Nobody Has It All Figured Out (And That's the Point

If you've ever looked at another therapist confidently screen feeding and thought, "I could never do that," this episode is for you. I started out as a speech therapist in the schools, and I loved the work that I was doing, especially like early language and all that. But then, you know, I saw that kids were struggling with more than communication. I also had an entire caseload of kids dropped onto my lap unexpectedly unexpectedly. I had asked to work with feeding cases. They said, we don't do that in this school. Somebody went on maternity leave, and all of a sudden I had 12 kids added to my caseload that I didn't have the week prior, and they all had feeding goals. And I was like, okay. Anyways, fast forward, I went— I worked in the schools for a couple years. I went to infants and toddlers, and then when my contract was done, I left. And so I took a little time off and then moved into private practice. And in private practice, I pretty quickly started seeing some of the same patterns that I saw when I was working with kids in the schools. Drooling, open mouth posture, picky eating, difficulty chewing, like all signs of something deeper. Okay. And I realized, I actually had already realized this, that no one had taught me feeding. Not in grad school, not in my, you know, not in my school job. And so when I was working in the schools, I was already like researching and shadowing and starting to take courses that I could find. I discovered that feeding therapy was the missing link, right, that connected everything I loved.

I noticed almost right away, about 24 hours after birth, I was new to everything, especially breastfeeding, but I was kind of like, I don't think this should feel like this. So, so I checked it out a little bit and I suspected her tongue tie. I saw a lactation consultant. She also suspected a tongue tie. So we went to an ericentric pediatric dentist. When she was 7 days old, and he also diagnosed a lip tie. So I believe she had a Class 3 lip and a Class 2 tongue. So we had both of those released, and just that whole process, only her being 7 days old, but, you know, getting some of the post-release stretches and things after the appointment— my husband was kind of deferring to me, like, what do you think? Is this okay? Should we be doing more? How many of the stretches? How much?

How long?

And I was like, I feel like I should know this, but I don't feel like I have enough background.

12+ months, like in toddler feeding and like upward. And I had never worked with like the birth to 12 crowd. So I wasn't working on like, you know, breast, bottle, or transition to solids. And so that was really humbling to have a child who had struggled.

I had no idea. And that's the thing, like then once you do finally find out, you feel so stupid and you're so upset. Like I always think like if I knew the information I knew now, with my first, we probably wouldn't have the journey that we had. Then I'm like, okay, but then I'd still be a teacher in a different life. So everything works out the way— nothing wrong with teachers, we love teachers. There's a system for me.

Exactly. I came back to my Maya Force. She was 24 months old. I flipped her over, I looked under her lip and her tongue and I was like, ah, there it is.

There you go.

We had painful breastfeeding for 13 months. At one point I would like have to turn my head away from her because I didn't want her to see like my face while she was latching.

So bad.

And like, when she was latching, my letdown happened, like, I'm like, okay, we'd get into a groove and it wasn't like as painful. It was tolerable at that point.

Yeah.

I had people saying the dumbest things to me. I took her to the IBCLC at the pediatrician's office. I sought out help and nobody, like, and of course it was like, take your car into the shop, you take the baby into the lactation consultant's office, and all of a sudden they position her, they get her down naked, they position her, they put her here, she feeds well, and they're like, look, she transferred.

And I'm like, and it never happens ever again.

That will never happen again.

Yeah. And it doesn't. And it doesn't happen again.

Yeah.

And that's what happened. And I was like, oh, it's like when I take my car to the shop and it has a noise.

Cool.

You got it.

Okay.

100%.

I mean, it's so stressful. Like she had that colicky baby with gas and didn't have reflux but had air-induced reflux and all these symptoms that I didn't know were tongue-tie related and just like digestion and texture part.

Is that especially when you are a first-time mom, you don't know what you don't know. I literally did not know what a tongue tie was. I had so much breastfeeding grief that I didn't even understand what it was like. I, I had babies a similar time with a lot of my friends, which a lot of people do, cuz when you're the same age, a lot of times that happens. And they would like pick up their shirt and they would just nurse their baby and it was going fine. Or their baby wouldn't take a bottle. And I was like, oh, what a problem. Like their baby won't take a bottle. My baby won't take a breast. If it literally, if his life depended on it, he would starved. If I didn't have a breast pump, this child would have starved. Really had to come to a lot of terms with that, and I had to forgive myself. I had to forgive him. I was very resentful, whether I wanted to admit it or not, but at the time I was very resentful towards him. Why can't you latch? Why can't you do this? And I was upset at myself, and there was just so much feeling of not being able to get over the breastfeeding journey that you didn't have that you wanted to have, whether it was like you ended up giving formula and you didn't want to. We love formula, formula's great, but if you don't want it, that's also okay. You're just forgiving yourself for that. And there's so much breastfeeding grief that comes to it. So those are the people that usually are able to then change their journeys for the next one. So it kind of just depends where you are at in your journey, but there's so much emotional baggage and stuff, and it all stems from the fact that you have no idea what the hell you're doing. That's really where it comes from. Circling back to the beginning of our point, 1,825 hours a year. That's if you're pumping 5 hours a day for 1 year. Like that, that right there is your answer. It is the time. It is waking up in the morning and you have a million things to do and you have to pump.

Getting ready.

Yeah, it's getting ready to go to bed and you're so tired and you have to pump.

50 to 1,500 hours depending on if you're combo feeding, if you're full-time exclusively pumping. Definitely exclusively pumping, you'll be closer to like the 1500, like you were kind of saying, number. And then it's like, that's like 37 full 40-hour work weeks. 37, 40.

I think that's more than whatever the job is.

Yeah.

Which is crazy. It really is. And like, it really does feel like a full-time job because between the pumping and then like the milk management. So if you have a lot of milk, you have to manage all that breast milk. If you don't have a lot of milk, you're stressing about not having a lot of milk. So on both ends, you're just stressed out.

I was diagnosed with ulcerative colitis when I was 18, and I kind of managed without medication for a little bit. But when I was 20, uh, almost 21, I had a massive flare. I was hospitalized for 8 days. I was put on intravenous medication, and they, the doctors at that time kind of told me, this is something that you're probably gonna have to take forever to keep this in remission. Definitely not a GI or, uh, a doctor, or I don't have a medical degree or anything like that. But the longer I took it, the more frequent I started having to take it because my symptoms would start returning. So for example, I started every 8 weeks, and then around 7 weeks out, I would start getting symptoms again. So then it was 7, I got it every 7 weeks, and then around the 6-week mark, things started returning. And I was like, this just doesn't seem right. Something seems off here. So the the holistic side of medicine was never something I even knew existed really until I sought it out. And I was just looking for really anything, anything to try. So I started working with a functional medicine doctor. It was probably 8 years ago now. And we did a really strict elimination diet. So very similar to what you were experiencing and, and talking about— no gluten, soy, dairy, you know, any, any of that stuff.

How to say no without like a little sprinkle of guilt. I've gotten a really, really I'm really good at saying no and throwing up boundaries and everything. But occasionally there's like this little twinge of like, oh, but like I could just say yes and maybe I should do that and like second-guessing myself. And I'm like, no, Hallie, no, no, no. So like just that little sprinkle of guilt, I would really like that to disappear in my next 40 years of life. How to consistently get 8 hours of sleep or even 7. I feel like I get into really good grooves and then it falls apart again. And I know how important it is for my health. Hello, you know, this whole podcast, right? But here we are. I'll take all the recommendations. How to keep my inbox at zero. Like, spoiler alert, I cannot. And honestly, I don't really try that hard. I do have programs I can go in and like categorize emails and delete them all at once, especially if they're like junk. But still, inbox zero. How to stop feeling guilty for resting, right? Just like literally just like, what do you guys call it these days? I'm an older millennial over here, so I think they call it couch rotting or something. I heard somebody say that recently and then I saw it used on Instagram and I was like, oh, this is a term now. Couch rotting, I think. Am I misusing it? I might be misusing it. But anyways, the point is how to not feel guilty for that, right? Because I own 3 businesses and I'm a mom of 2 and a wife and just all those responsibilities in life, right? Just being able to rest and not feel guilty about it and not have anybody around you make you feel guilty or not. How to stop filling every spare moment with something productive. We don't always have to be productive. And I, I think I'm getting a little bit better at that. I'm trying to like slow down in the mornings. There's this couch I really love in my sitting area. I've created this space in front big windows, like where the sun comes in in the morning. It's hot outside in South Florida, so I can sit on this couch inside of my air conditioning and still get the sun, look at some water, and just like breathe and take it all in. So I'm working on, I'm working on that, doing more of that and not letting that become like a 2-week thing that just falls by the wayside. How to stop doubting myself when stepping into something new? Because even though many of you see me as a big personality and somebody who is very confident, right, which I I am. Sometimes when I'm doing something new, I still get the same feelings that you do. I still maybe doubt myself or second-guess myself or kind of go like, "Oh, like, what am I doing here?" That's normal. It's human. And so I want to work on not doubting myself so much when stepping into something new because I know that that energy can also kind of like prevent me from bringing, you know, bringing it to the right people.

Every single therapist that you look up 2 colleagues, educators in the pediatric feeding space, started out feeling completely unqualified. Imposter syndrome does not mean you're not ready. It actually means you're growing, you're stretching. Like, it's that uncomfy feeling of doing something new, right? Your brain is trying to keep you safe by keeping you in what's familiar. And so the antidote here isn't like more studying, it's getting those clinical reps in, right? But with support, with mentorship. Right? And you're gonna build belief through evidence. One successful session, one client win, one affirmation from a mentor at a time. My confidence came after I took action, not before.

I had no idea that I could have looked at a slower flow, and I had no idea that a Phillips Avent level 1 is pretty fast compared to some other level 1 nipples. So yeah. Definitely professionally and personally, this has opened up a new world.

Well, I love that for you.

Love that.

And I think you highlight a really good point. So for anybody who may be, you may be a parent or someone who's maybe not a feeding therapist or someone who's not in the bottle feeding world, you highlighted something that I think most people don't know, that one, there are so many different manu—

a couple things actually, right?

There's so many different bottle manufacturers out there. Really the big point is across all of them. Like, a level 1 nipple on one bottle is not the same as a level 1 nipple on another bottle. And so actually looking at the flow and just turning the bottle over and seeing how fast the flow milk— you know, the milk flows out, even if it's your own hand or into the sink for a second.

Confidence, my friends, is going to compound when you have someone confirming you're on the right track. How do I know? We've had thousands of clinicians go through our programs and thousands of clinicians that could tell you this is exactly their experience because how do I know? Because they have. And this is where you start to build your confidence through repetition, right? And so look, start with simpler cases if you can, reflect on what's working and what's not working, repeat, learn, adjust. Over time, your brain is going to build pattern recognition that's going to make things click and you're going to move from like, oh gosh, I hope I'm doing this right, to like, okay, I have an idea, a pretty solid idea of what this kid needs. Like, I know what this child needs.

I can say now with much more confidence that I'm a pediatric feeding therapist. I work with infants and toddlers who have feeding difficulties. I can help assess with some breast and bottle feeding within our scope of practice as SLPs. Yeah, I can definitely give you some help and take a look and see if I'm seeing a suspected tongue or lip tie. That was something that even with my own daughter, I'm like, I think she tongue tie, but I don't really— I mean, looking back now, I'm like, oh yeah, her tongue was heart-shaped. Why did I even question that? Now I just, I feel so much more confident, especially with this 8-month program. So it sounds like a lot, and it is. I mean, it's, it's hard work, but I think this end result is very much worth it.

Quick disclaimer: all information, content, and material of this podcast are the opinions of the speakers. And serves as the informational purposes only and not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified healthcare provider. That wraps up today's special compilation. My goal with these episodes is to bring together the conversations and the insights that are truly moving the needle in our field right now. Next, whether you're a parent looking for answers or a clinician looking to sharpen your skills, Remember that the most important tool you have is your own clinical reasoning. Don't just look at the surface level symptoms, look at the underlying systems. If today's episode shifted your perspective or gave you a new aha moment, I would love to hear about it. Take a screenshot of you listening, post it to your stories, and tag me @HallieBulkin. You can always find more resources and past episodes over at untetheredpodcast.com. Thanks for tuning in, and I'll see you back here next week on the Untethered Podcast.