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Episode 8: How Tongue Tie Impacts Breastfeeding and Beyond with Dr. Liz Turner

, March 4, 2020

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Jacqueline Kincer  [0:03]

Welcome back to The Breastfeeding Talk Podcast. I’m your host, Jacqueline Kincer. And I’m so excited for today’s episode; if you can’t tell, I brought on the amazing Dr. Liz Turner, a dentist out of Denver, Colorado. Not only does she treat ties in her practice lip tie, tongue ties buccal ties, but she actually takes a whole airways-centered approach. And you’re gonna find more out about that in this episode and the airway connection to ties and breastfeeding. So make sure you stay tuned. And if you haven’t done so already, make sure you’re subscribed on iTunes so you don’t miss more amazing, life-changing episodes like this one.


Welcome to the podcast. I have Dr. Liz Turner here. She is an incredible dentist who practices out of Denver, Colorado, here in the US. And I’m super excited to have her on the podcast because I actually connected with her via Instagram, which is always fun, and learned that she has so much knowledge not just about tongue and lip ties necessarily, but also the airway. And in this episode, we’re gonna get into why that’s important when it comes to breastfeeding. So welcome, Dr. Liz.


Dr. Liz Turner  [1:54]

Good morning. I’m so excited to be here.


Jacqueline Kincer  [1:57]

I’m super excited to have you. You have so much amazing, incredible knowledge and experience to share with our audience. And I definitely want to dive into that.


But I would actually love to hear it, and I know our listeners would love to hear this as well. How did you get into what you’re doing now? Maybe even just how you became a dentist if that was always a goal, but I’d love to hear more about your background.


Dr. Liz Turner  [2:19]

I’m from the East Coast. And I went to dental school at Tufts. And I feel like I got an incredible education there. But one thing that isn’t taught and emphasized is the airway and the functional component of the tongue. And I think, and I hope, that education will be changing. But 10 years ago, when I graduated, I didn’t know anything about this.


So my experience started with the birth of my son two years ago, and I had a fairly simple, natural birth. I did have some intervention with medication towards the end of like 30-something hour labor, so the grand scheme of things is not as long as other people.


So overall, I’d say my birth was fairly easy my son came, and he didn’t have any problem latching, but he just didn’t seem as happy as he could be. He was kind of gassy, kind of fussy, and kind of fell asleep during feedings. And I was concerned, and it was a nurse on day two who said, oh, he seems to have a mild tongue tie and a mild lip tie. And everybody else said it was okay. The pediatrician said it was okay. Lactation said it was okay. And so from there, I was like, Okay, I guess everything’s okay. But I was fortunate enough, being in the dental space, that I have some incredible pediatric dentist friends who were a little more forward-thinking, and they were able to say you need to have that evaluated and you likely need to have it treated. And after I had him treated, he instantly changed.


He started sleeping better; gassiness, fussiness, clicking, and also the kind of falling asleep at the breast that he was having all went down.


Well, three days after he had his release, my father-in-law had a fatal heart attack. Luckily in the doorway of the emergency room. He threw a blood clot from afib, and he had years of untreated sleep apnea. He had a stutter and has had a stutter for his entire life. And that affected him a lot growing up, and he was lucky enough to survive after coding twice, fractured ribs collapsed lungs, and six days in a medically induced coma. And what does that do to a 70-something-year-old body? If we had only looked at things earlier, could we have prevented this problem?


And so that’s kind of where my concern over the airway and the relation to the tongue came from. And I just think that if we can address these little ones when they need to be addressed, whether it’s an IBCLC catching them, or a dentist or a pediatrician or speech or language, maybe we can prevent these problems for adults down the line.


Jacqueline Kincer  [5:27]

I love your story. And thank you so much for sharing.  And for our listeners who might need to play a little bit of catch-up if they haven’t been following along with either of us on social media, what we’re going to get into on this podcast, we’re going to nerd out a little bit here, because there’s so much clinical evidence and science behind this. But, an untreated tongue-tie at its core is really an airway issue. And when you can’t breathe, well, you can’t eat well, and you can’t do a lot of other things in your life well. And that can absolutely lead to sleep apnea. And sleep apnea leads to those kinds of cardiac issues like your father had. And it’s very scary.


We know from studies, that having sleep apnea can take another 10 years off your lifespan. So this is not a light issue. And what I don’t want, though, is for parents to hear this and freak out with their Owlet monitors or whatever go. Is my baby breathing okay? Don’t need paranoia here!


Dr. Liz Turner  [6:24]

Definitely not.


Jacqueline Kincer  [6:26]

But what we’re saying is that disrupted function, beginning in early life, doesn’t get better on its own, it doesn’t go away on its own. And it causes a lot of huge problems later on. And you mentioned speech in particular.


So, I would love to hear from your perspective; maybe what are some of the things that you see when we don’t get those ties examined and treated early on? Maybe some of those complications, what are people coming to you for in terms of dental work and things that need to be done that we could have maybe avoided had they gotten some earlier intervention?


Dr. Liz Turner  [6:43]

So from a children’s perspective, as we go through the life phases, from a children’s perspective, there are a lot of behavioral issues that children are medicated for these days; one in five children is medicated for ADD or ADHD. And I’m not saying all ADD or all ADHD is a sleep disorder. But we are one of the few countries that don’t test for the quality and the quantity of sleep before we medicate a child.


Well, with those medications, we put them on come side effects, which lead to more medications. And if we could just test to see if children are getting the quality of sleep before we medicate them, I would think that that’s a less interventional way off and a less complex way of treating somebody.


So behavioral issues, dental crowding, we see a lot of open mouth posture and open mouth breathing, forward head posture, we see a lot of bags under the eyes.


Jacqueline Kincer  [8:04]

And why is the, I just wanted to interrupt really quick, why is open mouth breathing a problem?


Dr. Liz Turner [8:09]

So nasal breathing is essential to health; we get more oxygen, useful oxygen into our bloodstream, if we’re breathing through our nose because there’s a component that’s released by our paranasal sinuses called nitric oxide. Nitric oxide is kind of the key for your body to be able to utilize that oxygen.


So if you’re not breathing through your nose, what’s going to happen is that what would be warm, filtered, humidified air as passes through your nasal passages is meant to is going to go through your mouth.


So we see a lot of inflamed tonsils and inflamed gum tissues, especially around the front teeth. So if you notice your child, when you’re brushing their teeth, that the front teeth, when you’re brushing our gums around them are particularly red, or maybe they do some bleeding, or the child really doesn’t want you to brush because maybe it hurts, that could be because they’re breathing through their mouth and instead of the nose doing the filtering, that it should be that the gum tissues and tonsils are doing that.


And I have a lot of parents come and say when I point out the tonsils and say, oh, those tonsils, they look like they could be a bit enlarged. They’ll say, Oh, I had my tonsils out too. And so a lot of it’s an ear, nose and throat issue and ENT issue, and that’s where we have to collaborate a lot as to when is the safest time to address these? How do we address them? Sometimes it does involve surgery, and sometimes it involves just working with the child to get them to break through their nose more efficiently.


Jacqueline Kincer  [9:45]

That’s really important that you said that. And you mentioned how nitric oxide is created in the nose through nasal breathing.  And one of the things I see with breastfeeding moms is often they don’t realize that they might have a breathing issue from an underlying tongue-tie or something else, and they might experience something called vasospasm.


So it’s a pain in their breast. And when we do something to create more nitric oxide in their body, which is a vasodilator, that vasospasm goes away. And so, a lot of the time, it’s not just needing to apply heat packs or all these things you might want to Google about vitamins and things you can take for vasospasm.


If you’re still mouth breathing, and that could be at night, maybe you don’t really do it during the day; you’re not going to get that correct circulation like you’re saying. So this is something that not just affects babies and children but even breastfeeding moms directly. So it’s interesting.


Dr. Liz Turner  [10:40]

We do see that there’s a relationship between erectile dysfunction and sleep apnea or sleep-disordered breathing for the same reason that nitric oxide is a vasodilator. So it doesn’t pass babies and moms; it affects men too!


Jacqueline Kincer  [10:55]

Every man is like now I’m going to go get a sleep study done!


Dr. Liz Turner  [10:59]

I think that’s true!


Jacqueline Kincer  [11:00]

It’s true, though! I mean, we’re not lying! The science is there. And what I love is that you’re not just a pediatric dentist; you’re a general dentist, so you see people across the lifespan. So you bring this really valuable perspective in, and I would actually love for you to chat a little more about when we do treat the ties and what happens when it’s corrected? And if you could talk a bit about your experience with that.


Dr. Liz Turner  [11:27]

So we want a team approach because what I do is allow the tongue and the lip to physically be able to accomplish the goals that it needs to, which is removing milk from the breast but also resting in the correct position, which is on the roof of the mouth.


And without the team approach to get the function down, then we may not see full success and release, even if it’s a full release, even if parents do the aftercare. The studies all show that yes, we do get improvement, but it really is working with functional providers or bodyworkers to make sure that everything is going as it needs to and we can accomplish those goals.


So when I talk about to parents, the aftercare, it’s always easier to treat a baby when they’re kind of fresh out of the womb, because you have a lot, number one more time to work with that child is doing tummy time. And in doing the aftercare exercises, the gentle stretches and you can associate those with all different things, whether it be feedings, whether it be tummy time, instead of having to have, I actually had to have my toddler rerelease, because, with my father in law’s experience, I did not do the aftercare as I should have, as I did not understand the importance of it.


I can tell you that it’s a whole lot more challenging to do aftercare on a one-a-half-year-old who does not want to have anything in his mouth beside his own toothbrush when he’s brushing his own teeth.


So, when we’re looking at it from a professional perspective and ease for the parents, and also what’s hopefully easier for the baby to figure out the feeding patterns when it’s earlier, and I’m sure you can attest to that, that it’s easier for the baby to kind of convert back to the proper pattern than waiting until they’re a little bit older, then we don’t get the tongue thrust in the swallow and things like that.


Jacqueline Kincer  [13:41]

You’ve really hit the nail on the head. Absolutely! The earlier we get it treated, the better. And I think that’s a question you probably get asked a lot when’s the best time? Do I need to wait until the baby is XYZ old? And, of course, there might be some situations where you don’t want to treat them right away. And those are decided by that provider who’s going to do the procedure like yourself. And sometimes I might see something where I’m like, you know, I don’t know like this baby has a heart condition. Maybe that’s why things aren’t going well. Let’s do a wait-and-see. I’ll do my thing. If it doesn’t get better, then we know.


Dr. Liz Turner  [14:13]

Or like women who’ve had traumatic births, and they have the baby has torticollis, or they have a preference to lay to one side. Well, it may be better to make sure that the baby’s feeling comfortable in its own skin and that everything is well-aligned. Birth is a traumatic thing for a baby. It’s natural, but it’s a challenge. So those are all times I maybe would wait to do a release.


Jacqueline Kincer  [14:43]

So true. And you mentioned the bodywork, and I definitely will bring a bodyworker on here to go into that topic specifically, but like you just mentioned torticollis yesterday, I had a client and this baby, Mom had been told, yes, there’s a tongue the tie. No, there’s not. And so she’s like, I don’t know what to think anymore. Can someone else just come in and tell us? And I mean, I saw it when the baby was crying. So it was there, right? It was, obviously.


But I said, Hey, your baby, though, and they talked about it right at the beginning appointment, they’re like, we can’t get him to turn his head to the right, he cries, he seems uncomfortable just laying down, and I was like, well look like, yeah, I can see how the ties are playing into things, and breastfeeding isn’t going well, despite everything that we’re doing. But if you decide to go get that release, while he’s that asymmetrical, one, maybe the release itself isn’t going to be….like the provider would do a great job, but there’s more tension on one side than the other. So trying to do a surgical release on some tissue may not turn out symmetrical. Once that torticollis corrects, now, you’re gonna be like, Oh, that looks a little askew under there, or they’re gonna heal with more tightness on one side than the other.


And so if the tongue, if one half, the tongue moves, great, and the other doesn’t, or we kind of did a procedure, but we didn’t do all the other things that we should be doing. And I think that’s a great example. Because we need the functionalist as much as we need the proceduralist, which is you. And that team approach is so so needed like I always tell people, it’s like, I feel like I’m like a salesperson for all the other providers. Because I’m like, it’s not just me, I promise! You will need more visits with me if you do not get the help of these other people. And it sounds like you found the same in your practice.


Dr. Liz Turner  [16:37]

And that’s the thing about the frenulum. We can all look under our tongue, and we all have a band of tissue, or some people call it a string or some people call it a chord. I think it’s a lot more dynamic than that. But we can all look under our tongue and recognize that there’s some type of a tether. Well, is it a tether that allows for proper mobility? Or is it a tether that’s interfering with function?


So not everybody needs to look under their own tongue or their baby’s tongue or their child’s tongue and say, Oh, my goodness, they have a tongue-tie. You need to look at the symptoms. You could have a child who is speaking properly, eating properly, and never had a problem breastfeeding. And yes, they have some type of a tether that you can see. But that doesn’t mean that it needs to be released. And that’s the same thing with babies too.


And so, by working as a team, we can make sure that we’re not putting babies under procedures that they don’t necessarily need. And like you said, it might be a cardiac condition or something that’s interfering with feeding or might have been the torticollis. that’s interfering with feeding. So there are a lot of different players.


Jacqueline Kincer  [17:39]

Yeah, no, absolutely. And I wanted to go back to a point where I think I might have cut you off a little too soon. But you were diving into breathing and sleep and those sorts of things. And you had mentioned that your son was falling asleep at the breast, which I think was different from what you meant by sleep overall. But I would love to hear more about the connection between sleep and tongue tie, as you mentioned,


Dr. Liz Turner  [18:07]

So I went a bit into what happens for children and some of the common things that we screen for also, bedwetting is another one, but when it starts to come to adults, I mean, a lot of adults are told that as you get older, you don’t need as much sleep, oh, I have to get up to the bathroom to go to the bathroom. And that’s normal because I’m just very hydrated.


Well, these things are normal; that clenching is related to stress, that TMJ pain, it’s just something you have to live with. Well, a lot of the manifestations of untreated tongue ties that can lead to airway issues are TMJ pain, especially in women; we have less testosterone than men. So we experience pain differently than men. Not that we don’t have higher pain tolerance, but the way we experience pain is different.


So TMJ pain, clenching, and grinding muscle tension in your face, in your back. We see a lot of like I said, people waking up in the middle of the night to use the restroom or not dreaming at all; a lot of the physical things that we’re looking for is that they’re these little bony growths that can form on the jaw. They’re called Toray. And people actually go to the emergency room thinking: I have a tumor.


Really what that is, is you’re able to clench four times harder than you’re able to chew. So think of chewing an almond, and multiply that by four. That’s how much your body is clenching in the night or grinding in the night. And your body’s reacting by forming bone so that it doesn’t break.


And our bodies don’t wake us up from complete sleep, but they take us out of the deeper phases of sleep, the really restorative phases of sleep. So when I have patients come and say I don’t feel rested after eight hours of sleep, I’ve just always been a light sleeper. I have insomnia. I wake up at 4 am. I can’t go back to sleep. Those are all major, major red flags that something’s going on in that sleep cycle that has to do with lack of oxygen.


Jacqueline Kincer  [20:19]

Yeah! That’s incredible. And I’ve seen that too. And especially I think there’s this idea to with being a new parent that what we expect to be sleep-deprived and things like that, or that pregnancy, that you’re not going to sleep well. But there are definitely people that go through those times in their life that don’t seem to lack energy or still sleep quite well despite being woken up frequently, they can fall back asleep very easily. And things like that. It doesn’t mean something’s wrong with you, like, oh, I just have insomnia or whatever.


Maybe that’s not actually a true characteristic of you. It’s due to a physical issue that’s disrupting your sleep. And it’s so important that we really do listen to our bodies; our bodies are trying to tell us things. And we’re over here like, well, you know, my jaw hurts. So whatever, like, it’s just expected, or I’m older, so I’m going to get up and go pee two times a night. And, it’s just kind of culturally accepted, right? Even in movies, we might see that or a commercial of some pharmaceutical for overactive bladder or something. But we’re normalizing it.


Dr. Liz Turner  [21:31]

I’m on a med!


Jacqueline Kincer  [21:32]

Yeah, great. Yeah. But there is an underlying cause. And I think what a lot of listeners would love to hear and one of the things that are just always fascinated me about learning more about this topic and working in this field is the tongue and how important our tongues are.


Dr. Liz Turner  [21:50]



Jacqueline Kincer  [21:51]

And I’m sure you can probably do, maybe even a better job than me of explaining how the tongue is supposed to function. Because that’s a piece that we’re not taught, right? We don’t go to elementary school and learn that. I mean, we know there’s a tongue in the mouth, but that’s basically it. And I don’t know, you went to Tufts, and I know they have a great program there. But I think a lot of dentists maybe don’t even learn that much about the actual tongue function. So I’d love for you to describe more of that for us. My memory of learning about the tongue was learning where the taste buds were and what their different names of them were.


Dr. Liz Turner  [22:30]

I remember learning about the actual function of the tongue and how complex it is; it’s a muscle. And so when I talk about tongue tie and airway, if you have an airway issue, if you have sleep apnea, it doesn’t mean that you have a tongue-tie. And if you have a tongue-tie, it doesn’t mean that you have an airway issue. But the two go hand in hand. And the reason is that if the tongue cannot elevate fully to the roof of the mouth, up to the palate, what happens is the arch, the top arch maxilla is going to develop very narrowly. And what we get is the elongation of the face; we get a narrow, narrow arch.


Sometimes people call that an overbite like the top teeth stick out over the bottom teeth, so we can get an appearance like that. But what’s happening in the roof of the mouth is the floor of the nose. So if that roof of the mouth is really high up because the tongue hasn’t been able to push everything out and flatten it, then you’re gonna get constriction in the nasal passageway. And that can also affect the airway in the back of the mouth as well because the tongue it’s kind of tied down to the hyoid bone, which is the bone kind of where Adam’s apple sits.


And in that compression in the back of the airway, it’s all muscle and tissue, so we can get restriction back there. And people are different. Some people have a nasal restriction, some people have an oral restriction, and some people have both, but ultimately, the tongue-tie is a major player in creating or not creating the proper airway space.


And when we think about cranial development and skull development, our maxillary bone and our jawbones are 75% developed by the time we’re four years old, which is why that emphasis on breastfeeding is so essential from a nutrition standpoint, but also from a developmental skeletal point. And the skull, it’s got a lot of important things up there nerves, blood vessels, your brain, your eyes, and all of that is meant to develop a certain way. And if it’s not allowed to do so, well, we can get things like astigmatism in your eyes and glasses, things like that.


Jacqueline Kincer  [24:50]

Oh my gosh! I was literally just gonna mention astigmatism. I learned this from you; you probably know him. Dr. Lopez. He’s an osteopath in Colorado. I’d love to bring him on the show just because I read an article.


Dr. Liz Turner  [25:05]

He’s wonderful.!


Jacqueline Kincer  [25:06]

Yeah. Oh my gosh! You have to tell him so we can get him on!


Dr. Liz Turner  [25:09]



Jacqueline Kincer  [25:10]

I reached out to him because he wrote this incredible article about cranial facial development like you mentioned, and impacting the orbits that’s kind of the upper part of the midface, and that can cause astigmatism, and I went to my eye doctor, who is amazing. And I think I’ve mentioned him on the podcast before. And I was like, Hey, I read this article from this osteopath, and it said this. And he was like, you know, I have to be honest, that’s never been discussed in my school or anything, but he’s like, that absolutely. Makes sense to me. He’s like, no, your eyeball is squished! So that’s astigmatism! And I was like, wow! So do you think that everybody with astigmatism has a high palate? He’s like, I might just start checking. And that’s the thing like when our ophthalmologist ever taught that well…



Dr. Liz Turner  [25:54]

They’re not taught that!


Jacqueline Kincer  [25:55]

And this is someone who lectures out of school. Yeah. And he’s like, I’m at a school. And that’s not talked about. So yeah.


Dr. Liz Turner  [26:02]

I mean, whether that’s something that they want to implement in their education or not, I do think it’s important for other providers to recognize that the body, it’s one piece, but it’s so multifactorial, and you can’t just separate the pieces of the body into certain modalities as we have without recognizing that they’re all related.


I mean, it’s like, okay, well, go see your ENT, go see your Neurologist, go see your Nephrologist. And I mean, I talk to a Nephrologist, I have some Nephrologists in treatment. And they’re more forward-thinking with this airway because they look at the blood gases, and they see high levels of calcium bicarbonate, which is a buildup in your body because your body is not able to read the system.


And so it’s really interesting how the airway kind of plays into every single modality of the provider. And like we were talking about the orbits, the sinuses, if you have constant sinus problems or postnasal drip, or you had to have your tonsils and adenoids removed, that all relate to your airway and how well you can function.


Jacqueline Kincer  [27:12]

Yes, that’s such an excellent point. And like you said, the body isn’t isolated into these pieces. In the beginning, we talked about heart issues. This is something where we need everybody involved. We need cardiologists involved with doctors involved. We need dentists involved, we need Lactation Consultants involved, we need Speech-Language Pathologists; it’s a massive list, right? We could just go on and on.


Primary care people, even urgent care sometimes, right? So we don’t really need everybody to know this information, which is why I’m so glad we’re doing this episode. And you mentioned something about breastfeeding, that cranial facial development, and how certain things are mostly developed by age four. And this is one of the reasons why I’m so passionate about what I do is because when breastfeeding is dysfunctional, so a baby that has a shallow latch, for instance, and they’re just kind of on the nipple, or they don’t have what I would say is functional breastfeeding, so they are breastfeeding, but it’s not functional, it’s not optimal.


So we’re just getting by. Maybe they’re doing some compensations, other things that themselves actually disrupts their genetic programming for they’re creating new facial developments. So they’re supposed to have these broad dental arches like you’re describing. They’re supposed to have an upper and lower jaw that is equally forward, not one over the other necessarily. And Breastfeeding can create that. But breastfeeding that’s dysfunctional will create those Elongated faces, those narrow arches, things of that nature.


And that’s what I want parents to understand more than anything; in a lot of ways is like just because you can speak doesn’t mean you don’t have a speech problem, right?


It doesn’t have to be a full-on stutter to say that you might need some help with your speech function. Just because you can breathe through your nose doesn’t mean that that’s happening optimally, right? You could have some obstruction that’s actually causing other problems. And I love that you’re saying that because you’re not saying well; just because you have this means you have that, but it does warrant some investigation. Is that right?


Dr. Liz Turner  [29:20]

Absolutely. And I think that the other thing to touch on is that, yes, we do have a genetic profile; we should have 32 teeth. 32 teeth are all of your teeth and your wisdom teeth, and you know, who do you know that still has their wisdom teeth? I know very few people, and I look at teeth all day.


I have a few patients, though, who were able to keep their wisdom teeth, and a lot of them were raised in a different country where the diet was different. So it doesn’t just come down to breastfeeding, but it comes down to what we go ahead and feed our children. I don’t like to call it baby-led weaning because there’s a very specific kind of protocol for baby-led weaning, but the idea is that we’re feeding our children purees and packets. And processed foods are really interfering with the musculature of the jaw and the skull and the ability for it to allow all of those teeth to erupt the way that they should.


So we see a lot of crowding, we see a lot of need for extractions, it was very popular over the last 60 years to actually remove extra teeth, or braces, because, oh, your jaws just too small, or your teeth are too big for your mouth. But we shouldn’t have to do that if we’re getting the type of nutrition and we have the functional component when we’re in our younger years. So I will say it’s like, impossible; my kid will not eat raw vegetables ever. And maybe I just need to try harder, but we all have to recognize it. Convenience is important.


And when we’re in our car, he’s eating Cheerios, but I do try and make him eat things like chicken and dried mangoes and things like that. And a lot of the pediatricians, too, say, well, it’s a choking risk and things like that. But the tongue, if it’s able to function properly, shouldn’t have choking issues because the tongue should be able to lateralize and elevate and form the bolus of food that the body needs to swallow appropriately and not choke.


Jacqueline Kincer  [31:33]

Oh, you are so right on! And for moms that I hear, Oh, do I have an oversupply? Or my letdowns too fast. And that’s why my baby’s choking. And I’m like, Nope, it’s because their tongue isn’t able to handle the flow of milk. There’s nothing wrong with you.


And I think that’s the message that so many moms are getting from health care providers that don’t have the same functional understanding that we’re describing is they’re basically assuming, oh, it’s my problem. And I’m like, No, actually, you’re doing just fine. Your body’s doing everything it’s supposed to be doing, but your baby is struggling. And that doesn’t mean they’re broken or not this beautiful miracle that you brought into the world. And I had a hard time with that! I was at a class this past weekend through the breath Institute. And they are just fantastic.


Dr. Liz Turner  [32:21]

But they had a wonderful panel of IBCLCs, like yourself, and there was something that I just really wasn’t aware of. And that was your body is going to make as much milk as it needs to for however many babies were born.


And the hormonal changes that are happening in your body, you still have a really high level of hormones up to like, months two to four.


And if that milk isn’t being removed from the breast, and you can correct me if I’m wrong, but if that milk isn’t being removed from the breast, but you still have that oversupply, your baby may be getting the milk, because it’s just drinking what’s being thrown at it because your body’s compensating because it thinks eight babies were born. But then, as soon as that hormonal shift happens, you could dry up. Correct?


Jacqueline Kincer  [33:12]

Yeah. And that’s where I hear, I cannot tell you how many times I’m just out and about; maybe I’m getting my hair done or something, right? And someone’s like, Oh, what do you do? I’m like, I’m a Lactation Consultant. And then everybody’s got a story, right? Even if it’s a guy. Oh, yeah, my wife, you know, but I will hear from so many women. They’re like, Oh, yeah, I breastfed in the beginning, but my milk just dried up at three months. And I’m like, Huh, that’s funny that that coincided when we switched from that endocrine, which is the hormonal production of milk, to the autocrine, which is how much milk and how efficiently is it removed from the breast decides how much milk is made.


And sometimes it’s a very sudden, overnight shift where moms are like, I don’t get it a week ago, my baby’s doing great, and now he comes to the breast. He’s fussy. I can’t pump anything. And you’re like, Yeah, well, that’s because that oversupply was there like you’re describing and often to these babies who are struggling, if they have to work harder, they get some lactic acid buildup, they’re sore, well they go to the breast for comfort, they may be nursing more frequently than what is really normal or because their function is disturbed. They’re swallowing air, their tummy is hurting, and then sucking and swallowing soothes the tummy.


And so they may have been great weight gainers in the beginning, or they may have nursed very frequently, but they weren’t nursing efficiently. The latch wasn’t right, or they couldn’t generate enough suction in their mouth. And it’s the same thing as if you use too low of a pump setting on your breast pump, you’re not going to make as much milk eventually.


We can’t assume that their mouth is just working great. I love that people say baby’s mounds are more efficient than your breast pump. Well, generally, they’re supposed to be, but they aren’t always, and we can’t always rely on that to be the indicator.


Again, not to create paranoia for anyone who’s listening. But if that’s happening to you, you’re in that two to the four-month postpartum period. And you’re like, what is happening? I had milk, and it’s gone. That’s probably not so much your issue unless you took a medication that could have impacted your milk supply, but it might be a baby issue that needs to be looked into. So I’m glad you brought that up.

You also mentioned reflux or air aphasia-induced reflux.   Let’s get into the nitty-gritty with that.


Dr. Liz Turner  [35:31]

Well, it relates to adults too. And it’s so so common, and then we medicate babies for reflux. And yes, maybe they do have reflux, or they’re allergic to lactose. And I know you go into that in some of your masterclasses and things like that when it comes to food intolerances, but maybe you’ve done everything that you can in terms of eliminating foods from your diet and your baby still has reflux.


Well, it may be a functional issue because, especially if you are supplementing with bottles, and I went back to work after six weeks with my first and now looking back, I’m like, whoa, boy that was tough, but it’s also the reality of a lot of us, and so bottles are necessary, be it breast milk or formula, but the baby doesn’t have to do the work it needs to, and it doesn’t have to have the same seal that it needs to so we are swallowing air, and that can lead to reflux. And we see a lot of GI, I don’t want to say food allergies, but possible food intolerances, inflammatory bowel syndrome.


Jacqueline Kincer  [36:55]

I’m gonna have to have you repeat that because somehow, we had a little glitch in the Matrix. Okay, you were saying? Um, hold on. Okay, you’re talking about reflux? Oh, you just started to get into, like irritable bowels, and things of that nature.


Dr. Liz Turner  [37:21]

So this goes into the cardiac stuff too. But when we start to think about adults, the sleep-disordered breathing that can come from not recognizing these things earlier can lead to a lot of IBS and food intolerances; there’s going to be a lot of research coming out down the line about the link between disordered breathing and certain food intolerances and things like that.


But those inflammatory processes also work into cardiac disease, diabetes, and even cancers that are linked to sleep apnea. And I don’t like using the term sleep apnea because everybody thinks, oh, 400-pound man, but there are so many different facets of sleep-disordered breathing, and I like to couple them all into that and no, breast cancer, prostate cancer of, pancreatic cancer, I believe have all been linked to sleep-disordered breathing.


Jacqueline Kincer  [38:13]

Absolutely. And as one of my mentors and friends, Roger Price, calls it, he says it’s not even sleeping disordered breathing; he calls it breathing disordered sleep. And I like that. I really like that. I like that distinction.


And like you said, about sleep where you’re not getting into those when your sleep is disrupted, and you think you’re a light sleeper, or you’re an insomniac. And, of course, moms are waking up with babies, but your body doesn’t get to go into that deep sleep where you have a restorative time where your body heals itself.


So when you’re talking about gut issues and things, well, yeah, our gut heals itself every night when we’re asleep, it’s supposed to, but if you’re not getting into that state, those specific brainwaves where that’s allowed to happen in your body. And then, on top of that, if you can’t breathe well, you’re getting raised cortisol levels. So those stress hormones are in your blood; those don’t just decline because you woke up for the day. In fact, most of us are hitting the coffeepot first thing in the morning. So we’re really jacking up those cortisol levels and compensating for the lack of sleep we got the night before. And now you have this vicious cycle of just your whole body chemistry being thrown off.


So, as many studies as we’re seeing, like you said, linking these things to cancers and various things, I’m sure more and more will come out because this stuff is going to get revealed because I feel like not just parents, but just individuals these days are taking health into their own hands, and they’re like, I’m sorry, genetics or whatever is not an answer for me.


There’s a reason why and if I could acquire this condition, I could probably get rid of it too. And so we’re seeing functional medicine and these things come out which is absolutely incredible, but I feel like we’re all just scratching the surface because as much as you and I know, we know a lot more than maybe a lot of people, but we’re still like, well, there’s so much more to learn at least that’s where I’m at!


Dr. Liz Turner  [40:10]

And that’s one simple question you can ask yourself and ask your children is, do you dream at night? Or does your child have nightmares, because there are four stages of sleep? And some of them are body restorative, and some of them are mind restorative. And if you don’t have one, then the puzzle can’t be put together and the link between the lack of REM sleep or dreaming mind restorative sleep, and Alzheimer’s is impossible to ignore.


Without that phase of sleep, where we’re reading our body of the build-up in our brain every single night. And also our ability to solidify our memories and form new memories and creative processes. And we can end up with mental components down the line, too. So, yeah, it’s all linked.


Jacqueline Kincer  [41:01]

Absolutely. And you know, mental health, we’re talking about that on another podcast episode that I have. But, it’s so important that we have to take such good care of ourselves.


And so if you’re a breastfeeding mom, and you’re listening to this and going well, yeah, you know, obviously, I’m sleep-deprived because I have a baby. Or maybe you have more than one child and are challenged. But let’s also just take a moment to have you check in with yourself and go hmm, but was this an issue just because the baby came along? Or have there been some patterns in my life before I became a mom, that you might want to think about looking at? Because if you don’t take good care of yourself, well, you know, you want to be around for your children. Right?


And we’re not trying to go doom and gloom over here. But it’s an important consideration. And this is why it’s really important to consider that some things in your baby that you might have read or been told or thought of, oh, well, you know, babies just spit up. Well, how much of that reflux would we really consider to be normal? And is any of it normal? And, what’s going on there? And like you said, it might not be an airway issue. It could be something else entirely.


But these sorts of things. Babies that don’t sleep well, right? That they wake up every hour. Oftentimes, I discover some airway issues. And now and I think airway is getting attention because I saw an influencer on Instagram the other day, she kept posting about all these nasal aspirators for babies on Amazon because she had a baby. And I was like, you know, that’s actually really great, though. Because if your nose is clogged, it doesn’t have to be related to tongue-tie or anything. Maybe it’s allergies or you’re sick.


Well, you’re obviously going to breathe through your mouth. And so there are even small things like that. So I’d love to hear from you, your perspective when it comes to a breastfed baby. What are some of the things if you could maybe make a little checklist or something for parents? What are some things that they might want to think about and look at when it comes to their baby? What are some things they could do? And I guess I kind of threw one on your checklist for you, which was to make sure your child’s nasal passages are clear. But, what are some things that you would suggest that they look at if they’re wanting to know, are things going in the right direction with my baby’s development in terms of the stuff we’re talking about? Or should I look into something?


Dr. Liz Turner  [43:22]

Yeah. So when it comes to the babies, I mean, Michelle Emanuel, who is the one who kind of trademarked tummy time method, she speaks a lot about open mouth posture. And that starts in infancy. I mean you can even see some sucking in the womb.  So we need to work on developing that musculature.


And one thing that people can do with their babies is just if they see their baby sleeping, and they have an open mouth posture, just gently shut their mouth and release it. If it has to drop open again, well, maybe we need to check and make sure the nasal passages are clear too.  But just encouraging that closed mouth posture to allow the nasal passages to function as they’re supposed to be one good thing.


Also, you spoke a little bit in your last podcast about positioning for breastfeeding, and we’re meant to breastfeed in movement at the same time. And I understand we need to sit and relax and let our bodies heal from childbirth, but our babies should be getting stronger, and they should be strong enough to be able to support themselves to a certain extent, as they naturally would get the food that they need.


So I would think that making sure that you’re varying your position for breastfeeding and not always constantly doing it one way. Even making sure, and this is something that maybe you can speak about more but making sure that both sides are getting utilized. Maybe one doesn’t produce as much but still using that side, if you can, I mean, I would think that from a functional standpoint for the baby that in a developmental standpoint, it’d be good to keep things symmetrical and not just unilateral.


Jacqueline Kincer  [45:13]

That’s a good point. Yeah. And I think to add to that about positioning, that it is important for it to be varied. Like, once you’ve got one down, you’re like this works! Now we can venture out and try some other ones.


But when I see moms who, let’s say they’re like, well, the baby only latches on the right breast and the football hold, but I can do cradle hold on the left breast, well, that means your baby is always laying on the same side of their body. So they’re basically always latching the same, and now we’re reinforcing that asymmetry.


So maybe they’re feeding off both breasts, but they’re asymmetrical in terms of their function while they’re feeding. And you mentioned tummy time, which is so great because that’s a great way to improve function, not just developmentally for milestones for your baby, some people think about it, you know, oh, yeah, to get them to roll over and sit up?


Well, yeah. But also, it has a lot to do with breastfeeding, because breastfeeding is not just postural for the mom who’s latching the baby, but it also is for the baby. So you’re talking about the posture of the baby, which is again, so important, that movement.


Babies stuck in car seats all the time, I’m sure you could agree, they’re not really breathing optimally. And they have to be in there, right? We don’t want anything bad to happen to your baby in the car. So we’re not saying don’t put your baby in a car seat, because they can’t do as well. But we’re saying it’s just for the car, they need to be out and be doing different things with their bodies when they’re not in that position.


Dr. Liz Turner  [46:32]

And I have to say, there is so much that, I don’t want to say I would do differently with my son, but I would have thought twice.


Like bringing the car seat in and setting it on the ground because he’s sleeping and, yes, we can do that at times. But there were times that I just did it out of convenience. I just didn’t want to wake him up because there were other things I wanted to do.


And looking back I wish that maybe I had repositioned him into his crib so that he could lay flat and things like that. And even down to the things that I fed him or fed myself and all that. But I mean, you were asking about things looking for breastfed babies, and could there be concerns?


Well, yes, like you were talking about the congestion in the nasal passages, clicking, falling off the breast, falling asleep at the breast, all of those things, reflux. And really, really long feed times. They’re not accomplishing their goal. And so then they’re hungry again really quickly.


But then in children too. I mean, I think it’s important for parents to just pop in and look at how their child is sleeping. Also, look for that open-mouth posture, and see if their covers are thrown all over the bed. And I have kids who tell me all the time. Oh, yeah, I kick my covers all over the place. And then when we start to put the pieces together, mom will recognize that you know, Child A has a tongue tie. A child B doesn’t have as much of a tongue-tied but has an airway restriction, and then also she’s got TMJ pain. And all of this stuff is so interconnected, because there’s a genetic component that comes into it, too.


Jacqueline Kincer  [48:12]

Yeah. And, and I love that! Reminds me of my appointment yesterday again. I had the mom and the dad there and the newborn. And the mom’s mom is there. She was in town visiting to help the family out, which is always wonderful, right? I always love, like, let’s bring the extended family in those people who are going to be at home supporting you when I’m not there. And the poor mom, she was like, Oh my gosh, she’s like, I just feel so bad. She was talking about her other daughter who I think she’s like 18 or 19. But she’s going through I think palate expansion, a bunch of stuff right now. And she was saying about all these problems that she experienced with her as a child. And she started breaking down in tears. And she’s like, I feel so bad. This is the answer. This is what was going on. And I never knew and I’m like, whoa, whoa, whoa, hold on. First of all, you didn’t know! But she just felt so emotional because it’s an emotional time and everything with this new baby. And I’m like, but now you know, and now you can help her and she’s still young. So we’ve got some time here, right?


And I guess that leads me to my final question for you, which is because you do work with all ages. Is it too late? Is there a time when someone’s like, oh, gosh, yeah, I totally have these issues. But you know what I’m already 55. Like, there’s probably nothing they can do now. Is there a timeline? Like, it’s just too late for you? Or can we always treat these things?


Dr. Liz Turner [49:42]

No, I have my 45-year-old husband in treatment. And because when we look at the genetics, I mean, I had my baby, and then we had his father. And when we tested him he was 6″2 and slender and fit and healthy. But when we start to break down the physical attributes of his face, and then also his signs and symptoms, we couldn’t ignore the fact that he has severe sleep apnea. And so no, it’s not too late.


And I think that’s one of the exciting things about being a practitioner in this time is we do have options for patients of all ages, whether it be therapy to strengthen the oral musculature alone, or whether it be that the tongue release and an appliance, or one of those other things.


There are so many options. And not everything is specific for one person, it’s not like medication, it really requires an evaluation by a provider who recognizes these things, and we all grow differently. And we all look different. And that means our structural components are different, too.


So I do not think it’s too late to get help. And you did talk about that in one of your podcasts like, is it too late, and you talked about the 16-month-olds who, after not breastfeeding at all, were able to go back to breastfeeding. Full time after two weeks, and the body is resilient in it knows what it needs to do. Sometimes it just needs help. And it looks different for everybody.


But I do think it’s a really exciting time to be a provider as medicines changing, and people are looking for ways that they can help heal themselves in a less conventional, less interventional way.


Jacqueline Kincer  [51:36]

I love that. And thank you so much for sharing that perspective. Because I do find that this is an important question. While the focus of your podcast is breastfeeding, whenever I work with families, inevitably, the parents are like, well, maybe there’s something going on with me or my older child or, you know, XYZ and that is one of the questions where they kind of go, oh, well, you know, my kid already had braces. So there’s nothing we can do now. And, turns out there actually is a lot. And it’s an ever-evolving sort of field. And it’s really a great message that you had there. And I appreciate you sharing that.


I wanted to just ask you a question that I love to ask anybody at the interview, which is, you kind of maybe said it already. But if there was something that you could go back and tell yourself or maybe something future-forward, like you’re gonna have this new baby, very soon. So is there some advice that you would give yourself going forward? Or in the past? Or just a message for a mom who’s listening to this, that you’d really like for her to hear and take home?


Dr. Liz Turner [52:47]

Well, that’s an interesting question. I like to think that I’m a fairly relaxed mother. I have a fairly relaxed child and a fairly relaxed husband. And  I wish that I had just taken more time to just spend with my baby as a baby and enjoy him as he was, and it’s still hard. I mean, we, as moms I think we maybe aren’t expected to but we feel like we’re expected to do so much.


And I remember my doulas, I had two doulas, I was lucky to have two because one had to leave mid-birth. And they’re both fantastic. But I remember them coming over five days after my birth, and I was holding my baby-making them each a latte and running around the home. And it was like Why did I need to do that? Why don’t I just sit down and enjoy this space that I have with my baby for the time that I have? Because they’re only little once.


Jacqueline Kincer  [53:54]

Hmm, that is so perfect. And for those of you who don’t know, Liz did tell me that she’s like a former marathon runner. So I feel like that might be just part of your personality.


And I know there’s a bunch of moms out there like that, too. But  I think about that, too. Very similar. After I had my first I felt like I needed to entertain all the visitors that came over. And with my second I was like, first of all, I don’t really want visitors. Leave your food on the door and ring the doorbell text me when it’s there. I’ll go get it.


But just I didn’t do that. And it was so much more relaxing. And I just had the best postpartum because you’re already trying to please the baby and take care of that to please everyone else. I don’t know sometimes if we have the bandwidth for that. So thank you so much for sharing.

Oh, this was so great.


Dr. Liz Turner  [54:42]

I’m so excited for all of your future episodes, and I can’t wait to hear what you bring on next.  It sounds like you’ve just got a wide array of guests and I learned something new from every single one. So I already shared one of your podcasts earlier with a friend about exercise, movement, and getting your body back. And all of those things hit me really hard. I just needed to give myself a break.


Jacqueline Kincer  [55:08]

Yeah. Awesome. Well, thank you so much for coming on the podcast. I absolutely appreciate you.  And thank you all for listening. I don’t know about you, but I just learned so much. And I nerd out on this kind of stuff, as I said in the episode, but Dr. Liz had some amazing things to share with all of you. And I just love her whole-body approach. As we keep saying on these episodes, nothing happens in a vacuum. And it’s important to really examine what’s affecting our health. It might be something that we just didn’t take into account quite yet.


So if you found this episode helpful, I’d love for you to hop on over to Instagram. I’ll link up Dr. Liz Turner’s profile there where you can connect with her. I know she would love to hear from you.


So if you found this information helpful, feel free to share a little screenshot of this episode and tag her in your stories, or post or send her a DM I know that she loves getting feedback about the people that she’s able to reach.


And if you’re in Denver, and you might have some issues, absolutely go seek her out. I think she is just incredible. And I love that we have providers like her available. So thank you so much for listening, I will catch you on the next episode.

In today’s episode, Dr. Liz Turner joins us to talk about the dental perspective of tongue ties and how they impact breastfeeding. But this conversation goes even deeper into the things Dr. Turner sees in her dental practice everyday–from speech issues, airway problems, and so much more–we get into it! If you’ve ever wondered what would happen if you don’t get your baby’s ties treated right away, or what to look for in yourself or your older children, this episode is a must listen!!

If you enjoy this episode and it inspired you in some way, I’d love to hear about it and know your biggest takeaway. Take a screenshot of you listening on your device, post it to your Instagram Stories and tag me @holisticlactation

I’ve got a special gift for all my listeners and it’s 38 powerful breastfeeding affirmations to support you on your breastfeeding journey, so go get that free audio now at

In this episode, you’ll hear:

  • How tongue tie affects breastfeeding
  • Warning signs to look for in yourself and your older children
  • Why a team approach is always needed to treat tongue & lip ties