stepping, like, all of these little things that you can look at and look at face shape, all of those, because all of that can impact nursing. There is you know the nursing function is controlled by the nervous system. So brain, spinal cord and a lot of that is going to be top parts of the neck too. I always say I'm really focusing on the top part of the neck. And as we grow older, that is where all of our flexion rotation, you know flexion and extension, rotation comes from all of that motion, the spine, the rest of the cervical spine is supposed to be more for support there. So that's where all of our motion is. So then to it's like, well, they nurse really well on the left breast, but on the right they don't. So they're having to turn their head to the left to get to the right breast. It's a lot less than writes as often. So, that gives some clues into insight into how is the bony structure because the structure is determining the function as well. So that is one part of looking at okay, top bones neck flexion extension, rotation and you even talked about our you know, as attention tucked are we looking at here? Like I'll even look that too if I lay the baby down. Are they like this? Can I not see their neck at all? I had one baby come in and she was like, I can see its neck now like after a few adjustments, because it's amazing, right? Um, and also to are we here, you know, are we super super arched and just like, really, really tense that's what I want to get to at the end because I think that sometimes to what we don't really, we can see the mechanical ones like I can see okay, my baby's right ears towards the right shoulder and they're looking to the left, that's clinical diagnosis. torticollis you know, flat head, you know, they've got a flat part on the right part of the head when you kind of look down on top of the baby. So those kinds of things you can see and you can say okay, they're not nursing well on one side versus the other. So there's there's there's aspects that you can see, and then there's other ones too, where it's like, they just cry all the time. They're fussy. Their nervous system is really stressed out is what I usually try to say and they're trying to communicate and the best way that they know how so sometimes. That's where you get the catch all diagnosis of colic and so, yes, they're looking into more of GI issues. Well guess what is part of the GI tract? It's nursing and feeding, that's where it starts. So it can be all connected. It's embryologically connected as far as development goes of the fetus as well. So when you Okay, so that's really looking at again, top on the neck, skull occiput those type of things there but then there comes into the aspect of the jaw and the masseter muscles, the muscles of the mouth and everything there underneath here, the hypoglossal muscles like there's so much at play with the newborn needing to create that suction in the mouth and really getting that tongue to the roof of the mouth and having that tongue function because I'll even look to if they can't stick their tongue out very far. In my mind. I'm like, well, we might need to we might need to see if there's some ties because we should be able to stick the tongue and it's the cutest thing everyone maybe does have ties and then they just start just sticking their tongue out all the time. That was wow, what is this new thing that I like? It's so interesting. It's like okay, we have better function there. So not only is it looking through the cervical spine, yes and no gosh, we need to get to the to the cranium. I'll get to that with flathead. So looking to bones of the spine, but then it's also all the muscles that are part of the nursing process and trying to create that suction for breastfeeding. Mostly breastfeeding, although I will still hear that oh yeah, they may make a clicking noise when they're, you know, feeding from a bottle. So that still clues me in that. We still don't have optimal function and it'll be differences on right versus left. Like lots of different things there. When looking at okay, so feistiness colic kind of went over that. I want to touch on the GI issues in a minute because again, that's the other end of the digestive tract. So the another aspect of and we talked about this trauma to the nervous system stress to the nervous system is yes that collagen fussiness, but then I'm looking at that extreme arching and the fist really, really clenched even the toes can be really curled and flinched. And that kind of clues me into we are really, really stressed out and we can't calm down. For whatever reason, you know, birthing process aspect of things or maybe in utero they were just really not in a great position the whole entire time and then had a stressful birth. When you look at two if we've got talked about torticollis where they're not really wanting to turn to one side, but that's the ear to one side and turning the nose towards the other. You can have they can not nurse well. On the right breast but not have torticollis per se, right like there's differences in nuances in the actual diagnosis. So you can just have issues rotation of the neck or you can have full blown torticollis we don't have to get into all that. But then also flathead so plagiocephaly so a lot of times you'll see babies with helmets for this to help work on head shape, although that doesn't really assess the neurological aspect of it. So that again, is another topic for another time, but that is something else that I see. Because then impacts nursing and that impacts feeding because typically with that we've got a major rotation to one side because if we've got flat part on the back of the right skull, then they're really checking out that right hand side of the world and so nursing on the window them on the right breast and the look to the left, it's going to be it's gonna be next to impossible and it's gonna be really, really difficult. And that looks at and we had an interview with Dr. Martin Rosen, who is an amazing pediatric chiropractor and does trainings for cranial work with infants and cranial apathy. And that whole interview would go into that because that's also showing that there's tension within the nervous system, but then that head shape is also impacting the nervous system, that structure is determining the function. And so a lot of times I see those babies, they're super fussy as well because their nervous system is really ticked off because they've got this distorted shape of the skull, and they're doing what they can to fix it. You know, they're screaming and crying and clenching and trying, you know the best that they can, but cranial work as well is important. So I know we talked about cervical spine, we talked about Jaws, the neck and the muscles of the jaw, and the tongue, but then there's also the aspect of looking at the cranial bones as well. So that's what I was trying to, I don't know cover all of those things.

9:10

There. I know there's so much there and I love pediatricians but they're not looking at all of those things. And it's not to overwhelm it's just to say that, wow, there's a lot going on and, and bodies are resilient. They figure out a way to usually to function even among stress. That doesn't mean it's optimal. And so just having your newborn assessed, a lot of people are like oh, I want to make other older like they have this vision of like having their baby assessed or adjusted as this aggressive thing and it is quite the opposite. It's very gentle and doing it sooner rather than later. And again, in conjunction with a lactation specialist and a pediatrician like all of these things can be assessed and I think why it's important to talk about the jaw and the mouth and the muscles and the bones of the spine all of that needing to be assessed for for optimal function as because those are all the things that are necessary for breastfeeding or chest feeding. You know there, the muscles and the oral motor skills that are used for breastfeeding are a lot more intensive than bottle feeding for most. And so understanding that there's multiple things at play here so they latch they suck they swallow and then they have to breathe at the same time. So all of that has to be operating optimally in order for the baby to effectively move that removes the milk from the breast and then you add in like the tongue being able to reach the top of the mouth and come out very far like full range of the tongue is all part of breastfeeding. And so if if those things are disrupted or not functioning properly, like the muscles and the bones, then they might have a hard time properly latching and removing the milk and if you're not able to properly if the baby's not able to properly latch and remove the milk, then that impacts your supply and it also increases the pain that you might experience during feeding, which has a downline effect. And so instead of looking and saying okay, what supplements do I need to take to boost my milk supply? I would rather say because you know, true low milk supply is really rare. It's really low less than 5% but that tends to be where people go or, or you know, upset like either spinning up a lot seemingly gassy, constipated or lots of images of gastrointestinal upset. They tend to think it's their milk. It's their milk, that's the problem, or what they're eating is the problem. Again, very rare. Your breast milk comes from your blood, not your stomach. And so this these are the things people can control, right? They it's like the identifiable things they can control so they try and that's what they're like, Well, let me remove certain foods from my diet or let me give them formula because my breast milk is upsetting their tummy or let me supplement because I'm not making enough milk because they're not latching good or the latch is so painful, I can't do it. And all of these are very real experiences, but all of those can also be impacted by the function of the nervous system. And so when you are willing to get that full assessment of the nervous system that can help eliminate and say okay, maybe that whatever probably thought it was maybe it was not, or it says okay, we've had this addressed and now we're still having issues so we can now look at these other things that are like in the lower percentage chance, whereas nervous system dysfunction is probably that there's always probably something going on there or muscular or skeletal like based on what we know the baby does go on the birth canal. So, you know, babies cry. It's normal. I want to try and normalize baby's crying because that tends to be obviously things that take people by surprise when they realize how much a baby cries, but a baby just unable to be soothed, you know, or really like excessive crying will be diagnosed as colic and that colic is not like a disease or a problem. It's just saying we don't really know what's going on here. So this is Colin and it usually pigs three to six weeks and then it should get better. Now that might be your experience regardless of having a lactation specialist and a chiropractor, but I just encourage saying okay, you don't have to. You don't have to say like, submit to that you can just say well, what else can I do here like cranial sacral therapy, chiropractic therapy, OT, lactation specialist and again, this is not accessible or easy for everyone. I get that it's a lot. It can be overwhelming, but these are options. So figuring out what you can do and knowing kind of signs to look for like baby Dustin signs. They can't say My neck hurts, but they can't like you were saying how they're turning side to side and we may not know it as parents but the professionals know what to look for, and, and can help. And so I think this is really important for me as a doula and what we share with our clients prenatally and postpartum. Especially because there's so much stress around feeding and it feels like there could be like a lot of problems and I felt like even in this conversation, it might feel like there can be a lot of problems, but working with the right professionals and doing it early kind of interfering. intervening early can really help reduce the overall stress around feeding and around. Care for your baby. And I don't know how to convey that enough. You don't know until you've like tried it. But you work with a lot of patients and we benefit we work with a lot of people. You know we encourage these things for and see the benefit you know, just understanding that it's all connected like birth process. Sometimes people are just like, babies here, we're all good and they don't necessarily look and that is of course we want everybody to be good. That's the minimum. But it's like but then like you and I know we kind of want to dig in and say

15:16

but is it optimal? Yeah.

15:19

There's no right or wrong. Size. It's not to say Oh, you did wrong here.

15:26

I have to they're like, What did i What did I do something wrong? I was like, oh, no, no, not at all. Not at all. And I'm going to

15:35

find even an induction that's not so yeah, prized. It's just understanding it's part of the process.

15:41

And that's what Dr. Martin Rose and I talked about to like it's the there's no shame there's no

15:46

shame because we can take the shame out of it. We can all just move forward right and I felt shame I have felt all kinds of things. As a parent, it doesn't go away. Like you feel like every decision you make you're responsible for the outcome. So this is, in my opinion, trying to set yourself up for success, and just being in tune with the function of the body internally and the sooner I think parents can be on board with that the easier it is for versus looking to these outside. Like medicines that say they're going to help with colic or bottles that say they're going to be anti colic or breast like but it's all marketing right? Like I would rather you have support from professionals like this and then those professionals can point you in the direction of maybe a product that might help ease you and I'm just going to add here what we're talking about products. If you have a baby who is breastfeeding and they're struggling at the brass or chest, but they take a bottle easier. I want to talk about how when I said it earlier, there are four the four functions of the breastfeeding. There's a lot that a baby has to do. It's a lot more work at the breast, but that work is important that actually improves the oral motor function of the whole mouth job base and all that but you know, they have to watch they have to suck, swallow and breathe all the same time. A bottle if you give it to them while they're laying like more reclined and the bottle is upright as soon as they form a suction on that nipple. The milk is forced out like a duck they don't have to do anything. So maybe they're struggling with some some muscular skeletal dysfunction. They are probably going to take a bottle easier. So that might if you if you're struggling and you need to supplement to kind of bridge the gap and you realize how well they take the bother that might make you even more like oh, it's just it's my breasts. It's my nipple. It's my milk. It's me versus understanding that it's just that's easier and more comfortable for the baby. That doesn't mean that doesn't have to be thing you choose. But understanding that there's a lot more in play for breastfeeding and it's not always and then when you give up on the bottle, you really really want to do what's called paste or responsive feeding where you're mimicking breastfeeding if you do want to protect the breastfeeding relationship, because bottle feeding with them, like reclined in your arm and bottle facing vertically. That's it's a water hose. So that is going to be easier for them. So that's all that that to me is a sign that they are actually experiencing probably some kind of neurological musculoskeletal dysfunction that can be assessed and addressed could improve the actual feeding of the breast.

18:36

Yes. That's so good. I'm glad you mentioned that all the parts of the nursing process because you know, again to and asking that it's like well, do they latch well or is there that clicking sound like there's so many parts and that's why I absolutely love to have like a team. You know, I love everybody on the team. And so it's not to say that one person isn't as important as the next in that newborn care, you know? Including the lactation consultants and concluded

19:13

a pediatrician isn't looking at the mechanical function of breastfeeding. They don't have time there hope

19:20

that they would begin to say, here's what you need to do. And here's the resources because from what I hear the most is what the pediatrician said that there's nothing else they can do to help this is in several situations, but yet they have not really exhausted all of their options. We'll just leave it at that. So yeah.

19:40

Yeah, to say there's nothing I can do then then that's when you know you need to look for support from another professional right and other like my my patients specialist, or an ibclc because they're not if there are feeding trough feeding issues. I mean, they might be able to spot the obvious tongue ties or lip ties. But that's gonna be it and they're gonna ask how feedings going and you're gonna say fine because you're stressed and tired and exhausted and don't want to be at that appointment longer than necessary.

20:10

And maybe baby is, you know, transferring milk and they're growing just fine. You know, kind of like, well,

20:17

right, the gaining weight becomes the only measurement of the only measure. Yeah, the opposite is good. Gaining weight wet diapers, poopy diapers. Female, not, I mean, if, if they are transferring milk and they are gaining weight, they're not excessively fussy. They are pooping every day, but not overnight. Not like crazy. You know they're they don't have the gas tight. Tight, gassy belly or peeing and pooping normally, you know, all the I would say gut project you're probably in good shape, right? Like I think of me from both sides. Like there are definitely

20:53

things we went through with those assumptions and the other ones I didn't touch on just yet was the constipation or even just get GI issues that's even reflux aspect of things because that's sometimes can be a little bit lower down the digestive tract. But um, I see this a lot with my infants who have nursing issues a lot of times the bowel and bladder function would not be optimal either. So they're not having a bowel movement every day or it's little bits in here throughout the day. It's not like the good not solid poop because they don't necessarily have solid, important, you know, but it's not you can tell that they're not emptying the bowels, you know, completely. And so there's different levels to that as well to which yes, I'm looking at and we've talked about all the top bones in the neck, we've talked about the cranial bones and we've talked about the jaw, the muscles of the tongue, but then there's also the aspect of looking at the sacrum because the cranial bones in the sacrum are actually attached through the meninges that cover the spinal cord. And so, again, structure determines function if I do have that super fussy baby and they've got that colic, sometimes yes, we're assessing the top bones in the neck and the cranium, but I'm also looking at the sacrum and pelvis alignment because doing adjustments in that sacral area can also significantly impact nursing and feeding. So this is what I say all the time. Everything's connected in the body. It really is, when you look at those those structures that are connected, especially as it pertains to the nervous system. So I did want to at least mention that aspect. I mean, it's not

22:51

it's there. Yeah, gas, like a tight belly and you can just tell when it's when a baby's upset from gas. So trapped gas, tight belly and constipation, and we hear it very regularly as to something that they're facing and so again, we're always like, we give some tips for them to things to do at home, but then comes to your chiropractor. Yeah, I guess. Yeah. I did want to make sure that we reference a very important

23:20

I was just about to like say, Hey, did we talk about that yet?

23:23

Yeah. So the podcast we listened to was that Dr. Shaman and I had been wanting, we've been kind of swimming around this topic. We weren't sure what it was gonna look like but then we both simultaneously listened to the same pathways to family wellness podcast that had Dr. Andrew duro on it. He is a chiropractor among amongst other things, but he published a research article, and then he spoke about it on the most recent pathways pod podcast, and it's like how birth trauma impacts breastfeeding. But his the journal article he wrote that I say if you want to geek out and go deep on this topic, you should go read, but it's called differentiating the impact of biomechanical forces of labor and delivery, versus the effect of a posterior tongue tie on neonatal and infant feeding dysfunction and it was a clinical evaluation. It's not as long as some so it's an it's got a great abstract and conclusion. And but I say so if you want to geek out, read the article, we'll link it in the notes if you want the like, easier to digest version and you'll want to listen to him on the most recent pathways podcast and we'll link that as well. Because when I say most recent,

24:51

we don't know we don't know when this episode is gonna it was so old and I really yeah I really enjoyed it and it's it he gets out a little bit more to on it as well really going into those mechanical forces during labor and birth. So I mean, it's it's really good but it's also puts you know, hearing this in a in a different light from a different person from a different perspective maybe some different words you know, that are used?

25:15

Well, yeah, I keep that really good. Talked about this topic and learned about and listened to it. And I feel like I'm always like, Lea, yeah, but I felt like that podcast made a lot of sense and resonated with me. And I felt like it was a cool one for us to come together from our different perspectives. To talk about and it's an important one that we hope leaves the listener you guys feeling more informed and more empowered to take charge of your health and your new baby's health so that you can, you know, thrive through motherhood? We hope you enjoy today's episode. Thank you for listening. If you like what you've heard here today, or in any previous episode, please be sure to leave us a review. Those reviews help boost our presence in the podcast world which means other more people can listen to us and we want to keep doing this for free and keep bringing this to you. So your reviews definitely help us do that. And then you don't have to it's when we read your reviews. We just get so excited and flooded with oxytocin because we can feel the love so we would love if you did that for us. You can also follow us on Instagram at alligned underscore birth. We post updates there and share all things birth and postpartum and motherhood. So yeah, have a beautiful day.