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Episode 27: Pacifiers, Cups, Sippy Cups & Starting Solids....oh my!

, , August 19, 2020

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Jacqueline Kincer  0:39

Welcome back to another episode of The Breastfeeding Talk Podcast. I am here today with not just one special expert guest, but two, and I’m super excited to have Kimmy Nishimoto and Megan Van Noy. They are both online myofunctional therapists and yes, we will talk about what that is. And they are the host of the Munch Bunch Mio podcast, where they talk about myofunctional disorders, airway issues, sleep-disordered breathing, treatment, swallow correction, and tongue ties. So welcome to the podcast, both of you. Thank you so much for being here.


Megan Van Noy  1:18

We’re excited.


Kimi Nishimoto 1:18

Thanks for inviting us. Yeah, we’re super excited to be here. So I’m excited to talk, you know about kind of how we all kind of interconnect and can work together.


Jacqueline Kincer  1:20

Yeah, me too. And, you know, some listeners might know I have talked about it a little bit, here and there in some episodes, I am also trained in orofacial myology. But I don’t really do that as anything primary, my practice, I use it with the babies I work with. So for those of those listeners out there who don’t know, what is myofunctional therapy, what what do you guys do? Exactly?


Megan Van Noy  1:18

Yeah, so myofunctional therapy, is, when I kind of tell people on the street after they give me like a crazy look. It’s basically it’s like physical therapy for your oral facial muscles. So like your face, mouth, tongue. And what I always kind of tell people is my goal is to have those muscles working for you versus working against you. And we do that by teaching people functional exercises, and helping them really learn how to breathe, speak, chew, swallow, and just function better and actually kind of function optimally, like we’re all meant to, and how we are born to suppose to be able to do that.


Megan Van Noy  1:18

And for a handful of different reasons, totally, probably different. So but a handful of different reasons why we don’t do that, and some of the habits that we develop, to kind of compensate for those things. So that can mean I have a blast teaching people, you know, these exercises. And really, it’s not just exercise and exercise based, but it really is fashion based, and working with people on that function. So you always get a start off for us. With what you do, Jacqueline, that way, it gets a lot easier when you know, kids come to see us or hopefully, they don’t even need us after they’ve been working with you. So yes, that’s always my hope. And I tell people, but sometimes I get people with, you know, older children or adults for themselves, who are realizing that their oral function isn’t up to par. And sometimes some things that will tip them off when I’m describing what I’m hoping to see in their babies, like, the tongue should be resting against the palate, and then they’ll be like, Oh, mine’s at the floor of my mouth or pushing up against my teeth.


Kimi Nishimoto  1:18

And you know, I’m like, well, that’s actually not the optimal position for your tongue. Or sometimes they’ll just tell me funny things. And I’ve heard so many things over the years, I’ll just see a short little list, I guess of you know, snoring is definitely one where, you know, or apnea where people feel like they wake up and they’re kind of choking on their tongues. I’ve had that described to me. But even people who feel like, they just have all this excess saliva that pools in their mouth, and they’re constantly swallowing. And so there’s just sometimes odd little things like that, that you hear or people that will say, Gosh, I sure do get hiccups a lot or every day.


Kimi Nishimoto  1:18

So there’s always something right. And I’ve gone down my own journey of learning and doing the therapy for myself. And I realized, wow, there’s not very much room for my tongue, which explains why it was never really in the right place. And at the end of the day, it might be pretty swollen from being up against my teeth if I was talking a lot. And so there’s a lot of things I think people might recognize in themselves. But, you know, what do you see are some of the most common issues, you know, no matter what age group that you’re working with.


Megan Van Noy  5:01

My gosh, I mean, you hit a lot of them, you know. And Kimi, I’ma let you take this one, because you’re so good at explaining this. But before you do, I also think what we run into a lot is, well, you know, everybody in my family does this, well, I’ve always done this, or what’s never bothered me more, or well, you know, all three of my kids and like my nephews, and niece, they all sleep with their mouths open. And so it kind of like what we always are when, you know, we always try to really kind of look between is what’s common, versus what’s normal. And just because things are common, and we all are doing these things we’re not supposed to, does it make it normal?  And so that’s kind of where we have to come in and say, okay, yeah, you know, everybody in my family does do this. But that doesn’t mean it’s normal, or doesn’t mean that it’s healthy. And it’s not optimal. So yeah, Kimi, you want to take away a lot of things that we see in patients. We actually have a whole episode on this on our show. Yes.  Yes, episode one. myofunctional disorders.


Speaker 1  5:57

The main ones are tongue thrusting, where you use your tongue to swallow sorry, you use your tongue pushing off your teeth to swallow. Or you have to use your lips and your cheeks to swallow, which Megan and I were just talking about that, because I had that grown up, and I’m getting wrinkles around my lips, you guys, it’s bad. mouth breathing is a big one that’s actually very unhealthy for you. Having a tongue tie, which you can’t lift your tongue to the roof of your mouth without straining your neck or closing down.


Kimi Nishimoto  6:52

We also see a lot of TMJ issues like clenching and grinding headaches, migraines, neck tension, poor posture, where your shoulders tend to roll forward, you lean your head or it’s uncomfortable to sit up straight, because you feel like you can’t breathe well. Other common ones are gum disease, a lot of cavity risk, like you get cavities pretty easily. Yeah, those are kind of the most basic one or Lipin competence, like where your lips just don’t want to stay together. I will admit that I had that growing up, I would look exactly like Napoleon Dynamite. I would drool while I was focusing in school and like saliva, which is all out of my mouth.


Kimi Nishimoto  7:46

So yeah, everybody has something like, I’ll just throw that out there. Not everyone is perfect. And we all have some sort of myofunctional issue. And the more you look into it, the more you’re going to be like, Oh my gosh, I have all the things is so true. I feel like we end up going oh, wow, I am way more dysfunctional than I thought. And why don’t people to do is to let that create any form of anxiety for them and know that it’s totally, totally fixable. And I actually find I still, it’s probably been three years now since I learned myofunctional therapy, and I still find myself doing the exercises, because they’re very satisfying. It feels good when you know that you’re like your body wants to move in the right way. You know, so I want to say there’s hope out there for people.


Jacqueline Kincer  8:40

You mentioned, one that I thought was really important for even just kids. That kids and adults shouldn’t be drooling, but a lot of people don’t know that babies shouldn’t either. Where we’re gonna go a bit with this conversation for those of you who are like, where’s this all going, if you’re listening, is I want to get into not just newborns and breastfeeding problems, but what happens beyond breastfeeding. Like, what are some of the things we need to look at? When your baby is transitioning to solid foods, they’re beginning that weaning process, they’re maybe a toddler, and they’re beginning to speak and how do we optimize that phase of baby and toddlerhood early life for our children and our babies? And so you mentioned drooling, which was a really good one because I see that a lot. And parents have these cute little bibs. They’re so cute, and they’re soaking wet. Yeah, why does this really happen?


Kimi Nishimoto  9:41

I would say like for me it was because I had really weak lips. And also my lips did not know that they should be touching each other because I was always breathing through my mouth because of allergies. So a kid who always has their lips apart or their tongue once To stick out between their lips, check them for allergies. Or you can do some oral exercises to strengthen their lips, or Megan and I are big supporters of mile munchie. They just came out a baby size from six months to 18 months and baby. So it’s so cute.


Jacqueline Kincer  10:25

That is so good. I’ve been waiting on that for so long, because I often have parents ask me about, you know, what can I do for my one year old and a lot of times, it’s really hard to work with that age because there’s they’re just not quite as verbal and getting their compliance can be super tough. So something like the Myo Munchy is a really great option.


Megan Van Noy  10:49

Yeah, so and then also just like, two things here, so one with the with the beam on sheet, it’s right now just available to professional. So eventually, they’re hoping to get it to where parents can buy it as well. But so that’s something to keep in mind too, is you need to get it a professional who can order that for you.


Megan Van Noy  11:09

You know, the the other thing I think was the drooling too, is that kind of tongue thrust swallowing pattern. So, um, you know, we swallow, and I’ve heard a few different numbers, but you know, we swallow anywhere from like 10,000 times a day to 24,000 times a day. I’ve also heard like, every 10 to 20 seconds, we swallow. And so if we’re not swallowing correctly, we’re kind of pushing that saliva out of our mouth versus actually swallowing it. And so I think a lot of the drooling comes from that, too, of not knowing how to actually swallow correctly.


Jacqueline Kincer  11:45

That is such a good point. And hopefully, with breastfeeding, hopefully, the baby is swallowing properly there. And we’ve gotten that will establish so by the time they’re moving on to solid foods. A lot of times they’ll be, we don’t get the chance to intervene early with breastfeeding or bottle feeding. And so we see some is sues. But one of the things I wanted to bring up that I get asked all the time is, you know, one, which bottle should I use for my baby, but then when should I stop using bottles. And so I usually tell parents, it’s usually around the time that your baby starts solids, which, depending on the baby is six months, plus, most of the time, and a lot of parents go, well, that’s a lot earlier than I thought, and there’s just so many options on the market. And, and I don’t want to leave the conversation necessarily, I’ll let you take the lead, but you have some really good information on that particular area of interest for parents out there. Because, you know, a lot of parents are working, right. And they don’t necessarily want to give a bottle longer than they need to, and they want their baby to develop these oral skills, you know, early and not be delayed in any way. So yeah, if if, you know, either one of you wants to chime in, Kimi, Megan, I know, you both have things to say on the topic.


Megan Van Noy  13:08

Yeah. Yeah, we’ll, we’ll kind of go back and forth here on this one. So, you know, for kiddos, there’s a lot of information out there talking about this stuff. And to kind of just give people tools kind of just off the bat here. You know, one of the kind of experts out there is Diane bar, and she wrote a book called, nobody ever told me that or nobody ever told me or my mother that and so she’s got a lot of great information. You know, really for this age group and kind of feeding your baby and toddler right, so that’s a great place that you can kind of start looking a lot of people also like baby led weaning, you know, and you had brought up that kind of six month mark. Um, and that’s kind of when you could start toying with and testing that like Open Cup type of drinking. And one of the big things you know, and Kim, you can chime in on this one too, but is you want to make sure that the baby can sit up. So that’s one piece of the puzzle is baby needs to be able to sit up in order to do a lot of this stuff. And you know, when you’re kind of doing some sort of Open Cup, drinking parents or grandparents or whoever’s kind of helping with the feeding, needs to help hold the cup and help do that type of thing. So, you know, we all know if you hand a baby a cup they’ll just fling it everywhere, so that you want to have…


Megan Van Noy  14:47

Trying to go one step at a time, you know, kind of you can even start with more of like a thicker type of liquid. So, you know, kind of the, what is it like stage one baby food, so you can even you don’t have to You start with water, you can even try just like baby food or do you know what one of the things like formula they can with baby cereal, milk, they can listen smooth yogurt, once you can have yogurt, you know, those types of things are things that you can try. And then eventually, you can try and get them to do like consecutive swallows that may be more kind of like a nine, you know, as they get more into like the nine plus month type of thing. So, that’s one thing that you can always try is kind of that open open cup.


Megan Van Noy  15:34

But again, you don’t want to just give it to your baby and let them like try whatever they want. It has to be led, you know, and led by you and really helping with that piece of it. So that open cup drinking and again, an open cup is like any cup without like a sippy on it or like a lid or a straw, like just a regular cup that you drink out of. I think you probably can get some maybe types of cups to either that have handles, but you know, just kind of that open mouth cup. So that really can help with the you know, job development, it can help with that lips and getting the muscle strength that we were just talking about. And then also developing those kind of cheek cheek muscles.


Megan Van Noy  16:16

So sometimes you kind of like having, you know, we want the rim to sit on their bottom lip. And then you use kind of tilt the cup up and help the baby kind of learn how to just take those small drink. So you do want it to be nice and small. Okay, so that’s a big thing is not big gulps. Not big drinks. Keep it small, just like you do with small bites and things. And that can be kind of helpful. So yeah, that’s I think that’s probably where, where I would start. So, you know, one tablespoon, I think at a time is that right, Kimi?


Kimi Nishimoto  16:53

Yeah, tablespoon.


Jacqueline Kincer  17:15

But yeah, we’re eager to jump to the next milestone. But we have to remember, this is something they’ve never done before. Right. So we have ease our way into it. And it’s, I try to when it comes to breastfee ding, I try to remind parents like when your baby starts breastfeeding, there’s a reason why you don’t have a full milk supply. In the first few days, you have these tiny, tiny, small amounts of colostrum for your baby to practice the suckling and get the swallow coordinated somewhat before they’re inundated with all this massive milk being thrown at them. So it’s kind of the same thing when we’re making this transition to other liquids or solids. So just a reminder for the parents out there.


Jacqueline Kincer  17:57

And then the way you were describing the cups. There was there’s one I don’t know if you guys have used it, but a lactation consultant and myofunctional therapist friend of mine recommended one called the DOJ V cup. And I will link that up since it’s an audio show, but it’ll be in the show notes, a link to it for parents so they can see it’s small. It’s got handles on each side, but it’s angled, so the cup is going to go over that lower lip very easily. But then there’s kind of a, the top is angled so that the part that would be near the baby’s nose isn’t going to be right up against the nose. So I do like that one. I’ll link that one up. If you you know, feel free to list any brands or anything and I know Kimi, you wanted to chime in about some things as well.


Kimi Nishimoto  18:48

Yes. So we polled our network myofunctional therapist online, and the parent reviews were that the Ark therapy cup was pretty good. It’s like a was it called the Ark therapeutics, Flexi cup. It’s an Open Cup with an area cut out for the nose. One of our friends did that around seven months old. The other one that they liked what was the easy peasy mini cup. Now a really popular one is called the 360


Kimi Nishimoto  19:29

Cup. And that one actually is not recommended by speech language pathologists. This is a post by Melanie Patek. She’s got a group called My Munch bug. And I’m just going to read her post about that. It says so many questions from parents about the 360 Cup. Let’s be honest, we’ve all bought them but after watching toddlers drink from a 360 and paying close attention to the motor patterns and muscles flexion and or bracing, all my I think I’ll just skip it. Why? Because kids do best with feeding tools that create muscle balance. We want facial muscles to work collaboratively with one another. Because those adorable faces are growing. The skull and facial bones are growing, the muscles are growing, the whole body is growing. Imagine if a toddler overused one muscle in their arm, would it impact motor skills in the arm or perhaps even bone growth? Possibly my point, I don’t want kids drinking from anything that creates a quirky way of drinking.


Kimi Nishimoto  20:35

I want kids drinking from open cups and straw cups that are developmentally appropriate and support typical development. I have however, used the 360 Cup as a tool to help kids learn to hold their tongue in the correct position for Open Cup Drinking. And then there’s a YouTube about that. Awesome that is so informative, because I feel like the 360 Cup has gotten really popular. But it can be something that requires like you said those those muscles working in a way we don’t want them to work in and yeah, Melanie Patek has some amazing information out there and she has a book as well, I think I will have to link that up or any way to get in touch and follow her on anything as well. I have read quite a bit from Diane Barr, like you mentioned at the beginning of the episode, and others about sippy cups, and they’re so pervasive. You can buy them at pretty much any store. What is the problem with sippy cups? So many parents say well, you know, I don’t want things to spill. That’s great. You’re telling me about the Open Cup? Why can’t I use a sippy cup? Yeah, you know, the idea is, we really want so we don’t want to spout. Okay, so that’s kind of that’s really what the sippy cups bring to the table is you kind of have that spout so you’re kind of sucking everything in, versus like actually drinking and getting that right. Toughen function. So you know, yeah, I mean, we, we live in such a world of convenience, right these days. And that’s what is really like, I think sometimes plays against us, is we’re always on the go, you know, we hand our we hand our kids those like, you know, applesauce pouches. And again, it’s like they’re sucking, they’re sucking everything out. So they’re kind of sucking their cheeks in. And they’re not actually getting kind of that natural, tongue swallowing and reflux that’s happening is we’re using the lips and the cheeks, basically overworking them to, you know, basically just get food or drinks down into the stomach, but not actually working on those correct swallowing muscles. So, you know, we want the tongue to do all of that swallowing, because that’s what really helps grow the facial structures and grow the jaw and, you know, not overuse or compensate with those lips and those cheeks. And so those are the things that you know, any sort of tacky or type of thing can really slow down, kind of slow down that process for lack of a better word or create kind of as bad habits. So we don’t want that spout we want babies drinking from a rim is really what it comes down to.


Jacqueline Kincer  23:29

That makes so much sense. And because also to compare it to breastfeeding. When a baby has a good functional language and is suckling at the breast appropriately, their mouth is open, it is wide. The tongue is cupping the breast it is extending over the lower gums. As they get older, it really starts to we start to see it extending over the lower lip. So we don’t want to suddenly have the tongue doing something totally different. Breastfeeding should be setting the stage for oral development. We don’t want to push them backwards the opposite direction. And if your baby’s been a really great breastfeed, or if they may really struggle with something like a sippy cup. If they’ve had problems with breastfeed, they may like it, but we still don’t want to reinforce those patterns.


Jacqueline Kincer  24:15

And you know, just for the sake of eloquence, you read something a beautiful post there to share Kimmy and I wanted to read this one from Rose who has a blog called because they grow it’s pediatric speech language and feeding therapy. And she wrote about sippy cups and those food pouches which like you said, Megan, you know, this world of convenience where we just here’s the pouch and you hand it to him in the backseat and, and all of that and what Rose said was that from a therapeutic standpoint, these were her words I cringe at seeing all the little mouths sucking away on sippy cups that cause tongue thrust or reverse swallow the next generation of lispers in the making, a sippy cup while looking Get a cup is nothing more than a public publicly acceptable version of a bottle? Which I think that is actually a fair comparison. I think she nailed it. She really nailed it.


Jacqueline Kincer  25:12

I’m like, yeah, it’s basically still creating a babyish thing for children, right? But I see five year olds with them. So then she went on to say, if it has a valve, it’s simply continuing to promote a sucking pattern that the bottle started. The child’s tongue is not learning a neutral position that encourages a symmetrical palate and appropriate position for speech articulation. Instead, the tongue is habitually pushing forward, much like it did. When nursing or bottled drinking, I would argue it’s not supposed to be when you’re nursing, but that’s okay. And then she said in sucking food from a bag more of the same. So I think she really summed that up that we’re really just trying to sort of normalize this bottle feeding kind of, you know, pattern. And that’s something we’re trying to get them away from, you know, when they are ready for solids.


Megan Van Noy  26:07

Yeah, well, I think so many times too, you know, I see I end up with, you know, adults, I see a lot of adult patients, but or even kiddos, you know, in there, you know, 6,7,8,9, however old, and parents will be like, well, or even just like adults be like, Well, why, like, why did this happen? And I’m like, well, we should be chewing our food, you know, 15 to 20 times before we swallow? When have you ever done that in your life? You know, like, we live in an industrial? Yeah, right. I mean, say, you know, we live in an industrialized society, and we live and, you know, we’re not chewing our food, like we’re supposed to. So we’re not growing our jaws, like we’re supposed to, and then we get the kradic teeth, our tongue doesn’t know what to do. And everything, just kind of like snowballs from from there. So, you know, it’s so good to chew your food, and then be able to learn how to swallow correctly. And so that’s kind of where all this starts, is with being able to, you know, get our tongues to learn in that neutral position, and learn how to swallow versus just continuing on this kind of sucking, tongue thrusting type of convenience, really.


Jacqueline Kincer  27:25

Yeah, no, I so agree. And I think I get this question from a lot of the families I work with, where they’ll say, Sure, we’ve done. Yeah, and they’ll say, we’ve done the tongue tie release, we’ve done lip tie release, you’ve done all the oral exercises you gave us. So you know, we’re not gonna have our child won’t have speech issues or ever need orthodontics, right. And I’m like, Well, you know, there’s a lot of factors. It’s not just doing those things in, you know, early infancy. And there’s all these other things that affect their oral developments, and, you know, cops and solids and speech. And I try to remind parents, especially, I remember this being a new mom that you’re trying to shovel calories in your face as fast as you can before the baby wakes up or cries or needs to be held again. And so I remember getting really away from chewing my food properly, and things like that, or I would grab a bite way too much food in my mouth.


Jacqueline Kincer  28:18

So then I can’t even properly chew it. And I’m just sort of gulping it down and chugging water after. And, you know, we’re all guilty of that at some point in our lives. But we have to remember that our babies learn so much about the world from observation. And when you’re doing that, if you’re let’s say your baby’s sitting in the high chair, or you’re holding them and you’re eating, and they’re watching you and they’re watching your facial muscles so closely, so intricately. And when they start to cool, and babble and make sounds, they look to you, and they’re imitating you. So one of the best things I feel like we can do as parents is to take a moment to slow down, be really conscious of are we choosing chewing with our lips closed? Are we chewing enough? Are we doing all those things and not only will you just feel better, and probably stop a lot of the indigestion or pick up eating or even gas after your meals, all that kind of stuff. But it’s gonna help your baby out too. And I just wanted to share that because I sometimes get parents just telling me that, “How’s your diet?”, and they’re like, “Well, you know, I shoveled a granola bar in my mouth before I got here.” And I’m like, “Great. That’s awesome. I’m glad you got calories.”


Megan Van Noy  29:32

It’s so true. I mean, kids totally like they’re totally imitators and like Sometimes, though, like, most precious ways, and sometimes you’re like, dang, you saw me do that now. That’s terrible, right. You know, how many times have you heard parents be like, oh, yeah, that’s my child. Right? And it’s because they are such imitator. So I I still think there’s families out there who you know, sit down to their meals together, but you know how many families are out there too. Woohoo, it’s like this kid’s got soccer practice, this kid had band practice this kids that dance like, we’re, we’re not sitting down for a family dinner, we’re not all sitting down, chewing our food, putting our phones away. And just like enjoying a meal, it’s like we’re just shoving calories in our mouths. So we can like, move on.


Megan Van Noy  30:19

So I think that is something that’s a pretty big shift and just kind of the world that we live in to. I mean, I’m guilty of it, my family’s guilty of it. You know, I think this time has really encouraged a lot of people to slow down. And so I think a lot of people are also noticing more of like, what their kids are doing. They’re like, I’ve never noticed that my kid just sits there with their mouth open all the time. I never noticed that, like, you know, my kid, is this much of a picky eater, or, you know, those types of things. So, I think people are starting to notice that more and more, as well.


Jacqueline Kincer  30:54

I know, I would agree with you. And I think it’s really important that we do make time to be more intentional with our eating that there. It’s not just getting a need met, it’s actually a process. And I feel like, I encounter this so much with the parents that I work with, where moms will be like, oh, you know, I’m just chained on my couch, I’m stuck there breastfeeding. And I’m like, breastfeeding isn’t just like a transfer of food, like, yeah, you could get it out with a pump in 10 minutes, and then give it to your baby in a bottle. And they could drink it in 10 minutes.


Jacqueline Kincer  31:24

But, but breastfeeding is something to be experienced. And it’s so much more than food. And likewise, any mealtime can really be much more than food. And it’s its behavior, its emotional regulation, we get, you know, if we’re eating well, and it’s releasing endorphins and oxytocin, the act of swallowing can be very calming, then we help create an emotional state regulation, we’re sitting still, we’re, you know, making eye contact and engaging with others, there’s so much more we could be doing at a meal time. I think it’s important. And I also want to impress upon parents that, you know, I think a big objection to people really feeling like, I can’t use anything but a sippy cup, too, is that we’re allowing our children to have foods and beverages away from tables. And so you know, it’s one thing when you’re on a road trip in the car, right? You may want some water refresh yourself.


Jacqueline Kincer  32:20

But I’ve always sort of been like, my mind is blown a little bit when I see these minivans with Kool Aid stains all over. And I’m like, who the heck wants their kid to have Kool Aid in the car? I just let my kids have water, of course. And water should be the primary fluid that we’re giving once we’re talking about not being breastfed or whatever, but, or formula fed. But it’s like, does everything have to be eaten on the go? Or can we teach our kids a little bit and babies we have to meet their needs, right?


Jacqueline Kincer  32:51

Their babies, but right, a little bit of delayed gratification, or this is the place where eating and drinking happens. This is the place where play happens. This is the place where now happens. They don’t all have to. It’s like chaotic, when we don’t have designated spaces for things and this is kind of like a Montessori concept. So if anyone wants to listen to my interview I did with parenting expert, John repaint all we talked about this, but I did want to talk about Kimia especially I know you have some information on this about straw cups, because yeah, there’s a need, right sometimes, yeah, we’re going to be at the park or wherever in the car, and they’re thirsty. And so what is the what is the option for not open cup? And you talked about straw cups briefly? Uh huh.


Kimi Nishimoto  33:37

Yeah. So this comes from Diane bar, about straw drinking. And she says it’s particularly important for jaw, lip, and cheek development. You can start around six months, and the child will learn to drink from a straw bottle. The really popular one right now is called the honey bear. And you can buy on top tools online, it’s like 799. And it’s got a straw. You put the straw on the lips, but not on the tongue. And that encourages the baby to wrap their lips around it, and to swallow and drink. And over time they can do like swallow after swallow. The important thing was not to put the the straw on the tongue because that will encourage improper swallow. Or you can cut the straw down. So the babies don’t put it too far back. Or there’s also things called a lip bumper you can put on there just so they don’t put it too far into their mouth. That’s a good option.


Jacqueline Kincer  34:48

Yeah, that sounds really great. And yeah, who doesn’t love a cute little like honey bear and if anyone’s wondering what does that mean Honey Bear straw cup. Just if you buy a bottle of honey, and it’s in the little plastic bear shape. It’s been splayed out with a lid and straw on it, essentially. So your kid is going to love it, I promise.


Kimi Nishimoto  35:07

Yeah. She also invented putting, if it’s hard for them at first, to just put thickened up liquid, so like baby food, then with water, or things like that, basically, you’re trying to get them to wrap their lips. And then to swallow normally, versus like, if you did an experiment right now, you had a soda. If you put the straw too far back, you’re gonna tongue thrust swallow on it, versus if you just bring it forward a little keep your lips together, then you can use your palate to swallow.


Jacqueline Kincer  35:42

Yeah, everyone go and try that right now. Your eyes Starbucks it within the car with you. Try it out. I think this actually leads me into a question that might be one listeners are thinking of two, which is okay, I get the cup thing. Great. Thank you for the resources. I know what to buy. And I’ve got some excellent tips. What about foods do what about spoons? How do we go about that? What’s good, what’s bad? There’s so much more research out there. Now there’s so many people that have really just gone so in depth like yourselves to, you know, work with kids. And this way, how do we get our kids fed when they’re ready for something other than formula or breast milk?


Megan Van Noy  36:30

You know, so much of it, I think comes back to again that like that mimicking thing, right? So. And baby led weaning tends to be a pretty like popular resource for that as well. And, you know, just letting kids try a bunch of different things. I mean, we all know at some point, you’re going to have to do some spoon feeding, we’re going to have to, you know, no babies perfect, no scenarios perfect. Um, and, you know, you want to be able to make sure the baby can wrap the lips around the spoon, use the lips to pull that food onto the tongue, and be able to, you know, kind of, versus kind of suck it off the tongue or like lick, you know, hug. Sometimes kids like to lick spoons, we want to be able to use those lips, pull that off the bullet off the spoon, and then we can get that correct, swallow. So, Kimi what else you want to add on that?


Kimi Nishimoto  37:31

Yeah, I’m just getting back to like, I grew up in a big family of like, we have seven of us in our family. So the older ones partly raised the younger ones. And so I just took all that information, watching my mom. And then when I became older, and I would go volunteer at an orphanage in Thailand, I just would do those same things that my mom did. But my mom would just take a big old spoonful, put it in the babies, now, the baby would spit it out, and then she’d wipe it off and then put it back in. But you actually, the recommendation is to let the baby kind of get it off with their lips. And then if it’s dirty, try to have them try to lick it off. So they’re using their facial muscles and their lip muscles more.


Kimi Nishimoto  38:19

The other thing I just thought about it while we’re talking is like one of my passions is to go to Thailand, and I volunteer at this orphanage in Northern Thailand. And those little babies are so resilient. They’ll be like a year old and cut feeding themselves. And it’s a little messy, but they can do it. And it’s just amazing. Yeah, yeah, and I think same thing with even starting to work in solid foods and stuff. Like, yeah, you know, don’t give your child like a giant like, you know, carrot that they can choke on but, you know, cutting up in those small pieces. And again, I think it really comes down to like, watching your kids watching them to you know, and, you know, watching just see what they’re doing with those, you know, with those particular things, because again, you know, we want them to chew their food a bunch, and we, you know, not rushing them to just because we’re trying to get from A to B, like, their meals are just gonna take longer, and, you know, and that’s okay.


Jacqueline Kincer  39:18

Yeah, that’s a really good point that you’ve made. And I remember sort of with my second, you know, second babies, you’re less, you know, hyper anxious about so many things. And I remember just, you know, breastfeeding her and, and, you know, I would be out and about with my son who was a toddler and he would want a snack and I’d give him a snack. And I remember one day my daughter was maybe seven months old or eight months old. And you know, we had, she’d been eating solids and things and I didn’t think to bring a snack for her because I just thought, you know, she breastfeeds right. And we were at this park and I tried to nurse her and she was like, ah, and she was reaching for her brother’s food and I was like, oh, geez, I totally forgot that. you like to eat food now that you might need something else. And so it is important that we start to make that time, right? Like you’re saying, and, you know, I had like goldfish crackers or something that were totally not appropriate to give her and I thought, well, yeah, that’s right, I need to make, I can’t just leave the house on a whim, I need to make sure that I’m making sure this baby gets fed.


Jacqueline Kincer  40:24

And, you know, I think a lot of parents have some fear, like a lot of parents want to do baby led weaning, but then either they’ve heard something, or they have fears about, you know, like I just said about goldfish crackers would not have been a good choice. And obviously, there are much better choices, like we’ve talked about, but you know, for the parents out there who are like, well, you know, what about choking, you know, and so they sometimes prolonged purees? And how, how long should periods or mashed foods be used? And then, you know, if there is a concern about choking and gagging, what are some of those issues? How can we address those, Kimi?


Kimi Nishimoto  41:03

Well, if there’s choking and gagging, of course, like some things are just not age appropriate, right? But sometimes, that baby has a tongue tie. And if it’s not super obvious to the parent, it could be what’s called a posterior tongue tie. So kids that are constantly spitting out food, packing it in their cheeks, gagging and choking often should be probably, you know, evaluated by someone for a posterior tongue tie. Hmm, yeah. Yeah.


Megan Van Noy  41:37

And then also just kind of keep track of what you’re feeding them, keep track of how big the bites are. But yeah, a lot of times the choking, the gagging, the spitting up, all, you know, all of that type of stuff. Well, a lot of times we some sort of tongue tie, which, you know, is it’s such a tricky, like, tricky topic. Because a lot of pediatricians either aren’t specialized, or they aren’t, you know, well trained in that area. And there’s also a lot of dentists, EMTs. Other, you know, specialists who are also aren’t well trained in it. So, I guess we’re saying that you need to find somebody who is well trained, who has done the research, you know, Richard Baxter wrote the book, tongue tied, he talks a ton about babies in particular. And so even just going to his book, tongue tied, or his website, there’s a lot of resources there to where you could look and see, okay, what is my baby struggling with these things are is my toddler is struggling with these things?


Megan Van Noy  42:44

And, you know, what can I do about it? So, it does get dismissed a lot, but it is a real thing. And, you know, these kids turn into, you know, 567 year olds who are picky eaters, who are texture aversion, don’t like things because of how they feel in their mouths. And a lot of times it’s because there’s been some sort of tongue tie that’s been missed. Like, Megan and I, we are both here to tell you that posterior tongue ties exist because we have them. Yeah, I had I released at almost 30. And Megan is having her hers done this week. Yes. 30. Next Thursday, I’m going to fly to LA to see Dr. Soggy so ah, yeah, very, very excited about that. And I’ll tell you, I was a colicky baby. I also I’ve never liked like tomatoes, because I don’t like their texture. You know, I wasn’t like an extremely picky eater, but somewhat of a picky eater. And a lot of times it was texture based. And you know, so and then, you know, even as an adult, I’ve had a lot of issues with like acid reflux and that type of thing. So you know, those are just kind of some really brief food signs.


Megan Van Noy  44:03

But a lot of times you’re picky eaters, you’re messy eaters. Kids who just cannot chew with their mouths closed, who ended up with so much food all over their face and all over there was a lot of times those are kids who, you know, kind of struggle with some eating issues as well. So, I would say, definitely look out for the tough time.


Jacqueline Kincer  44:25

Yeah, I wanted to maybe share an example of what you’re talking about, with a good friend of mine, who shall remain anonymous, but they became my clients because we were at a basketball game one night and and the dad was he’s a physician but but not a pediatrician. And he said, You know, I cannot get my son I think he was six at the time he anything other than chicken nuggets and macaroni and cheese. And I looked at his son and he has a very, very narrow face kids very skinny, kind of have some dark circles under his eyes. And I said, does he snore? And he’s like, yeah, how You know, and I was like, just just to guess he’s like, no, like, why would you? How would you know? Are you like the Medical Medium? I’m like, No, I just looked at his face. And I’m like, I bet you he’s tongue tied. And he was like, what is that?


Jacqueline Kincer  45:13

And so sure enough, you know, we looked in his mouth. He’s got this crazy high palate, and this weirdest tongue tie. I mean, I can’t even like a millimeter, maybe that this kid could move his tongue. It was so shocking. Right. And then his, you know, adenoids were a bit swollen and things. And what was so funny was when I first month, the mom must have been first or second time where we started chatting, and she was telling me how she breastfed her kids till they were three and this and that, and I’m going, how in the world, did you breastfeed? breastfeed him till he was three? Yeah, she did. But you know, here he is, three years later after he’s weaned. And he can only handle these very soft foods, right, and just had such a small nasal airway, where he was having to chew with his mouth open because he couldn’t breathe in his mouth, he couldn’t breathe, right? So he had to breathe through his mouth and chew at the same time. And it’s exhausting to try to do that. And then you snoring at night and all these things.


Jacqueline Kincer  46:15

So, you know, actually, it’s, it’s a great story, because I ended up doing myofunctional therapy with with the boy and his older brother who’d been in speech therapy for like three years, and ultimately got the ties released, they’re doing Power expansion, all the things and, you know, happier kid, being able to sit still in school can eat lots of different foods now can chew properly, they were able to put the boys in an etiquette class, or they learned how to eat properly, which was so great, but they couldn’t do those things before. And I think sometimes, when our kids are older, we start to think, Well, maybe it’s just because he’s a boy, he’s a messy eater, or, you know, my kid doesn’t listen to me or they’re distracted. And it’s like, our kids, much like babies. Yes, kids can to some degree be manipulative. But a lot of the times when when I see behavioral problems, or I hear about them, I’m like, Well, is it a behavior problem? Or is it like a physiological problem? Because, yeah, I think, you know, like you said, you were a colicky baby, right? Because you just made your mom miserable. Right?


Megan Van Noy  46:15

I wasn’t on purpose. You know, and I think actually, I think that’s such a good point, Jacqueline, and actually, Dr. Dr. Baxter talks about this in his tongue tied Academy course. I don’t know if he does in the book. But him you may remember this, Kimmy and I both took that course. And he said, sometimes we put like personality traits on to actual symptoms. You know, like, Oh, they’re just a picky eater, oh, they can’t pay attention to anything, or oh, it’s like you assign almost like a personality trait to an actual symptom. Versus being like, Well, wait, is this behavior because they can’t breathe? Like, they’re hyperactive? Because they don’t sleep at night? Or they’re a picky eater, actually, because they can’t move their tongue. And so they can’t chew their food, like they’re supposed to? Or, you know, oh, they’re just a bed wetter, because they’re like, a bad kid, or, you know, they just, they’re going through stress, whether, yeah, or they’re going through something.


Megan Van Noy  46:29

And it’s like, no, these are actual symptoms of these types of myofunctional disorders. And it’s not a personality trait, you know, because even said, like that, you know, this, this kiddo you’re working with could pay attention in class more, you know, it’s probably less of a distraction to the other kids. And all of a sudden, it’s because that he was sleeping well, and he could focus and he could breathe, not because he’s a bad kid, or, you know, just like a rebel rouser. It’s because he, like, couldn’t breathe. You know, we’ll see that a lot too, with kiddos is, you know, they, when they’re little, like, their parents would be like, yeah, they were kind of a bully to their siblings or their you know, and it’s like, well, they’re not a bully, they couldn’t breathe. Again, you know, kind of putting these personality traits onto kids, when really, like, they’re just trying to tell you or their bodies are going to tell you that something else is going on.


Jacqueline Kincer  49:17

Hmm, yeah, I love that. I think that’s a really good message for for parents who maybe are first time parents who are listening who have a baby, and they’re concerned about, you know, you know, parenting in these later years, or they do have some older children and they’re wondering, you know, now it’s even more stressful because they have a baby too. And they’re just trying to, you know, manage the household and they’re seeing these issues crop up. So it’s really good that we’re talking about these and Kimmy, you had said something important to you, which is, you know, sometimes a lot of these things are tongue ties, and sometimes it’s more than tongue tie. Maybe it’s also allergies, or sometimes it’s only allergies or, or other things like allergies are always something to look into because, yeah, if our noses are congested.


Jacqueline Kincer  50:02

You know, everybody knows when you have a cold and you can’t taste your food. That’s not very fun. Right? So, which funny, I’m saying that in the times of COVID, because those are some of them. Don’t say that out loud. Don’t panic, panic?


Megan Van Noy  50:23

Well, yeah, and I think too, so sometimes I’ll tell like, there’s kind of like a bunch of different causes for the companies about functional disorders. But, you know, one of them is that, like, can you actually breathe through your nose? So I tell people, when they, they feel bad, or they’re like, Oh, I can’t believe I’m doing this. And I’m like, Well, okay, so you have two options. If you can’t breathe through your nose, you have two options, one breathe through your mouth or to die. Like that’s it. There’s nothing else you could do, right? Until we can get you breathing through your nose, and actually being able to do that stuff. Like, what are you supposed to do?


Megan Van Noy  50:55

Yeah, I, one of the big things, I think I really want to like, hopefully get this point across is, like, if there are new parents out there, you know, parents with like, multiple kids out there, like, Never feel guilty. If you didn’t pick up on some of this stuff. Right? When the baby was, like, we don’t know, we don’t know. And the fact that you’re learning now you’re picking up on these things. Now you’re researching this stuff now is great. You know, like, I think every I’ve three sisters, I think both my parents had every single one of my sisters tongue tied. And you know, I’m the only one who’s ever, you know, because of what I do have, like, notice that right, you know, and my mom’s you know, at one point, my mom’s like, well, I didn’t know what I’m like, Mom, I would have never expected you to know.


Megan Van Noy  51:41

But now that we know, you know, we can do things, we can do things about it, like I can do something about my clenching and grinding, I can do something about my headaches, I can do something about my acid reflux. And you know, I’m never upset at my parents for what they didn’t know, you know. So I hope other parents can like give themselves some kind of like Grace within that to have, you don’t know, you don’t know. And so whenever you learn it, and you put it out there and you like start helping your kids no matter how old they are. I think it’s great.


Jacqueline Kincer  52:13

That is just so words of wisdom. Absolutely. And I think for I went through a phase like that, like, oh, I can’t let you know, I wish I would have known. And I hear that so often, even when it comes to breastfeeding issues. Oh, I should have seen you sooner. And I’m like, Well, you know, you’re here now. And so that’s all we can do. And you both are just so I mean, this is just scratching the surface on what the two of these wonderful women know. But I know there’ll be people who are listening like, Okay, well, how do I work with if my child does have a tongue thrust? Or has a tongue tie or whatever?


Jacqueline Kincer  52:49

What do we do? How do I work with someone that’s as knowledgeable as you and you both do work online? Not just because of COVID. So I would love if you each took a moment to just tell our listeners more about working with you. How do they get a hold of you? And of course, I’ll link everything up in the show notes for everyone.


Megan Van Noy  53:08

Yeah, yeah, of course. So I so just kind of full disclosure, I usually work with kiddos kind of five and up anymore. I specialize even more so in like adults. But Kimmy is our like, we call it many miles so that like for and under she’s kind of become our expert in that. But you know, for your you know, for your kiddos, even if like you’re an adult, you’re like crap, this is me. My website is WW dot Oral Facial My practice is called Northwest Myofunctional Therapy. So you can contact me through that no problem. You know, you can always find me on Instagram as well or Facebook. So we’re all on social media. You could also contact us through our our Munch bunch, podcast Instagram as well. So that’s kind of the best way to get a hold of me and then Kimi, I’ll let you say your stuff.


Kimi Nishimoto  54:12

My website is www dot mouth muscle And you can also find me on Instagram and Facebook and our Munch bunch mile podcast. You can find it on anchor on Google podcast, Apple podcast, basically all the main modifying Yeah, all the main podcasting sites. We do lots of different things. So far our most popular episodes are about what is in myofunctional disorder or like things that can go wrong with your mouth. We have a theory Megan and I that most of your dental problems actually come from myofunctional disorders. Yeah, let that marinate for a second here.


Kimi Nishimoto  55:03

All you’re grinding receding gums gum disease decay, it probably has something to do with that. struggling in the dental chair feeling like you can’t breathe and get your teeth cleaned at the same time. It’s like you’re always like, move your tongue move your tongue like gagging on the X rays. Yeah, yes. Yeah, it all comes back to that, because we’re dealing with your mouth, you’re breathing your tongue, which translates into your airway. So that’s kind of what we do. And like Megan just said, I am the mini mio person. So someone that wants to contact us. They would come to me for consultation and therapy if needed, or referral to someone else. Like Jacqueline, we like to send people to her if it’s a question about babies or breastfeeding issues, we like to send them on to Jacqueline.


Megan Van Noy  56:01

Yeah, and even so even if patients contact me and our kiddos for and under, I usually just tell them that Kimi’s my mini mio girl and send them that direction too. So we all work together, I think it’s really, really important to work kind of in collaboration with other people to have this like cohesive environment, because, you know, we’re all one piece of the puzzle. And we all kind of play a role within that. So I think it’s really important to work, you know, with other professionals, you know, I don’t know at all can be doesn’t know at all. But you know, we we do know really great people who can help like if you have that high, narrow palate and your six year old, like, I’m not going to expand your teeth for you.


Megan Van Noy  56:45

But I know a great early intervention airway orthodontist who can, you know, we’re not going to come to your house and release your tongue ties, but we know. You know, we know some great dentists and t. So we’re just one piece of the puzzle. And I think that’s really important to remember as you’re trying to work nationals. So, you know, and then also, you know, Kimmy does, she’s not just a Minnie Mouse girl, she does work with all ages as well. So, you know, we have, we have my I think my oldest patient is like, mid 60s. So I think I’ve even had a seven year old reach out once, but, um, so you’re never too old. And you’re honestly, you’re never too young.


Jacqueline Kincer  57:28

Those are such great points. And I do want to encourage people don’t be afraid of like reaching out to the wrong person. If if we can’t help you, we will send you to someone who will. And if you certainly won’t be one of us, but I know sometimes. There are unfortunately professionals out there who don’t ever send you to someone else. And they just say why can’t help you? And you’re like, Okay, well, so, yeah. So just don’t be afraid to ask, you know, sometimes they’re busy. And they forget to say that. So say, Well, okay, I understand that you’re not the right person, do you have someone you would recommend, and we will all try to get you pointed in the right direction. I know, so much of the time, I’m just connecting people with, you know, another ibclc in their area, or a dentist or you know, what have you so, you know, please reach out and, and for those of you who are listening going, Well, I think that my baby, you know, my three month old is having some of these issues. You know, that’s where I come in.


Jacqueline Kincer  58:22

So I don’t want people to feel alone. Like you have to wait until your child’s older to work with Kimi or Megan or someone like them. You know, there are lactation consultants like myself who are trained in these myofunctional techniques for babies who are breastfeeding too. So and we do know a lot about bottle feeding, by the way. So it’s not just breastfeeding necessarily, but you want to optimize the infant feeding. So that sets the stage for them to be know doing better and all these other phases of feeding and life and all of that. So if anyone needs help with, you know, a consultation or exercises, I am happy to do that with folks online or send you to someone else who might be local to you. So yeah, well, I love everything you guys have said any last thoughts, something that you want to leave our listeners with that maybe we didn’t get to


Megan Van Noy  59:13

I feel like we covered everything and then some. I don’t know Kimi was probably I feel like that’s pretty much it.


Kimi Nishimoto  59:20

I just like wanted to drop one last little token of knowledge here. There’s an awesome book that just came out called Breath by James nester. Oh, and there’s also like, interviews and podcasts but he talks about how if we don’t chew properly, or if we’re not using our muscles, like we’ve been talking about this whole time, our jaws don’t develop. So he’s got studies about how the human face has shrunk because of dysfunctional muscles, and also like how we breathe. So check that out, too. It’s called Breath by James nester. Awesome, awesome. Yeah, yeah, yeah. There’s a ton of great books and resources. We’ve dropped a few different names you know For Kids, Larry Kudlow has a good one, too. I think it’s taught SOS for Tots or tots for SOS. But you know, so for kiddos and babies, there’s a ton of great resources out there. So the other thing you can always do is you can find kind of your local areas, either tongue tie support, or baby tongue tie support, or functional therapy support group and ask a lot of questions on there, too. There’s a lot of great professionals who can give feedback.


Jacqueline Kincer  1:00:25

Yes, that is so true. And for anyone who’s listened and probably thought, well, I’m going to go back and take notes. Or maybe you’ve been taking notes, don’t worry, I’m going to link up all of these books, all of these products. I’ve been taking notes as we’ve gotten. Most of these will be Amazon links, because that seems to be where people buy things these days. If it’s not available on Amazon, I’ve definitely got the link for you. So if you’re listening, going, what was the name of that cup or whatever, you don’t have to go back listen up. So just check out the show notes. So thank you both Kenny and Megan, for sharing your expertise and your experience with us today. It’s been so valuable to have you both on the show.



There are many baby products that are damaging to an infant’s oral development. In today’s episode we have Kimi Nishimoto, online myofunctional therapist, as well as Megan Van Noy, online myofunctional therapist to discuss the many products out there. This amazing duo are the hosts of the Munch Bunch Myo Podcast where they talk about myofunctional disorders, airway issues, sleep disordered breathing treatment, swallow correction, and tongue ties. We give you some amazing resources and product reviews that you don’t want to miss!

In this episode, you’ll hear:

  • How are straws helpful?
  • Dangers of food pouches
  • Why sippy cups are bad
  • Tips for starting solid foods
  • How ties affect oral function in children beyond breastfeeding