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Your Baby Feeding & Language Questions Answered with Nadda Warshanna

Episode Summary:

Today on the podcast, Nadda Warshanna, a certified Speech-Language Pathologist, Feeding Therapist, Lactation Consultant (IBCLC), and Sleep Specialist, joins me to talk a bit about almost all of those things that she’s an expert in! Nadda provides valuable insights and tips for parents, emphasizing the importance of recognizing food-readiness signs, removing the stigma around seeking support, creating a nurturing environment for language development, the dreaded tongue tie, and so much more. This whole episode was really a giant FAQ where I got to bring questions that my clients bring to me over and over again (as well as things I’ve wondered as a parent myself). This is one of those episode’s where you’re going to want to grab your journal or open the notes app on your phone. I can’t wait to hear your favorite takeaways!

Topics:

  • First food exposure that is safe and low pressure, and Nadda’s take on baby led weaning vs. purees 
  • Remember that gagging is a normal protective reflex when starting solids and when you should actually be worried about choking
  • Knowing when to offer breast milk while you’re trying to increase interest in solids
  • Overcoming the obstacles that come with asking for help so that you can feel confident at every stage of your parenting journey 
  • Permission to disagree with your pediatrician when it comes to specific needs for your child 
  • What to look for when it comes to your baby’s stools while introducing solids 
  • What to expect when it comes to language development in the first two years of your baby’s life
  • Tips on raising your baby in a bilingual home so that it’s beneficial and mindful to your baby
  • Tongue ties: what they are, signs to look for, and how to treat them

Resources:

About Nadda:

Hi! I’m Nadda “Ned-uh” Warshanna, a certified Speech-Language Pathologist, Feeding Therapist, Lactation Consultant (IBCLC), and Sleep Specialist offering infants + toddlers holistic therapy in the early years.

Connect with Nadda:

Read a raw, unedited transcript of this episode.

Brittni (00:01.093)

Hello, hello. I am so excited for today’s episode. I have Neda of 2Can Grow with us. And I just want to, I’ll quickly preface this by saying that the reason I’m so excited about this is because in addition to sleep, I think as parents we feel a lot of stress about feeding and language and all of that. And on top of that, they’re all kind of intermingled and connected. So this is a really…

important episode. I’m so thankful that you took the time to be here. And if you would just jump right in and introduce yourselves and tell us who you are and what you do.

Nadda (00:40.534)

It’s nice to see you and my name is Neda. I am I feel like I wear many hats So my first profession started as a speech-language pathologist and then when my sister had her baby her first baby I entered a rabbit hole of sleep and I became a sleep coach where then after that I became a lactation counselor and I just recently passed the boards to

now be a lactation consultant. So I’m an SLP, a feeding therapist, lactation consultant, sleep coach. And I primarily specialize in birth to 12 months, but really will work three and under all the early years of childhood offering feeding, sleep, and early language support.

Brittni (01:26.265)

Well, congrats on your IVCLC because I know that is not an easy feat and it just kind of ties together everything perfectly. So parents are so lucky to have you. I also have to say that we have the same sleep certification, so our views on sleep are very aligned. So one thing that I wanted to just, I kind of just want to jump right in and talk to you about…

Nadda (01:50.955)

course.

Brittni (01:53.513)

starting solids, because I know that this is a, it’s ever evolving, right? Like I, when my daughter was recently six months, it was more like I didn’t know anything about the tongue thrust, like for a sign of readiness. And so I think it’s ever changing. So what are some signs of readiness for starting solids?

Nadda (02:14.306)

Of course. So typically we’re recommending starting solids around six months of age when the gut is way more mature and babies exclusively need either breast milk or formula up until then. They don’t need any solids where we might hear some outdated advice on starting around four or five months. But typically we’re looking at six months and six months because some other signs that we’re looking for is

Brittni (02:29.542)

Thank you.

Nadda (02:38.634)

Being able to sit up with minimal support meaning like if you were to pop your baby down They’re not like leaning to one side or leaning the other side or leaning forward that they can sit up with good stability And have good head and neck control We’re also looking at their ability to like reach for items grab them and mouth them And I think the most obvious sign for most families where they think that their baby may be ready even if they’re not

quite ready is showing interest in food. And I feel like that’s the first time where we like see eyes open wide and leaning forward or opening their mouth, which is a very important sign, but we want to see that plus all the other signs to help us know like that a baby is fully ready for starting solids.

Brittni (03:20.261)

Thank you for that. And I love that you brought up like the being, seeing their interest, but also those other aspects need to be in play as well. Because I think I, I do see a lot of families where they’re like, oh, they started showing interest at four months. So we just started giving them solids. And what would you say to that? Like they need to have the other signs.

Nadda (03:40.01)

Yeah. Right, I would say it’s so great that they’re showing interest. And I would still recommend waiting at least until we’re closer to six months where we’re seeing some of the other signs of readiness. But there are also some things that we can do to help them be ready for starting solids. So this is between three and six months, especially is a great time to introduce oral motor mouthing teethers that are stick shaped, especially. I love stick shape because.

One thing that we’re going to work on when we start solids is chewing. And so stick shaped teathers allow you to practice munching, encourages the tongue to move to the side, which will help us manage different textures of food. But the other thing that we can do in addition to like teathers is resistive food teathers. So resistive food teathers are essentially a food that will not break down when your baby is exploring or mouthing it. Think of a carrot stick.

a celery stick, a pineapple rind. So it allows them to experience like the texture and the flavor, but they’re not actually consuming any of that food. So really good for sensory exploration, sensory mapping, getting their mouths familiar, but also building up some like jaw strength, stability, tongue movement for starting solids when the time is right.

Brittni (04:59.757)

And that’s fun too, because I think when we have little ones, we’re like, what am I going to do all day with them? These are simple activities that seem simple, but provide so much healthy sensory input for them.

Nadda (05:11.062)

And I think what also can be really great is I feel like, even for me as a feeding therapist, I get nervous with starting solids because I’m like, oh my gosh, they’re gonna gag, they’re gonna spit it up. And so these opportunities to explore with teathers, whether it’s food or just oral play teathers can help desensitize that gag and get baby more comfortable with things in their mouth. So you’re giving them this like oral motor sensory food experience before you really have to dive into.

Brittni (05:17.19)

Yeah.

Nadda (05:38.134)

the like offering the solids and being like, oh my gosh, what’s going to happen right now? So I find that that’s like also like low pressure food exposure too.

Brittni (05:47.417)

That’s great. The gagging, I wanna move on to baby led weaning versus purees and kind of your take on that. And then I’ll probably, unless you answer it, I’ll probably have some questions on gagging after that.

Nadda (05:59.914)

Yes. So I will say that I’m not like for baby lead baby lead weaning versus like purees. I think of purees is just another texture. So as adults we eat purees like yogurt, hummus, applesauce, mashed potatoes. So we eat a variety of purees. It is just one other texture that is good for babies. But we also want to be thinking of whole foods because

When we’re thinking of baby-led weaning, the whole purpose really should be about giving babies opportunities to explore and self-feed, but also to progress through a variety of different textures. And the reason why progressing through textures and not sitting on one texture for too long, such as a really smooth puree, is because that’s a completely different motor plan than eating solid foods. That doesn’t require actual chewing when we have an applesauce or a mashed potato. But when we have a sweet potato, we

or a piece of me, you actually have to have a completely different motor plan where we’re moving our jaw up and down and the tongue should be sweeping to the side. And so the more opportunities we have to offer a variety of different foods, the more we’re supporting their long-term oral motor feeding skill development. But I think that it doesn’t have to be so black and white where on day one you’re offering solids right away or you’re only offering purees. You can really take it at a progression that…

works for you and your family where you may start with smooth purees, but with the goal of progressing to maybe a chunkier puree and then working on a soft solid and then offering a harder to chew food. So you can kind of work through it in a way that feels good, or you can do it simultaneously and give your baby those different opportunities. And thinking back to the oral motor, like the teethers I was talking about, you can always use those teethers too as a chewing practice where…

you dip some of the puree into it where they can then mouth it or munch on it to give them those opportunities as well if you’re not fully ready for like offering a like chicken bone.

Brittni (08:00.233)

That’s great. And it’s so funny because I’m internally laughing at this because you know, when you’re a first time mom, you want to do everything perfectly. So I remember I was like fully baby led weaning and I don’t know why, but I like had it in my head that I couldn’t do purees, right? I’m like, okay, we’re doing baby led weaning. We can’t do purees. But I think that gives so much freedom in like do what feels comfortable for you and focus on the variety, which can take a lot of that pressure off.

Nadda (08:20.846)

Great.

Nadda (08:27.53)

Yeah, and I also like to think of like, purées are also to me so messy, and as much as I love messy sensory food play, it also makes me like just a little bit anxious where I’m like, this is gonna be a lot of cleanup. Like my least favorite thing about solids is the cleanup where I’m like, there’s even some benefits to offering the soft solids because the yogurt won’t like splatter everywhere. You won’t have like a mess of hair to clean up. I mean, you might still, but there are like pros to everything. I think the only.

Brittni (08:38.512)

Thank you.

Brittni (08:47.182)

Yeah.

Nadda (08:54.954)

like caution is like don’t wait too long before offering like before offering different textures and really trying to offer at least like even the allergens by like nine, 10 months where we can, we do see in the research that starting or like progressing textures later after that age can like contribute to challenges with feeding.

Brittni (09:18.217)

And one big question that comes up with baby lead weaning is the gagging. And I remember, gosh, this was probably one or two years ago. You did a really good post on like red versus blue, what that means for gagging and choking. So if you can go into that a little bit.

Nadda (09:34.602)

Yeah, so gagging is to be expected when we’re starting solids, whether it is a puree or a soft solid, it’s protective. It helps babies become more comfortable with foods, understand what size they’re able to manage more appropriately. So it teaches them like, oh, I actually need to take a smaller bite or that was too big, I’m going to push that out. And it protects them rather than like encouraging or being a cause for choking. Choking is, has much lower risk as

if we are preparing food safely and appropriately, and I think of it as like, if we put a food between our finger, like a soft solid, if you can mash it between your finger and your thumb and your pointer finger, it should be safe enough for them to manage and chew. But when we are gagging, what we might notice is that we’re still hearing some noise. It might sound like, I don’t even know how to describe the sound, but you’ll see like a grimace in their face. Their eyes might start to water, their mouth will open.

and they may propel the food out. And I find the best way that we can support a baby in that moment is by being calm and modeling what they can do instead of like trying to put our finger in their mouth or bring the food out. Cause putting your finger in the mouth can actually lodge food further back in the mouth and be a higher risk for choking. But what we can do is maybe.

lean our head forward, open our mouth and model like, oh, you’re trying to spit that out. Like that was really tricky. That was a big bite. Let’s try to get a smaller bite. And so we’re talking them and like coaching them through that experience. And most babies will want to continue to explore their food. And so I always look at their mood, right? Like you can continue the feeding if they’re like, oh, I’m going back for that piece and I’m going to try again. Or you can offer a smaller piece and just help them kind of manage that a little bit better.

With choking, we’re not going to hear any noise and it’s gonna be silent. And you’re going to, you may notice that their like complexion will change color a little bit more. And so that’s just something where we’re being mindful of. But in my experience, I’ve never had a family that I’ve worked with or a family or friend tell me of a choking experience when…

Nadda (11:46.134)

because they’re doing their best to prepare those foods safely. And there are lots of really good resources out right now that can show you exactly how to prepare those foods. So I’m thinking of the Solid Starts app, which I think is just a wealth of knowledge. And it’s amazing that it’s a free resource for parents, because you can look up any food, and it’ll show you how to prepare it from six to nine months, from nine to 12 months, from 12 months on. And I think there even is a recipe under each page of how you might even offer it to.

Brittni (12:13.861)

Wow.

Nadda (12:14.918)

your baby. So it’s a really wonderful resource for parents. Even their blog posts are just so informative with lots of really good tips that and like reputable trusted providers that you can feel confident being like, okay, I need some answers. Is this normal or like what should I do instead? You can check that out too.

Brittni (12:36.182)

I think it existed when Lila was starting solids, but I had no idea about solid starts. And now I’m like, oh my gosh, this is so amazing.

Nadda (12:43.25)

Yeah, it’s really wonderful. And even for professionals, they have like a directory for professionals and courses that you can take to, to just learn more. So I just find that they have really created a beautiful kind of team of just providers, so many different kinds of providers, not just like a pediatricians, OTs, SLPs, and medical providers who are coming together to create a platform that is really comprehensive for parents.

Brittni (13:08.301)

And I will, if you’re listening, I will link solid starts in the show notes so that you can easily access it. But speaking of solids, kind of moving on from that starting mark, I work with a lot of breastfeeding families and they get to that 12 month mark and they’re like, my baby is still obsessed with the boob. They don’t really like solids. Can you talk about kind of, is that normal? When should a family kind of start?

worrying or kind of looking into maybe we need to be talking to somebody or looking a little bit further into this.

Nadda (13:40.766)

Yeah, that’s a great question. And I have that often in my console. And what I will say is that right at 12 months, and it’s hard because we’re like at 12 months, your primary source of nutrition is solids now and we’re like, the last 12 months, we’re just like primary source of nutrition is breast milk or formula. And so I think it can be like an abrupt because we’re like, we want to start weaning off the pacifier weaning off the bottle, we want to also make sure that they’re exclusively eating their solids. And so

Brittni (13:43.961)

Yeah.

Nadda (14:07.53)

My first thing that I look at when we’re looking at, if there’s less interest in solid foods than nursing or having the bottle, I want to figure out why that is. Is it because we are grazing or snacking all day long, like having an all day buffet of breast milk or bottles or whatever it may be, or even a sippy cup or a straw cup with milk in it, or?

Do we have a structured day where meals are separated by two, two and a half hours apart with snacks in between where they are able to like build up a hunger drive to come to meal time? So I first try to look at like what is the current feeding routine and what is their schedule like to see are there modifications that we can make to just even increase their desire or interest in eating foods? Cause if they’re full off of breast milk, then it will be really hard for them to come to the table hungry and interested in eating. And so-

We might think about, you know, are there boundaries that we need to start setting or times where we’re saying like milk is We’ll have milk after lunch or we’ll have milk at nap time rather than just offering that breast milk whenever they ask for it right like every family can do what feels good for them But when we’re thinking about you know interest in solids that’s one of the first places that I go to the other things that I’ll look at to is

Are there certain textures that we’re having a harder time with when we’re eating? What kinds of foods are we offering them? Are we offering them at least one safe food on their plate during that meal time? Are they gagging all of their food? Or do they have any constipation or any discomfort that they’re experiencing that may tell us like, okay, let’s dig a little bit deeper. Could there potentially be reflux or allergy or intolerance that’s kind of deterring them from wanting to eat those foods? Or is it a lack of oral motor skills?

affecting their ability to manage different kinds of foods. So lots of different layers that were going on there. And I would say, if you are a parent who is feeling stressed about meal times, if your child comes to the table and they seem stressed about meal times, if they have a food repertoire of less than 20 foods, or you only can give them this certain brand or a certain shape or whatever it is of that food that tells me like,

Nadda (16:21.806)

There are some things we probably could look into a little bit more and could warrant a consultation. May not mean that you need full on feeding therapy, but I think it’s always worth a consultation if you’re worried. I encourage families rather than waiting and seeing to check and see because the earlier we intervene, the better for our kids and for you too as a parent and just having tools to be able to support them when you’re not with us.

Brittni (16:49.273)

I love that and it kind of relates to sleep, right? Like I work with so many families who choose not to sleep train and they’re like, they feel like they have to do it alone then, right? Like, okay, if I’m not sleep training, I don’t need support, but we need to see it as we can’t do parenting alone. It’s meant to be done in a village. And so that village might be a sleep specialist. It might be a feeding specialist. It might be a lactation consultant. And that doesn’t mean that there’s anything wrong with your child. It doesn’t mean that you don’t know how to do it. It just means that

Nadda (16:57.218)

Right.

Brittni (17:17.957)

You’re getting the support to help both you and your child.

Nadda (17:21.826)

And I also think that right like as when you become a parent, I’m not a parent yet but when you become a parent you’re like handed your baby and no one really people teach you about like preparing for birth and like setting up a nursery but no one really prepares you or helps you even understand what to expect when it comes to sleep or feeding or language development Where you’re like just left to kind of figure it out, but you don’t have to figure it out on your own, right? This is this is why there are

Brittni (17:33.585)

Hehehe

Nadda (17:49.426)

experts and professionals who are available and want to help you. And I think it’s just kind of figuring out like, you deciding when do you feel like you need that help or if you may need the help or your child may need that help. And knowing that like we’re available and providers like us, we wanna provide holistic care that really looks at both the parent and the baby that nurtures their attachment and like what is biologically normal. And so…

We’re here and it can feel like intimidating to also ask for help. And I think sometimes even for me, I feel like sometimes asking for help feels like a sign of weakness. But I think really it shows that, you know, our strength that we know when to reach out and when to get that support. And that there’s like never be afraid to ask for help. That’s as hard as that is. Like I’m looking at myself in mantra right now. That it’s okay to ask for help and like we want to help.

Brittni (18:35.28)

Hehehehe

Brittni (18:41.361)

Totally, totally. And one little follow-up there, which I’m sure you hear a lot too, is like they’ll be like, well, the pediatrician said everything is fine. So just kind of talking to the fact that pediatricians are great, pediatricians serve a purpose, but they’re not specialists in every area. And so if that gut feeling inside of you is like, okay, the pediatrician said everything’s great, but this doesn’t feel great to me, you don’t have to listen to exactly what the pediatrician says.

Nadda (19:09.706)

Right. And I think too, I always think of it as like, when I am feeling like I have migraines and I never go to my primary care physician for migraines, I go to my neurologist or when I have a skin problem going on, I go to my dermatologist. So we as adults are not going to our, we go there for a wellness visit or if we need to get papers for like immunizations or whatever for a job, but we’re not going there for very specific.

needs. That’s why we go to specialists. And it’s the same for our children where our general provider, the primary care provider, the pediatrician is there to make sure our baby is growing and thriving and they are getting whatever they need to support their health and wellness, but they are not specialists in these areas. They probably learn very little in medical school on speech and language development or on sleep or feeding. And so

it’s okay to take in whatever they say with a grain of salt, keep what sits well and let go of what doesn’t. And if you have concerns or you’re doubting what they’re saying, it’s always okay to seek out a second opinion. And what I find too, is a lot of families come to me and they’re like, well, my, my pediatrician didn’t give me a referral. Most of us providers who are in private practice, we never need a referral. And so don’t be afraid to reach out even if you don’t have a referral.

from your pediatrician, at least when it comes to like language and feeding. And of course, you never need a referral for sleep.

Brittni (20:38.833)

Yeah. Following up on that, I have one kind of last question for solids. You brought up constipation, which is something that I see a lot with babies who aren’t sleeping, is constipation. What is a normal or expected amount of bowel movements? And I know it changes through age, but for babies.

Nadda (21:00.822)

So I would say just like adults, a baby should be passing at least one soft stool a day. And when we’re not, we want to kind of figure out why. And I think like, especially if there’s any straining or difficulty with like getting that bowel movement out, then we want to figure out like what is causing that. And if we’re starting solids, right, are we eating foods that are more constipating? Should we start to add foods that help your baby poop better?

and see what changes happen there. Sometimes even as like if a baby, I have a lot of families who like will transition to formula, if they’ve transitioned, sometimes the formula can be more constipating. So different layers that kind of looking at, but as I’m saying with like everything, so many layers to everything. But we, I would wanna see short answer, one stool a day at least.

Brittni (21:45.42)

Right.

Brittni (21:52.505)

Okay. And if they’re not doing one stool a day, start kind of digging and investigating a little bit.

Nadda (21:57.318)

Yeah, and I would say like, okay, if it was every other day, I don’t, I think there’s like such a divide because there’s not like that much information out there on this. But in all the courses I have learned is we really should be going once a day. And some people might say like, oh, if you’re breastfed, baby, it’s normal to go like every other day or every two days. But I’m like going with what I’ve learned. And that has been one stool a day.

Brittni (22:25.045)

And I can’t remember where I saw this, but somebody said, like, think about if it was you, like, would you be comfortable if you had gone three days without having a bowel movement? If the answer is yes, I would be very uncomfortable, then our child is probably very uncomfortable, too. So I think we kind of like lose sight of that. And this is not judgment, because I when you’re a parent, you do kind of lose sight of that common sense. It kind of takes you away. But that can be a good rule of thumb. Like, is this something that I would be comfortable with or that I wouldn’t?

want to start asking questions about?

Nadda (22:57.326)

And I think of too, especially with sleep at night, if we’re really congested or if we have any stomach challenges or if we have a cut, we feel things a lot more intensely as soon as we lay down. And so imagine having a really bad stomach ache. As adults, we can curl up or get a heating pad or take medicine, but a child doesn’t have the ability to have their needs supported on their own, where that is likely why they’re calling out to you and needing that support.

when that happens and kind of figuring out like, okay, could it be environment or could there be an underlying red flag that’s contributing to those wakeups and looking at like their mood and temperament when they are waking up calling out to you to help us know like, okay, is constipation something to look into?

Brittni (23:42.245)

That was also helpful, thank you. And I’ll share at the end of the episode too, but you can work with Netta if you have like feeding questions or anything like that and her information will be shared below. But I also want to, I’m really excited, like you know so much that we get to touch on so many different topics. But next I wanna talk about what to expect with language in the first two years.

Nadda (24:06.254)

Okay, it’s a big question. I feel like there’s so much I could say about this too. And I think that when we think about language development, knowing that there’s so much that happens in the first two years. So babies when they’re born, as soon as they’re born, they are learning language even before they’re born and it develops and every baby develops language at their own unique pace. And so I like to think of learning language as

Brittni (24:10.242)

Okay.

Nadda (24:34.238)

learning how to do something new for the very first time. So the analogy I like to think of is like riding a bike. So the first thing when we’re riding a bike, we’re not just like cruising down a hill, but we may ride on soft grass with tricycles and our parent may hold our hand and like push us along. And then we may take the tricycle off and go on the driveway. And then from the driveway, we’re…

going down the hill. And so we’re moving through a series of steps until we master that skill. And it’s the same idea as we’re learning language. Babies, from the day that they’re born, are going through a series of mini milestones that are helping them get to using first words. And I think that this is important to consider, because oftentimes, when I have families come to me, they’re like coming, and they’re like, they’re not using any words. And then I’m like, well, let’s take a step back and look at, do they have those foundational pre-verbal?

language skills that we want them to have in order for them to use words. And some of those skills that we’re looking for and starting at birth, right, because babies are communicating with us even before they’re using words, maybe through their facial expressions, their body language, their gestures, whether it’s a soft coup or a goo or a babble, those are all intentional forms of communication that babies make.

The way that we respond helps them know, oh, you sent me a message and I hear that and I’m responding, letting you know, like we have this back and forth turn taking going on. So we have intentional vocalizations, we have attention, turn taking, imitation as they’re starting to get older, they’ll start to imitate the sounds that we’re making, they’ll start to imitate our babbles and they may start to imitate word approximations as they’re getting closer to 12 months.

And we’re also seeing their understanding starting to grow. And what we know is that understanding typically proceeds our spoken or verbal language by about three months. So children are really taking in a lot and understanding a lot. And before we can ever expect them to use words, we have to know that they understand those words in a variety of different contexts. And so I know this is like so much information, but thinking of like…

Brittni (26:35.373)

No, it’s great. It’s great.

Nadda (26:37.822)

you know, when we’re thinking about their language development, not even thinking about what is your, when are you going to say your first word, but like, are we sitting and, you know, enjoying this time together where we have this connection, because connection comes before communication. And if we have that shared engagement, shared connection, we’re going to see other things follow with taking, looking at us, engaging with us, vocalizing, responding to the sounds and the words that we’re making.

And with time and exposure throughout our daily routines and play, they’ll start to have an understanding of like, oh, this is what milk means, or this is what means when we say night night. And that will then lead us into those first words developing and so past that too.

Brittni (27:21.693)

One question I have is, I think I’ve read somewhere that like, even if the word is wrong, we can count it as a word. Like if they have a word for a specific item that is not, I can’t think of a good example. You might have one since this is what you do. But where it’s their specific item and they call it something that we don’t call it, but that’s still considered a word, right?

Nadda (27:35.266)

Yeah.

Nadda (27:43.07)

Mm-hmm. Yes. So I think parents are actually really pleasantly surprised when they hear what counts as a word. So when we think about what counts as a word, right, it can be a word that sounds like a word that we’re saying, a true word approximation, or it might be an animal sound, a vehicle sound, a fun sound like, uh-oh, we, oh no, woof, or a word approximation like what you were just sharing where I’ll share an example of my nephew. He used to say um for up for like

Brittni (27:47.579)

Yes.

Nadda (28:12.802)

four months, just would say, um, and we’d be like, and he’s like pointing with his hand up and you know, it’s super intentional that like, he’s telling us up even though he’s saying, um, and because he was using that approximation consistently, independently, and in the right context, so very meaningfully, it counts as a word. And so that’s what we can think of for any trying to track our kids workout is, are they using that word independently, consistently and intentionally? And that helps us.

Brittni (28:17.895)

Thanks.

Nadda (28:40.394)

know that does count as a word for them. And what your child says matters way more than how they’re saying it, especially in the first three years. So if they say um for up, I would just simply respond and say, oh, you want up. Up. OK, I’ll pick you up. So that at least they had three opportunities of hearing me say up. But I’m not trying to force them to say a word or do anything in that moment. I’m just modeling without expectation because with time, that approximation will start to form into the true.

word that you and I would say.

Brittni (29:11.441)

Trusting in the process, which I know is very Yeah One thing that I did want to talk to you about in terms of language is I know that you’re bilingual So I know I have a lot of people in my computer community who are raising bilingual babies What are some tips for raising bilingual babies?

Nadda (29:14.575)

Everything parenting.

Nadda (29:32.022)

Yes, so I would say all language milestones expectations are exactly the same for monolingual babies and bilingual, trilingual babies. And I always encourage families to speak in the languages that you feel most comfortable and confident using. You’re going to see online probably a lot of different approaches to exposing your baby to the languages that you speak, such as like one person, one language or…

You’re doing it in one, only speaking one language in one place or at a certain time, or both families are speaking simultaneously, both languages. And there isn’t one right approach. The right approach is what works for you and your family, because for some families, like they might choose one person, one language, but oftentimes we end up falling out of that because it’s just so much easier to talk in like the primary language that both parents speak. And some families don’t have partners who like speak the exact same language, right? And so,

thinking about like what would work for you and your family and what do you feel most comfortable and confident doing and There are things that we are being mindful of though when we’re wanting to raise a bilingual child So I don’t think the approach necessarily matters But more so that we’re thinking of the quantity the number of words that a child is hearing in that language The quality of that language. So are they hearing a variety of different kinds of words and the opportunities to practice?

So those are like the three key things that we are really focused on when we’re trying to support and raise a bilingual child. When we think about quantity, what we can see from the research is that children need at least 80% of exposure to that language to truly benefit from that language. So if a child’s only hearing that, hearing Spanish, for example, for one play date or circle time activity, but never again,

It’s going to be really hard for them to learn to understand those words and then eventually use it on their own. So we really have to be very intentional, I think, especially in today’s day and age of exposure to that language. And when we think about quality, oftentimes families come to me and they’re saying like, oh, I’m not that proficient in this language. Should I even bother speaking to them in that language? And I am, I would say, fluent in like…

Nadda (31:48.006)

Um, not like proper Arabic, like I don’t think I could do like a full on like medical like consultation in Arabic, but I’m conversational fluid where we can talk about things. Um, and everyone understands what we’re saying, but there are some words that I might not know or like takes me like five minutes to be like, what is this word again? And it doesn’t, it’s okay that we don’t know all the words, right? Sometimes we lose words in English too, but what matters is that we’re offering them

Brittni (31:52.945)

I’m going to go ahead and close the video.

Nadda (32:16.098)

the opportunity to even hear our language. Because for most of us, or at least for me, my extended family all lives in Egypt. And so when I have children, it’s going to be very important for me to raise them to be able to speak Arabic and English so that they can connect with them and understand their culture. And so I think that whatever amount of whatever language you speak is super beneficial. And we just are mindful again about the quantity, right? Where are there other family members or friends or play groups or even?

songs that we can listen to or books that we can read that expose them to our language and give them a more rich, more rich input. And then the practice, right, that goes hand in hand with those two, because we need to have them hear that language in a variety of different contexts in with different family members. And that will allow us to then have that understanding so that when we’re ready, we will be able to use those words. And oftentimes we’ll even find that

when children are becoming bilingual, they’re mixing English and Arabic together, or Spanish and English together. And that’s actually a really good sign for bilingual language development because it’s showing us how resourceful they are with being able to pull from each vocabulary and put sentences together. And it’s oftentimes a very natural part of most of our languages. I know in Arabic, we mix a lot of Arabic and English together now, where you might even hear Spanglish and things like that.

It’s very, and if that’s how your family communicates, then it’s okay for your child to be communicating in that same way too.

Brittni (33:47.477)

I’m laughing internally at that because Lila’s dad is from Chile, so he only speaks Spanish to her. When she was really starting to talk, we would go to the park and she would say half her words in English and half her words in Spanish to these kids that only spoke English. They would look at her like… It’s funny because it does come out, but one thing that’s interesting just hearing you say that is now Lila and I’s dad were not together when we were…

we would speak Spanish to each other in front of her, but now she’s getting Spanish with dad and I always try my best. I’m like, okay, I’m going to speak Spanish today. And then like an hour into the day, I’ve already switched to English without even realizing it. But she will understand, she understands everything he says, but she won’t speak back to him in Spanish. And I’m sure it’s because it’s really only him, his family’s in Chile. So they do

Nadda (34:26.754)

Yeah, yeah. Hard!

Brittni (34:42.209)

a lot, like you said, a lot of different exposure to it, just her dad. So we shall see if the Spanish ever comes out again.

Nadda (34:56.221)

Yeah, I

Nadda (35:18.69)

some children that she are of the same age who also speak Spanish where she’s like, oh, like they speak Spanish too, this could be fun. Or I know I can engage and do this too. So it may not even necessarily be other adults that she needs that exposure to, but maybe like a music class or like a book time class, or now they have like the Yoda player that comes with Spanish like cards and things like.

Brittni (35:35.194)

Yeah.

Brittni (35:41.977)

I didn’t know that. Oh.

Nadda (35:43.242)

Yeah, I think that they do have, um, Spanish and you can even make your own Yoto cards too where you could put stories or if there are other stories that you know that have like an audio, like there’s just so many resources now that, um, are available to, to families raising bilingual children.

Brittni (36:00.949)

Yeah, well, and it just goes to show, right? Like every home is unique. If we would have, if her dad and I would have stayed together, maybe she would have like, you know, be speaking more, but it just, the path is unique is what I’m trying to say, I guess.

Nadda (36:14.086)

Yeah, and it’s also like never too late to like amp up the exposure or change like, there’s always room for changes throughout the years.

Brittni (36:17.957)

Totally.

Brittni (36:25.229)

I think when I was reading or when I was learning Spanish, I read that you have the ability to like fully 100% learn a language up until the age of 10. Is that right? And then after 10, you can still learn a language, but it would never be like fully.

Nadda (36:43.182)

I think that there’s like a lot of nuance to it where you still, you still, I think even as an adult, we could, it just takes way more intentional effort, time, investment, like commitment to learning that where when we’re younger, we take in this information so much more easily. And what I will also add is that within the first, like when, when you’re born, you’re born knowing how to say all the sounds and all the languages of the world. And it is,

especially in the first nine months where our brains are starting to be like, oh, this is a sound I know. Oh, this is sound I know. And knowing like, these are the sounds of my languages that I’m using where outside of that, right, it then can be harder because we’re like, oh, I have to learn how to say that sound now. Or just be more, it requires more input and like quantity for that to take in and then start using.

So I feel like the first three years are just such a beautiful time for us to invest in doing this. But I feel like it is so much harder now to like truly raise true bilinguals, but it is possible. We just have to be very intentional about it.

Brittni (37:51.045)

That’s so interesting about the brain. I never thought about it, right? Like you could take a baby born in the US and put him in France, right? Like it makes sense. The brain is primed to pick up on everything around it.

Nadda (38:04.15)

Yeah, and even we can see that newborn babies can discern like rhythmically similar languages and from rhythmically like dissimilar languages. So like English versus Chinese, for example, right? Like they can tune in and know which caregiver is speaking what language and be able to like, basically compartmentalize and know like, this is my person who speaks to me in this language and this is my person where like Lila’s kind of doing that with like dad can speak.

he speaks Spanish and then you’re speaking, you try to speak Spanish and English, the female probably knows that she can speak more English with you. And so she like knows who those people are and probably now even at school, she probably is like able to identify these are the friends who speak English or these are the friends who may speak a different language.

Brittni (38:35.124)

Hehehehe

Totally.

Brittni (38:49.577)

Yeah, the brain is so amazing.

Nadda (38:52.602)

is the faculty.

Brittni (38:54.509)

I’m gonna pause and ask you, we’re at 38 minutes. I say I usually keep interviews at 30 minutes. We didn’t get to tongue ties at all. Do you want to touch on tongue ties or do you feel like that’s too expansive of a topic?

Nadda (39:09.374)

I feel like there’s so much to say about Tung Tai. That like, I could keep a brief of like defining it and identifying like, if you have concerns, then like consult with this person. I feel like there’s like so many nuanced things within the Tung Tai chat.

Brittni (39:10.445)

That’s how I feel.

Brittni (39:30.061)

Here’s what I’m wondering. We could do like, can you explain what a tongue tie is? Can you explain like what to look for? And then maybe that’s a good way to like tie into your tongue tie guide and just say like, we, you can go further into it. Do you have time? Does that work for you? Okay. So let me, I’m like gonna now like jump back in. Another, oh wait, I’ll stop. Tell me when you’re ready. Okay.

Nadda (39:45.962)

Yeah, yeah, that works for me.

Perfect.

Brittni (39:56.385)

Another thing that I want to talk about, and we could probably do like a full podcast episode on this by itself, but since we’re talking about solids and language and all of that, I want to chat quickly about tongue ties. So can you just first start off by saying what a tongue tie is?

Nadda (40:14.206)

Yes. So I’m going to start by saying that we all have bands of tissue in our mouth and medically we refer to them as tethered oral tissues and on social media or on Google, you’ll most commonly hear them referred to as like tongue, lip, and or cheek ties. And essentially what these are congenital formations, and we actually have seven in our mouth, that are bands of connective tissue.

And a true tongue tie is that band of connective tissue or the frenula or frenulum for one is restricting the mobility of the tongue or the lips or the cheeks that is then contributing to functional challenges. So when we’re thinking about tongue tie, right, there’s one band of connective tissue under the tongue. We have two lip on upper lip, lower lip, upper cheeks, lower cheeks. And so we

Not everyone has a tongue tie. We all have frenula or the frenulum under our tongue, but a true tie is one where there is functional impact or challenges that a parent or a baby are experiencing as a result of restricted mobility. So that is what tongue ties are in the simplest form.

Brittni (41:30.661)

And what are some signs or red flags that we would be looking for if we think, hey, you know what, I think something might be right, might not be right. Or we see a post on tongue ties on Instagram and we’re like, oh my gosh, does my baby have one? What are some quick things we could look for?

Nadda (41:48.274)

Yeah. So I’m thinking of just for our, what we’re talking about our infants and young toddlers. So we’re looking at signs in mom and also signs in baby if we are, if you’re a nursing parent. So in mom, you might have nipple pain, nipple trauma damage. You may have like creased or cracked pinched nipples or your nipple may come out looking more lipsticked after breastfeeding.

You may also, around three months, you might notice a dip in your supply or you might have concerns about your milk supply. So those are some of the main concerns that I’ll find with parents who are coming to me who are expressing nipple pain, nipple trauma, or pinched nipples and their feedings feel endless. They never feel lighter and softer after a feeding.

or the breasts never feel lighter and softer. In an infant, we might see a variety of different signs and symptoms. But I’ll also add is that a baby who has, may have a tongue tie or suspected tie, it may not necessarily have every symptom. So every baby presents differently, every mom presents very differently. Some women don’t even feel any pain, but then the baby’s having a hard time transferring milk, or they may have lip blisters on their lips, or they may have a white.

that white coating on their tongue, which we often hear as referred to as milk tongue. They may have lots of or be labeled as colicky or have reflux. Those are like the most common symptoms that I will see. And the other really big sign that I feel like was just a shocker to me when I entered this world was mouth breathing, where this is something, mouth breathing, colic, reflux are like the, I feel like the top three things where they have become so.

They’re so common that they have become normalized today that no one thinks twice about them. I know when I used to look at pictures of babies sitting in their mouth open, I’d be like, oh my gosh, they’re so cute. And now I see them like, oh my gosh, this baby, like I need to get in their mouth right now and see what is going on. And so I think mouth breathing is like a really big thing that I’ll see especially with sleep, but also with feeding too, affecting like more restless frequent waking because when we’re thinking about

Brittni (43:46.518)

I know.

Nadda (44:03.478)

and this is like a whole other side thing, but very briefly, is when we’re thinking about mouth breathing, at rest, our tongue should always be resting on the roof of our mouth, suction to the palate, lips sealed, breathing through our nose. This is what calms and regulates our nervous system. It allows us to breathe in filtered air. When we’re not nasal breathing, what happens is that we are taking in unfiltered air, more bacteria, which can then increase inflammation, increase the risk of developing more infections,

long-term enlarged adenoids, tonsils. It also, we have a harder time calming and regulating and our body can never go into a deep REM restorative sleep when we are mouth breathing, or we then develop compensations where we’re sleeping on our belly or sleeping on our side and our neck is tilted upwards. And so there are lots of other things that then cascade after once you are like habitually mouth breathing where it’s, we wanna kind of figure out.

and get to the root of like, why are we mouth breathing? It could be a tongue tie, but there could be other things that are going on there as well. But I think that tongue tie, or not tongue tie, mouth breathing, reflux, colic are like the three main things that I’ll see in addition to like the milk tongue, lip blisters, and just like feedings being endless or super restless as well.

Brittni (45:26.053)

The colic, right? Like anytime I have somebody who says my baby is colicky, even if I haven’t even seen an intake form or like a list of red flags that I check for, I’m like, okay, let’s dive deeper there. Like what discomfort is it? Could it be a tongue? I mean, but the colic doesn’t necessarily mean a tongue tie. I don’t wanna say that. But the point being that there’s discomfort there and that’s a sign of, hey, let’s look into this.

Nadda (45:50.102)

Yeah, and I think also thinking about a baby, the only way of communicating with us is through tears. And that might be, mom, I need some comfort, I need some reassurance. But if those tears are accompanied with arching and thrashing and just like grunting or lots of apparent things, signs of discomfort, we wanna figure out why are we just uncomfortable? Are we taking in a lot of air during our feeding, which is then making us gassy?

Are we not transferring efficiently and we’re still hungry? Like there’s so many different things that we want to figure out a baby isn’t just going to Babies are not meant to just be crying all day long and to be like that And so if they are like that we want to get to the root of like why is that happening? with them

Brittni (46:34.449)

Totally. And kind of circling back to the pediatrician question, if I have this happen all the time where they’ll say like, I suspected a tongue tie, but I took them to the pediatrician and they said there was no tie. I always say like, get a second and third opinion if you have that gut feeling, but could you speak to that as well?

Nadda (46:52.886)

Yes, there are very few, I would say skilled providers who specialize in TIEs. And I have dedicated like the last four years of my career, like complete pivot to become a specialist in TIEs where we’ve invested so much time, money and continuing education and courses to really understand them, to be able to assess, identify and treat them. And pediatricians, like we had said before, are great providers on

overall health and wellness, but more often than not, they are not taught about this in medical school. I think I was taught about this for one slide in a PowerPoint in one course I took in grad school and never again. I didn’t actually fully learn about it until I entered the sleep world, and then I just was a domino effect of things like that. Taking what they say with a grain of salt, because if they have not observed a feeding with either at the breast or at the bottle.

If they have not done a full on oral motor examination, then they cannot confidently say there is no tie there. We’re looking at function. We’re not just looking at the appearance of, or the presence of that frenulum, because some are even more obvious, where you can just see it when a baby opens their mouth, because they’re towards the front of the mouth, but others require a trained eye, where we really need to do a deep lift under the tongue, where a baby is lying down, their head is under me.

So I always am curious when a family tells me that and say, what did their assessment include when they told you that your baby did not have a tongue tied? Did they look at you? Did they look at your baby? Or did they just tell you they could stick their tongue out? Or what is it that was said? And that would then direct me to the providers who would be able to assess, which would either be a speech and English pathologist,

an occupational therapist or a lactation consultant. And right, we’re not all trained the same. So you really need to make sure that your provider is trained in TIEs and for SLPOT, oral motor feeding, to ensure that you’re getting the right support.

Brittni (48:58.785)

One question for you, if a family were to work virtually with you, can you look for a tie over like a virtual consult?

Nadda (49:06.946)

So my virtual consults are a little bit different where I do send a handout ahead of time just instructing them on how to complete a virtual oral motor assessment. And they’ll most of the time will send it to me if a parent doesn’t send that to me.

then we will do it together. And I think it can be really helpful to have the parent actually do the oral motor assessment piece so that they can feel what I’m feeling. And I think also it just gives them more confidence of like, oh man, like, okay, I feel and I can understand and I can also support my baby. But we’ll use a lot of like analogies to describe like, when you put your finger in your baby’s mouth and they’re sucking, does it feel like a nice strong taco mold? Or does it feel like a beef patty that is just like going up and down?

Or when you’re feeling their palate, does it feel like a Play-Doh mold or does their tongue like hook up like you’re reaching a 10 foot ceiling, right? That can give us some information of like, does this baby have a high palate? Do they have good tongue extension and is their tongue lifted well? Do we hear any sounds? And so we can do oral motor exam virtually. It just requires a lot more teamwork and effort to get that done.

Brittni (50:16.581)

Okay, perfect. Well, thank you so much. Like I said, I feel like we could stay here like even longer and do a whole another episode on this. But I just want to thank you so much for taking your time out of your day to be here today, for sharing your wealth of knowledge. And where can we find you? Where can we learn from you?

Nadda (50:34.89)

Yes. So I have an Instagram page that my handle is at to like the number dot can grow. And then my website is also to can grow.com. And you can either reach out to me on Instagram or on my website. And on my website, I have other supporting resources. I have a tongue tie guide and like a preparing for postpartum checklist with my favorite like feeding sleep, language types of

products that I recommend and also don’t recommend and other resources there.

Brittni (51:09.585)

Perfect, thank you so much. And I do just want to shout out the tongue tie guide is amazing, amazing. If you have any questions on tongue ties, if you suspect your little one has a tongue tie, if they have a tongue tie, check out the guide. You’re welcome.

Nadda (51:22.626)

Thank you. And it’s going through a little revamp right now for it’s like one year anniversary where I’m adding in videos because I’m learning so many families are not, don’t have people available to them. So hoping it is even more helpful with the update.

Brittni (51:35.981)

Well, it’s a wonderful resource and I am so happy it exists in the world. But thank you so much again. Thank you for being here. This was such a wonderful episode.

Nadda (51:46.179)

Thank you so much for having me. This was so fun.

Brittni (51:48.373)

Of course.

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