Speaker 1: 0:42

Here we are. Hello, hello everybody, and welcome to another episode of Beauty, of Breathing Podcast. I have another Instagram celebrity with me today, dr Eric, how are you doing?

Speaker 2: 0:57

How's it going, Renata? Thank you for having me. Yeah, Speaking of celebrities, we were just speaking about Josh Madsen. So, yeah, I'm so excited. Look at my face. That's the way I am. I'm so excited. I mean I cannot I cannot hide it. I'm so happy to be here as your guest and and yeah, I love your title First breaths, first words. It's amazing. Yeah, it's going to be a great talk.

Speaker 1: 1:21

So you guys hang around. We are getting ready to actually go live on both of our Instagram accounts so all of our followers can join in the conversation. You guys are welcome. If you're listening to this live, you're welcome to send us some questions as we start going through this wonderful talk we're going to have. So I'm going to go ahead while you guys are getting ready and we're going to introduce our speaker.

Speaker 1: 1:43

So the topic today is from first breaths to first words, oral restrictions, airway health and team-based pediatric care, presenting Dr Gary Galindo, a pediatrician based in Guadalajara who is redefining how we care for our children. With nearly 20 years of experience, he's turned the standard consult into something much deeper, focusing on how breathing, sleep and oral function shape a child's development. From tethered oral tissues to airway health, to the importance of chewing and the impact of sleep on behavior, dr Galindo connects the dots between symptoms and root causes, bringing both precision and empathy to his practice. He's a board member of ICAP and an ambassador of the Bright Institute. Thank you so much for accepting our invitation. We have a couple of friends in common that connected us whenever we're looking for someone in Mexico to help one of our patients, so thank you for being here.

Speaker 2: 2:49

Yeah, and I have a story, whenever there's a chance, about connection in Mexico and how like it was someone. It was an adult that had myofunctional therapy and that needed a third release and it was a complex case and she lived an hour drive from here and she had a myofunctional therapist from New York, but they were friends. She was doing therapy but she was ready for another release because of two bad releases previously and I connected her to Neil the chiropractor, our friend, because she needed his help and then the plan was all the way up to see dr zaggy to do a perfect release, a proper release, and then and it ended up working so well.

Speaker 2: 3:33

So speak about connecting, so and from mexico all the way, all the way to california. So, uh, and, and, yeah, uh, and I was an adult. But uh, yeah, like we, we have to act early, right, yeah, 100. This is interesting you mentioned in the few minutes that we talked before we went live and I was an adult, but, yeah, like we have to act early right, yeah, 100%.

Speaker 1: 3:47

This is interesting. You mentioned in the few minutes that we talked before we went live. You mentioned Dr Zaghi. Of course, I've been working with Dr Zaghi for a while sending him patients. He's absolutely wonderful. We love him. You mentioned Dr Josh Medicine, who we just interviewed for Aerie Circle and for the Beauty of Breathing podcast, and you guys connected also with at Dr Zaghi's Breathing Institute.

Speaker 2: 4:11

Yeah, exactly, I think I've texted him here and there. I mentioned like he has already three centers, 40 plus staff and I told him we need something like that in Mexico. I mean, if you're planning to expand, and he's just like you, he's such an entrepreneur and I know he's going to have some big plans all over the world, but we need them. I mean speaking of growing healthy and finding what could be a hindrance to your development. I mean it's such an important topic, right, and it's connected to the airway, like primitive reflexes.

Speaker 2: 4:49

He was mentioning how you go from the gross motor, right, you go from the gross motor to the fine motor, and he's speaking how the tongue and the movement of and all the oral functions are sort of like a fine motor skills, right, and I see, as a pediatrician you mentioned right on it was like, uh, you hit the right chord that uh, as a pediatrician because I'm, by training as a pediatrician like, what does a pediatrician has to do with? Uh, tongue ties and and and and the socks all breathe. It's because the only way, uh, I can contribute as a pediatrician is, uh, to connect the dots. I sometimes, I sometimes, when I tell the patients I know a lot about everything and at the same time, I don't, I know nothing, because I mean, I'm, I mean, I see people from your specialty Dr Zaghi has an ENT and orthodontists, chiropractors, craniosacral therapists I mean special people that are specialized in functional neurology.

Speaker 1: 5:47

No yeah.

Speaker 2: 5:49

And I'm just a general pediatrician, but I'm the primary care physician, you know.

Speaker 1: 5:55

Just a general pediatrician. We need y'all's help. You know you guys are the first line in front of every child out there. You guys are the first line in front of every child out there and I'm going to say this the hardest professional to talk to to me has been pediatricians, because you guys are so busy, you have so much going on. You're over there saving lives, you know, and we just want a little bit of your time to talk to you guys about sleep. You know, let's do sleep studies as a how can we start doing sleep studies as part of screening for children just in? You know, not in lab, but at home sleep studies or just having simple questionnaires, because I believe that it's such an important pillar that is being ignored by so many medical professionals when it comes to overall health. Why do you think we're not really looking at sleep?

Speaker 2: 6:51

I think it has to do with our backgrounds, right. I mean everybody started, I mean, as a therapist, as a pediatrician you need to have like a life-changing event, right, it's a never-ending process of learning. You have to be humble enough to say you don't know I think this has come from Zaghi and from someone else that you never know what you don't know, right, and you do like Dr Richard Baxter says, you're not ill-intentioned, you just do what you can with the information you have, right. And if you don't have that curiosity, that humbleness to say there has to be more, and if you get rid of that mindset of just being the band-aid, you know, to solving problems instead of going to the root cause. So to me as a pediatrician, from personal experience, I think it's the way we are trained and and and you need to have this, this enlightening moment, this aha moment, to say you know what this is just not making sense anymore. Trying to medicate kids from the early stages, right, with reflux medications, with trying to say, oh no, the solution for a two-year-old to sleep better is melatonin, right. Trying to say, oh no, the solution for a two-year-old to sleep better is melatonin, right.

Speaker 2: 8:08

And then you find these amazing tools like the Pediatric Sleep Questionnaire. You mentioned sleep studies. I mean, just try to find ways to ask the right questions right. Take the time, whenever you have the time, take a moment to ask the right questions, right. I have like screening questions that are like very focused.

Speaker 2: 8:29

And then you find patients, bernardo, that say, by the way now that you mentioned, yeah, of course, I see that my kid is drooling at night. I know that he wakes up thirsty, you know? Or, yeah, I have so many pictures on my phone of my firstborn, and every time I took pictures of my firstborn, when he was an infant and a baby, a little child, he was already sleeping. He was always sleeping with his mouth open, right, and uh, and then, like, so it starts from curiosity, and, and, then there's so much information out there. But it's like if you start from that point and then you go down the rabbit hole, right, and you never stop here we are right. We never stop. Here we are Right. We never stopped learning and and and.

Speaker 2: 9:09

Patients like being able to listen, right, I take the time to listen because patients have so many things to say and and and. I think it's actually I know it's a cliche, but it's like just being with an open mind to say what else could there be there, right, what else could that be? And then I think from Josh I could take the systems-based thinking right. He has this pyramid. You go like everything is connected and then moving away from the westernized way of seeing medicine, right. When I was like everything in compartments, right, this division of the human health, right. And then when you find out about fascia, this cotton candy, that's connected everywhere, right.

Speaker 1: 9:53

I love the cotton candy.

Speaker 2: 9:56

I just read it from Tom Myers book, so I just highly love it.

Speaker 2: 10:01

Yeah, I mean, because it is actually a cotton candy, right, it goes, it's intertwined in every part of the body and in every part of your cells, right? So when you have a systems-based thinking and then you help parents connect the dots, so you narrow it down and as a pediatrician, as a primary care physician, what I can contribute to your specialty, renata, is like trying to make like the connections of the specialties you need. So here in Mexico, that's what I do. A patient comes nowadays it's not only about the tongue tie, it's more about craniofacial development, right? So what's going on? So you have nowadays, mainly my consults, first-time patients are mouth readers, right? So you have you need to ask about the oral habits, no, and then change your mindset, renata, because it's people here in Mexico. I know you speak Portuguese and uh, and you see in Latin America that, uh, like the pacifier is so ubiquitous, right, it's, it's so like I mean, and then it's a little bit of a culture, because in Brazil it's huge.

Speaker 1: 11:06

I mean, I had a pacifier until I was four or six years old and you see eight-year-olds with a pacifier. In Brazil. I mean it's not that common, but very common for a four-year-old still to have a pacifier in their mouth all the time. It's cultural for sure.

Speaker 2: 11:20

Yeah. So and it's not about shaming parents, it's telling them you know, it's okay that you didn't know, but I mean, let's find ways. Now I'm amazed with a, with a Nene pacifier, for example, like you need to the tongue to start working differently, you know. And then you try to explain in simple terms. You know what the pacifier is doing is separating, creating a gap between the tongue and the floor of the mouth and the roof of the mouth. So that's and all the biofunctional evolving system inside you, right, how the lips, the nose, the tongue, it creates this vacuum.

Speaker 2: 11:55

So you try to explain parents in simple terms if you act early, right, acting early makes a difference because, for example, you deal with adults and you know it's going to take more time, it's like a marathon. So and and in marathon you get, you hit the wall and sometimes you want to abandon the race, right? So and I, I think linda uh donofrio says like she likes to work better with adults, because when she works with kids it's like okay, you did it, now you have to do it for the rest of your life. Those good habits, now you have to do it for the rest of your life, you know those good habits.

Speaker 2: 12:27

Now you have to do it because this is forever right. I mean good oral habits, good uh posture, good sleep, and now, uh, as you can see, and and stop me whenever you can uh, because I I speak too much.

Speaker 1: 12:40

I said to you you're good, I love it. I do have a question, but keep going.

Speaker 2: 12:45

So it's about trying to find ways to act early to have a better outcome, a more impactful change. And in Brazil, I love it because they're trying to identify in utero right and like the malocclusions. They're trying to do ultrasounds to identify malocclusions that could cause a lot of trouble with the socks, follow breathe problems and a lot of troubles with breathing right.

Speaker 1: 13:21

Yeah, tell everybody a little bit about that.

Speaker 2: 13:27

So obviously we have our genetics right, but then, as Dr Felix Leal says, then we have epigenetics right. So you have, and then a myofunctional therapist that's pretty well known. It was a guest with Neil. It was like saying it's going to take. You mentioned you had a case yourself with pacifier use, if I understood correctly.

Speaker 2: 13:49

So it's going to take like three or four generations if we want to do some epigenetic changes to see that we don't have this offspring of like, maybe this retrognetic small developing jaws, retrognetic small developing jaws, you know, because it's all about the weird society societies, like Dr Kevin Boyd says, the weird societies are Western, educated, rich, industrialized. So with our civilization habits we have to wait a few generations to see those changes. But to narrow to your question is we could be more impactful if, since the ultrasound, we could see a child that's already maybe sucking their thumb, because we know from early start, from the first trimester, there's already development of swallowing movements, right. So if we can identify early like again in brazil with tong tai identification protocol that they established in 2014 so so if you see that you have any changes, you could start using some kind of oral motor therapy to promote, because what I'm trying to explain is like, form follows function, right. So if you act early and that's why us pediatricians here in Mexico, we are the ones that are present at the birthing event yes, so if you're able to identify, you know, movement of the whole body, like a physical therapist says, do a lot of tummy time, extension of the neck, that's all these things.

Speaker 2: 15:33

The fascia acts early. The like jaw says the autonomic nervous system from the polyvagal uh theory. So starting early so you're able to see how, in the first 12 months to 24 months of life, you see how the phase starts developing differently, right, and that's and just like, that's kind of like a conservative, conservative intervention, and you see better breathings, better breathers, better regulation of the nervous system, system, because now we know how it's connected, right, and then you have kids. Uh, you cannot imagine how long I told neil I don't know how long it has been that I have not given medicine for colic, you know oh my goodness, hearing this from a pediatrician, it's crazy.

Speaker 1: 16:23

But how? What inspired you to shift from traditional pediatric care to a more integrative approach focused on breathing, oral function and sleep?

Speaker 2: 16:34

I mean long story short, everything started with tongue ties and shout out to my mentors, dr Richard Baxter, dr Zaghi, I mean I, I know another cliche, but I do stand on the shoulders of giants and first it was tongue ties or restrictions, and then you know, eventually you're going to see that it's not enough, you know. And then so that was one part of the story, and the other one, renata, is like kids were not improving. I mean it as a pediatrician, with my medicalization, like like all medicine-based treatment, band-aid approach, kids were not improving, so we're not getting better. And and parents were all over informed because of social media and they were not, they were not finding the answers.

Speaker 2: 17:25

And then I think I got motivated because when I connected, I mean now my right hand is a physiotherapist Every time a baby comes to see me they have to go to see a physiotherapist.

Speaker 2: 17:39

I even do early interventions and I go to the nursery and I take with me a physiotherapist to check for primitive reflexes, the soft, solid, brief pattern, the need of a nidney pacifier. So, and then what I found out? The combination of physio osteopathy, which shout out to Brazil, which is amazing the osteopathic school in Brazil and then me as a pediatrician, just being like the guide, and everything started working perfectly. I told Nio those stories, so that's why I got into this and, like I told Gigi Tadros, now this lens, it's hard for me to see it differently. I mean you have to stay with your open mind because I mean you were so biased, right, without confirmations, but I mean be aware that there's more to know always. But that's that's uh. That's the story of what uh brought me to this space.

Speaker 1: 18:32

Yeah, that's incredible. And then you mentioned dr neo bukandani. He's an incredible chiropractor. Uh, in the west coast he's treated me before and, oh my gosh, you just melt on his hands. He is going to introduce us. So thank you, dr Neo. He's over here listening and you mentioned I just sent her a patient yesterday. So it's crazy how all of us are connected in such a way and with the same mission. You know.

Speaker 2: 18:58

Yeah.

Speaker 1: 18:59

What is it that one of my mentors says Something about? You know there's no competition if we're all going in the right, in the same direction. You know it doesn't matter. All of us are going to be in different levels of our careers, even if we're in the same specialty. But if we're all going into the same direction, which is to help more patients find the root cause of symptoms and be healthier, we are all in this together.

Speaker 1: 19:29

So I love that approach how did your early clinical experience with unresolved symptoms in children shape your current philosophy on pediatric care. You mentioned you started with tongue ties. What was it that you were seeing that you started thinking maybe the tongue restriction may be an issue?

Speaker 2: 19:48

Well, it was as a pediatrician I do believe I am to the heart a promoter of breastfeeding. So initially I was, like already not very happy with the pharmaceutical companies, uh, sponsoring physicians to go to the conferences you know so a lot. It all started. And then with my own kids that, uh, we didn't have. And my, my 14 year old, and I have a big pass right there he has a tongue tie. He cannot. So it's always personal, right. So I mean, breastfeeding was not working. And on ib, IBCLC who's amazing over here, she's kind of like my partner in all these cases and she mentioned, you know, what do you know about tongue ties A friend of my dad who's a pediatric surgeon told me how to do the scissor release and initially I didn't know a thing. I'd be very, very accepting to be criticized by Dr Gehary that I was just doing justa small snip, you know, of the tongue with the scissors and things were not improving.

Speaker 2: 20:56

And then I discovered this world from therapists. I mean the connection from pediatric general care and physical therapy. I don't know from pediatric general care and physical therapy, I don't know You're going to listen to me so many times say physical therapy, because the body, the way you do as any kind of I don't know if it's the right word, but it's so many times mentioned that in the States, the body workers I mean the CSDs, the OTs, everybody, even the myofunctional therapists, because you know, like it's not only about from the eyebrows to the base of the neck, right, it's all connected. So I think I mean finding ways that kids got better again, as I said. And you mentioned about collaborative work, right. I mean, if we focus on patients, on parents, which are looking for answers and not getting them, and I don't know if it's modernity, but you cannot see patients by yourself because the cases are too complex, right. And you find out that if you work together and you connect people to many specialties, you see better results right.

Speaker 2: 22:13

So, and then you know it as a specialist if you only do the quick fix of a frenuloplasty and you don't do the pre-habilitation or the prep work, and if you don't do the follow-up, you're going to end up not getting any results. Not better breathing, not better functional patterns of the mouth, right, not better swallowing, a lot of compensations that decompensate many other things, right. So we need each other. So, uh, otherwise, otherwise I don't see myself. I don't see myself working on my own with all these complex cases. Uh, I mean, nowadays you need an allergist because I mean I have six million people.

Speaker 2: 22:59

I mean six million people in the metro area here in. Guadalajara Can you imagine pollution here?

Speaker 1: 23:05

Yeah, I mean yeah.

Speaker 2: 23:08

Cheers to your mate that you're drinking and my coffee.

Speaker 1: 23:10

I am drinking yerba mate.

Speaker 2: 23:15

Yeah, and so, and then, and all the you know, mold inflammation, chronic inflammation, so many things, environmental right as a as a specialist in your case. You see a lot of people having environmental issues, right, you see?

Speaker 1: 23:29

a lot over here where I am in georgia. Whenever you arrive and you're landing with the plane at this time of the year, you just see yellow. There's so much pollen over here. The biggest issue is definitely allergy to pollen. It is insane. My, all my furniture outside, everything is yellow. The car is everything's yellow.

Speaker 2: 23:50

It's kind of crazy how intense it is the pollen over here yeah, and like dr zaki said, december on our update at the breathe institute, it's uh seeing beyond the airways as well, because so many things could influence, uh, I mean I love his phrase that it's that it's breathing is the beginning, but then you see what the factors are, uh, that could be influencing negatively, uh, your bad breathing right from the start. Formula, formula usage, bottle, drinking, pacifier, not movement. You know the compartment syndrome that Dr Gigi mentions Kids are all the time on their strollers. They're not moving enough.

Speaker 2: 24:34

So then there's a connection, like a lifelong connection, of things you can do like interventions, connection of things you can do like interventions. So if you find all these connections and you see there's no quick fix and you encourage parents to keep, uh, looking for improvements and it's here and there, we're not perfect, you know it's here and there bit by bit, so, uh, so parents can endure, right, because if you tell them, oh no, there's going to be this long term, and you like, like, like, invade them with all this information, it's overwhelming. So you want parents to keep up right.

Speaker 1: 25:09

A hundred percent and how? What are some symptoms for parents listening? What are some symptoms that you're looking for when a new baby comes in in terms of maybe could be tongue tie or lip tie? What are you looking for?

Speaker 2: 25:25

I like from the basics that I've learned from physiotherapists you try to look for tensions, right. So, and then also from Josh, you try to look for the basic knowledge of primitive reflexes, right so, grasp the movement of the neck, all this asymmetrical tone, neck reflexes, the basic reflexes, right, the Babinski. So you try to look for neurological stability, right. And then you try to like and also a big mentor, nancy Calamusa, she told me, like the importance of the socks, follow breathe pattern. So you try to see the breathing pattern in a baby. I mean from even just using your eyes to see. So you put your finger you try to see uh, uh, uh, you see an actual breastfed, breastfeeding moment. So for parents, you could see the position of the positioning of the baby. Uh, if the baby has a lip seal, you can teach them the resting position of the tongue, right, you can tell them, you know it's important for the baby to move its neck from side to side. Unfortunately, here in Mexico we have a high rate of C-sections, right so, and you know from physiotherapists that already having a C-section, it's a flag that you have to understand that the kid was not having maybe the best proprioception right, the best movement activity in the womb. So you try to see. You know, a C-section it's not a shame, it's fine, it was a decision. A C-section, it's not a shame, it's fine, it was a decision. But we have to be more aware of baby's posture, baby's tongue position.

Speaker 2: 27:07

Let's do an evaluation of a sock swallow breathe. Let's find you, as soon as possible, a consult with an IBCLC, and that's what I tell parents. So my dream team as a pediatrician is like okay, you come first week and I tell you okay, let's do an evaluation of the socks while you breathe, tell me about breastfeeding, tell me about a little bit about sleep. Let's see movements. Let's see those primitive reflexes. Let's look for neck tensions, right, let's look maybe from already, like one month. I've seen kids one month already having plagiocephaly. You know, that's a big sign, you know.

Speaker 2: 27:43

Or kids that are like every time they're feeding, or you do the right questions, like feeding and they have like, just like the fists you know, always my son always had his hands like this yeah, and then you see the feeds, like the feet already like curled down like this, you know, like a, like a, like a like grasping, you know, and that's a sign according to uh, like what I've like this, you know, like a, like a, like a like grasping, you know, and that's a sign according to uh, like what I've learned.

Speaker 2: 28:05

So you try to look for tensions, right, and then uh, so you take time to explain parents. That's what I would say as my answer, that's what I could tell parents. So, and then sometimes parents are not aware that it's not okay to have your not appropriate uh, a proper lip seal, lip seal, right. So I tell parents you know the baby, and like lift this chin as many times a day as possible and then lower the chin again and look at the tongue and it was like I didn't know that and it's like and and that helps baby self-regulate, right.

Speaker 1: 28:37

Yes, I have a video of benny when he was asleep and I showed these on my talks. I just spoke this weekend in Seattle at the PNDC, which is a huge conference. It's funny because when they invited me I was so busy, you know, and I was like, yes, sure I'll come, and I thought it was a study club. I got there. It's a 4000 people conference. I had four lectures in one day and two of them were sold out. So I was super, super, super excited.

Speaker 1: 29:09

And I show one video in one of these talks and it's of Benny whenever he was asleep, and I show exactly where you should push underneath the chin whenever if there's their mouth open. So you're not necessarily pushing the chin, you're pushing the tongue underneath. So you have to see where the tongue is right underneath here and then you push and you hold lightly, you just press on it gently and you wait for the child to swallow. As soon as they swallow you can let go, because the tongue stays up there and the lip stays, stay closed yeah, and you see, and when you try to do it like uh, repetitively, you see how I mean.

Speaker 2: 29:40

you see even how babies relax. You know it's like and, and learning, learning the complexity of the tongue as well, right, all the cranial nerves and all the muscles that connect to it, and then uh again, uh, the floor of the mouth right and all the connections with uh, with uh, like the muscle chains that you see, all the way to the shoulder grid and to the back of your, yeah, to the top of your back, so, and it goes all down to your spine. So, and then you learn to see those things and as a pediatrician, again just being able to identify, you know what I think I see something, let's go ahead and find out. And then you ask the question, question did you see that your baby is like a colicky? It's like a little bit like already like clenching itself, like bending its knees, and it's not not breathing appropriately, you know.

Speaker 2: 30:33

So all those things that I, that I find, and and to me the most humbling thing is like, uh, even you cannot imagine how I don't do as many tongue tie releases in babies as I thought I was going to do According to the teachings of Dr Baxter. I thought I was going to be like, yeah, dr, tongue Tie here in Mexico, and no, because there's so many prep work, right, I mean so many things that have to go beforehand. And I'm not saying we don't need to do tongue tie releases and it's so. I guess sometimes it gets so political right, so divisive.

Speaker 2: 31:12

but if you find like there's work to be done beforehand and that gives reassurance to parents, right and uh and then, and then they don't feel the pressure and the stress that it's all about a surgery, it's more than that A hundred percent.

Speaker 1: 31:32

You mentioned a little bit colic. What do pediatricians learn about colic and how do you see it different now?

Speaker 2: 31:42

I thought before that colic was something that was like the rule of threes, right, it was three hours a day, first three weeks of life, up until three months, and it was like no explanation. We don't know what's going on there. It's mostly gastrointestinal and it just it will go away. It's mostly gastrointestinal and it just it will go away. And it was this. I mean this conformity of saying it's normal, and I always like criticize myself that for pediatricians or physicians. If you see a pediatrician saying to a parent it's normal, maybe it's the meaning, I don't know, I don't know, to all of us.

Speaker 2: 32:26

I don't know, but I'm too ashamed to say, and let's see, maybe it will fade away and let's just wait on it. And then you have sleepless nights and nothing solves it and nothing solves it. And then you feel that you are doing good because you're prescribing dry water instead of a Milicon, and it's like, oh no, now I'm a naturopathic physician and all good, and I mean I cannot be criticized anymore. And then you see, well, but what's beyond that? I mean what's going on? And then you find out about what's what's beyond that, I mean what's going on. And then you find out about the vagal nerve right and you find about the and then all about the vagus.

Speaker 2: 33:09

I'm so, I mean I am so it blows my mind everything that's behind that cranial nerve. So, and then you find the connection with breathing and the digestive system and the parasympathetic nervous system and you see, oh, now I see there's that connection. I was not willing to study, I didn't, I was not willing to go to my physiology 101 when I was in med school and now it becomes so handy and the connection with the body, right. So what licked to me renata was like again, I mean, I've said it three times, but I mean body work. You take a colicky baby to a cst and they work. They work on the dura, they release all the tension, how the fascia is connected to the digestive system. You help babies regulate their nervous system, their respiratory rate, all those things, and you have the heart rate variability and all those things get regulated and then all of a sudden the baby's not colicky anymore, oh my goodness, if.

Speaker 2: 34:22

I had known.

Speaker 1: 34:27

Yeah, if I had known my 10 year old yes, zoe when she was first born, oh my lord, she had lip tie, tongue tie, two ibclcs, uh, checked her, they both said there was no ties. Um, and zoe would start crying every night at 9 pm and go sometimes until 1 am for six months. I thought I was going crazy and my mom just kept going. My mom lived here for six months to help me and she just kept going. Renata, she's hungry, just give her formula. And I was looking, I'm like no, but I have milk. Like I don't understand, this can't be it. And two or three times Zoe as a little tiny, tiny newborn, she choked on milk where it would come out of her nose, but she would turn purple and just stop breathing and I had to suck stuff out of her nose for her to be able to breathe again, turn her upside down. I mean we've done a few things and those are all signs that I had no idea. I had no idea that they were all related. I had recently found a photo of her sleeping right on top of me but with her mouth wide open and her tongue low. I had no idea, and even though I learned all these things before I had my second one, benny. I still miss his lip tie. Isn't it crazy? Knowing what I know? I still miss his lip tie.

Speaker 1: 35:47

So that's where the whole team is so crucial for you to be able to better treat these kids, these patients, because it's so complex and I do believe that moms are blind to their own children's issues. You have to have a set of you know, a different set of eyes to look at them, to be able to help you. And going from colic, let's talk a little bit about tonsils and adenoids. Yeah, we all know how much of a huge talk this is. You know most of our patients. You know, of course, I'm a mom before I'm a therapist. We do not want to go through surgery first. You know, of course, I'm a mom before I'm a therapist. We do not want to go through surgery first. I know that there's a couple of different ways that they can either just shave them down or they can remove them completely. As a pediatrician, what has been your experience in evaluating tonsils and adenoids? When do you feel the need to send to an ENT? What are your usual recommendations to a parent of a child with enlarged?

Speaker 2: 36:44

tonsils or adenoids. You know, back in 2002, right from studies, and again shout out to the giants like Dr Guillemin-Alt and Audrey Yoon and all those specialists, right so, and shout out to all the dentists. I mean, as a pediatrician in 2002, I think it was like you know, you have sleep issues, you have a large adenoids and tonsils, go to an ENT, remove them and you're done with it. And then Dr Giminal and people like from his, from his specialty, and all those amazing people and researchers, they started to find out that was not enough. And then we're trying to find, we're trying to discover all this craniofacial anomalies, right Malformations and like the reduction of space.

Speaker 2: 37:34

So, as a pediatrician, that's also another thing, renata, that has changed to me and I remember, like my dad is a pediatrician or not. Other has changed to me and I remember, like my dad is a pediatrician I've been a pediatrician for almost 20 years and I just have it so freshly in my mind 10, 15 years ago like, let's just wait it out. When your child turns six he'll be fine, you know. Now he has like a lot of ear infections, you know, sinus, sinusitis. Let's give him 21 days of antibiotics, you know, and and the symptoms will resolve themselves, and just wait it out and eventually, I mean, as a pediatrician, I'm trying to save you from surgery. I'm so good at this, I'm wait. I'm telling you to wait until six years old and forget about asking about, uh, forget about asking sleep questions.

Speaker 2: 38:23

It was like all the meds, all the antibiotics, all the steroids like prednisone, and let's see what happens. And then, all of a sudden, it was like, yeah, what about maxillary narrowing? What about the top of the mouth? Is the base of the nose? What about that structure? What about your basic anatomy, Dr Eric? It was, like you know, like oh no Now. So to me as a pediatrician, I mean honestly, to me, a lot of kids come as math breathers. So now you have me measuring the intermolar diameter, doing trmr, uh asking, and ordering cbct scans of the airways a different a different approach, and then it's like yeah, act early.

Speaker 2: 39:15

I like airway circle. I think it's a another podcast and uh, they have uh another podcast is or airway foundation, foundation. I'm sorry they say I like the model that says fix before six. Yeah six and so the earlier the better. So, as a pediatrician, I tell parents I mean, yes, I know some uh, some uh large adenoids are all the way an indication for surgery. But you really need, I mean, their neighbors, you know the orthodontist and the ENT. Their neighbors, I mean they live close by.

Speaker 1: 39:53

And they don't talk.

Speaker 2: 39:55

The roof of my, the ceiling of my office is just like the floor of my office on top, and they're like this is a mouth office on top and they're like, just be like this is a mouth and on top that's the nose. I mean, I think you need to talk to each other, you know. So I mean there's a collaboration as well. I tell them, yeah, you need to go to cnent, but your child is already three, so he could be uh, scanned with a cbct and let's see what the orthodontist has to say. You know, because I see there's some narrowing of the maxilla and, and you know, like we have to do that early expansion to make a better breathing and sometimes it could be, uh, no need for surgery. You know, that's what I could tell you about enlarged tonsils and adenoids.

Speaker 1: 40:39

Do you make any other? Different lengths do you make any other recommendations as far as diet or allergens?

Speaker 2: 40:46

uh, and now it's that nasal hygiene, right, a nasal space, uh, high pressure, low volume space. And then, and when you have sinusitis, I tell patients you have to do high volume, low pressure, like sinus means and and like, that's like to me, that's very clear, right. And so you have like, just nasal, usually like. And now people say, dentists, right, nasal hygiene has to be like mouth, like your teeth hygiene, because and I posted a story and it was funny and I think I got a pretty good traction it was like if your kid doesn't want to brush his teeth but rinse his nose, so the mouth is, so the mouth is going to stay closed.

Speaker 2: 41:27

And if you don't give ultra processed foods, yes, you have lip seal and the saliva is acting as it should. I mean, I mean, uh, if we were like before the agricultural revolution, we didn't have toothpaste, it was all our saliva and our chewing. You know, and I like to think in evolutionary terms, you know, so I tell nasal rinses, it's so important nasal rinses and because of pollution and pollen and pollen and and mold, so nasal rinses every night and also diet.

Speaker 2: 41:59

We know dairy. It's kind of inflammatory, you know, and overall you see people that have chronic inflammation and so you have to. I usually do a high dosage of vitamin d. Yeah, amazing dha, uh. So my package of like immune, my immune package, as at Renata, is probiotics, vitamin D, omega-3, and then nasal rinses. And then, with families, I go through environment here at my office I have a HEPA filter, so I do. And then, like Dr Zaghi mentioned, it's like your dehumidifier right, your dehumidifier right, 55% humidity. Go on Amazon, buy a measure of humidity. So you go environmental, you go diet, you go basic nasal rinses and sometimes you do a little bit of steroids. But you see, overall, and then, yeah, I mean kudos to you all Like let's see, see about your chewing.

Speaker 2: 43:06

Let's see about your swallowing. Let's see about your breathing. Let's see about your horror habits. Let's see posture right and and and, and. I think that's my contribution to families to tell them how to uh, how to walk, uh that path amazing all we're getting to the end of our meeting today, but I have two last questions.

Speaker 1: 43:26

One of them is what would you recommend for everyone listening out there patients and myofunctional therapists alike? Uh, what would you recommend a better way for us to approach our pediatricians?

Speaker 2: 43:44

Wow, I don't know why I listen to you guys and they tell me in the States. You cannot imagine how hard it is for us to talk to pediatricians. I think, advocacy, find one pediatrician that can spread the word, that could be one. And I think, uh, you, uh, the culture there, there in the states, a lot of meet and greet, a lot of social, you know, like, let's connect, let's uh have a, so, uh, like that's the way of spreading the word, that I would say, uh, we need to broaden our learning. So if I go three years back in time, I would love to have something like the 101 of Mayo, something basic.

Speaker 2: 44:37

I think you've already done it. But it's like I would say two things to make my question. To be on point, I think find one pediatrician that's on your side and that could be a good advocate to keep spreading the word. And the other one is keep working on the importance of the team-based approach and also, I think, through parents, parents, I mean help. I mean, if parents tell their stories, pediatricians listen to their parents you know, and uh.

Speaker 2: 45:12

So if parents tell, tell you. As a pediatrician, you know what. I went to bernarda and my kid is breathing, sleeping better. You know those antibiotics for the otitis media, the one that's over current, I mean because of the function of the tongue and the position of the of the muscles.

Speaker 1: 45:30

Everything's getting better, so that's what I would answer um, and if there's any parents listening to this who has had improvement, you know, on their child breathing, sleep, with myofunctional therapy, with orthodontics, with any airway specialist I think it's called airway revolution my friends over there they're collecting stories. Yes, they're collecting stories. So if you'd like to share your story, I know a lot of our parents do not want to share photos and I want to share anything, but if you know how many other lives you would be saving by sharing yours, I really would ask you to think kindly to be able to let us share your stories. And then the last question that I have is and I'm going to share first and then you can share what is one thing that you would tell young parents? One thing you tell young parents that you wish you knew whenever you had your little ones.

Speaker 1: 46:33

For me, actually, there's two.

Speaker 1: 46:36

One I usually tell girls that are pregnant that I used to meet whenever I was cleaning their teeth go ahead and have an appointment with an IBCLC, an international board certified lactation consultant, before you have a baby, if you're wanting to breastfeed, because breastfeeding is so difficult, it is a learned skill and for you to have all the information before you, even you know the challenges arise if you already know what to do if they come.

Speaker 1: 47:06

It'd be a lot better because after you have your baby, you know hormones are high and you're stressed and you're exhausted. And it's a lot easier if you already have, you know a phone number that you can call and somebody to help you, and you already know what to do. And then the second thing that I'm going to share is I wish I knew how important movement and massage is for little ones Like I totally just want to have another baby just so I can massage the heck out of them all the time. So to help them move and to help them, you know, with the growth and development. If I had any idea how important it was, I would have done it all over, but your turn my turn.

Speaker 2: 47:50

You beat me to it. You beat me to it, but I was gonna say movement. I I am impressed how uh much lack of awareness is to the import, to the importance of the body connections through movement. So my recommendation to a young parent is do body work on yourself. You know, and we are so interconnected as human beings and nervous systems. So my recommendation is I would treat you with a gift card for both of you, as a couple.

Speaker 2: 48:23

Go to an osteopath or a chiropractor or a body worker and do some body work yourselves. And as a pregnant, as a pregnant, uh, uh, future mom to be I will do a lot of body work during and here's another gift card to you as soon as your baby's born, even if it was a vaginal delivery, go and have a cst session and or have it along with your baby. I've seen so many cases like laurie laurie hendrickson that does work with moms and children, with their infants at the same time. And you see just like you melt like butter and it's so. You breathe better, your mood changes, you even poop better, you know.

Speaker 1: 49:10

Yeah, all of your systems are affected, number one by your breathing, and then everything is just a cascade.

Speaker 2: 49:18

Yeah, so breathing, breathing and body work. That's what I would say, that's what I would tell parents yeah, Breathing is so important.

Speaker 1: 49:26

I love it.

Speaker 2: 49:28

Again we end up saying breathing. I love that from Dr Zaghi, because breathing is the beginning. You know, I love that.

Speaker 1: 49:35

I always say the first thing you do when you're born is the last thing you do before you die. If breathing is affected, it's going to affect every single system in your body. So breathing is always number one. If you're a mom and you have a child who has enlarged tonsils and adenoids and you're trying to do myofunctional therapy, you're trying to do any of these habit correctors. It is not going to work. You have to address breathing first.

Speaker 1: 49:58

We know that we don't want to do surgery first. However, are you willing to stop all sugar, all dairy, all processed foods, you know, maybe gluten? We have to try and see what are the things that could be affecting our child, but there are answers out there. We don't know yet exactly 100% of what causes enlarged tonsils and adenoids, but we know that these things can make them worse. So, of course, mouth breathing does not enlarge them, but it does make them worse. Anyways, this has been such a wonderful talk. How can people find you Share with everyone your Instagram, your incredible Instagram account, and your practice. What else do you have? Do you have courses or a book, or go ahead?

Speaker 2: 50:40

I was thinking about you guys like you people like you do a lot of things to spread the word and you're like such a big entrepreneur and like I don't know how you do it. But yeah, I need to work on my courses. I don't have any courses yet, let's do it. I mean, yeah, I mean I need a course. There's a lot we need to like two seconds. We need to like homogenize knowledge. I mean, here in Mexico we have so many disparities so we have a lot of general physicians that don't even know. I mean like, forget about pediatricians.

Speaker 1: 51:18

Physicians overall.

Speaker 2: 51:20

So we need to do our social like, social service. You know, like so, thinking about a course for general physicians. So I need to do my course, I need to work on my podcast, but for now, to answer your question, just find me on Instagram, drericpediatra. That's where I post the most. I also have a TikTok account. That's not that very active, but Instagram is where I connect with the right people, such as yourself, and, yeah, I think that's my go-to place Instagram.

Speaker 1: 51:51

It's been a blessing.

Speaker 2: 51:52

Yes, look where I am.

Speaker 1: 51:54

Yes, and since you mentioned that, on Aerie Circle, we do have a course that I made for anybody who wants to get their feet wet. It's called Intro to Airway and we have 14 different speakers. Some of the best speakers in the world are a part of that course and I just I have it tucked in and I didn't really promote it at all. So if anybody is interested in taking Intro to Airway, you can email me at renataairwaycirclecom and I'll give you a link for it. But it's a wonderful, wonderful course. We talk about breastfeeding, about muscle movement, about physical therapy and airway myofunctional therapy, sleep. We talk about everything. It's an incredible course.

Speaker 2: 52:38

I need to take that course. That sounds amazing. Yeah, so I need to get my feet wet. Yeah, a little bit more. Yeah, thank you for for this. It was an amazing time, a great conversation, and yeah, here's for keep connecting in the in the in the future, right, thank?

Speaker 1: 52:56

you guys so much. And this uh thursday, don't forget this thursday on airway circle we have dr stanley lu, who is an incredible surgeon, sleep surgeon. So hope to see everybody there. Thank you so much, dr Eric. You have a wonderful day.

Speaker 2: 53:11

Yeah, likewise. Thank you everybody. Have a good one, Bye.

Speaker 1: 53:15

Bye-bye.