This week I had an article featured in WRAL Go Ask Mom. I shared my thoughts about building the birth team you deserve with the help of a doula and the benefits of continuity of care. Check it out and please share!
This week's guest blogger is pediatric dentist, Dr. Jasmine Elmore. Dr. Elmore has a unique background making her a top leader in her field. I am often asked about tongue ties and nursing by new parents and I am very excited to share all the information she has shared with me regarding pediatric dentistry.
1. Give me a brief background on yourself and No Limit Baby.
As a board certified pediatric dentist who served mainly underserved communities for many years, I built relationships with a lot of children and families. As I have always cared about the child attached to the teeth and not just the teeth attached to the child, I started paying attention to things that were not taught in dental school. I started to notice that a lot of children had asthma, allergies, gut issues, and their teeth were almost always crowded. Furthermore, it really bothered me that braces didn't permanently resolve the problem. In fact, they didn't address the root cause of the problem. Also, I noticed that children were breathing through their mouths all day, parents complained of poor sleep all the time, teachers expressed behavior or attention concerns in the classroom, and so many of these kids were on medications already. Growing up with a single parent mother who was always focused on prevention and being proactive instead of reactive, I wanted to find answers. There had to be a reason that I was seeing this all the time. I'm leaving out a lot of details, many include my own health struggles, but here are a few things that turned a corner for me.
I read this article and watched this video.
I had no idea how mouth breathing negatively impacted our bodies. And it became clear to me that there is a link between how we breathe and sleep and our oral health. So, once I discovered that I personally struggled with the effects of a tongue tie that went undiagnosed, I became passionate to help others. I studied for years to fully understand the ins and outs of what is really happening. I had to also take time to accept that the health education system doesn't know how to teach us these things. The book Breath by James Nestor connected the dots for many people across the country, and I received a lot of phone calls and emails from people looking for help.
I posted on Instagram my personal story and it led to many opportunities to speak on podcasts about how seemingly insignificant actions (like how we breathe, chew, swallow, sit, talk, talk, stand, and sleep) can have huge effects on our overall well-being. Here is the Instagram post.
And after studying and learning from the best minds in the world about ideal health, mouth breathing and sleep, I started No Limit Baby. Because every baby deserves to breathe, feed, and sleep without limits and I wanted to help parents put a plan in place to have a healthier baby.
2. How and why did you start No Limit Baby?
After studying with The Breathe Institute in 2018, I realized that everyone locally had this thing all wrong. When a baby shows signs of struggle, it's better to address the behavioral aspects first for long-term success. I heard too many stories and saw too many children who had tongue ties repaired but still had a lot of symptoms. And, I wanted to know why. So many parents didn't know about why they even needed the procedure and didn't know how to care for their babies before and after the procedure. I became passionate about being a part of the solution. I started No Limit Baby to bring the elite and high-end care from California to North Carolina. The Breathe Institute and Dr Chelsea Pinto are considered at the top of the food chain for this care, and I wanted to learn from and to be affiliated with the best. So, after years of learning directly from Dr. Pinto, I became the first dual trained affiliate of The Breathe Institute. I'm now looking for amazing lactation consultants and other baby specialists who want to get additional training to be able to increase their awareness in order to help more kiddos. Additionally, parents need support outside of the procedure. They need quality health information and they need to be able to ask questions. So, we are starting a community over the next couple months to help with quality information sharing and support.
3. You recently made some business changes. What prompted these changes? Describe the process from revamp to relaunch.
When you love people and want to help them with all the things you've learned from so many different genres of medicine, it gets very hard to not want to do all you can for everyone. From 2018-2020, I obtained two additional degrees, attended a sleep mini-residency program, traveled the world from Australia to Canada learning alternative opinions on the proper growth and development of our children, and studied over 1500 hours of coursework in about ten different areas of holistic health. So, when I opened my start-up business in 2020 to a waitlist of people, I offered so many different services that I had people coming in from a variety of states for a variety of different reasons. It very quickly became confusing to explain what exactly we "did" because we "did" so many different things for so many different people. And, I sat down one day and decided I needed to focus on the most important age group - birth to two years old - because the most important aspects of development are happening during this time. And, more importantly, the need for providers who understand the entire circle of life is huge. So, we decided to open a new branch called No Limit Baby that focuses specifically on the needs of 0-2 year olds and their curious parents. It's been fun!
4. What is a tongue tie?
A tongue tie occurs when the thin membrane under the baby’s tongue (the lingual frenulum) restricts the movement of the tongue. All babies are born with some of this tissue, but for approximately 3-15% of newborns, it is so tight that they cannot move their tongues freely. This can affect their ability to breastfeed and lead to poor latch, nipple pain and trauma, decreased milk intake and a decline in milk supply over time. The medical term for tongue tie is “ankyloglossia” and studies show the defect is likely hereditary.
Many babies with a tongue tie, also have an abnormally tight membrane attaching their upper lip to their upper gums (the labial frenulum). This is called a lip tie. Babies with a lip tie often have difficulty flanging their lips properly to feed and can’t create a proper seal at the breast. This can cause them to take in excess air during breastfeeding, which often makes these babies gassy and fussy.
The question that many parents have is, why is it important to care about a tongue tie?
And, I use an analogy with parents to best explain why we should care. Let's say you have a rock in your shoe as you walk from the front door of your house to the car. That's probably more of an annoyance than anything, right? You would just remove the rock and go about your day. This time, let's say you have a rock in your shoe and you walk from North Carolina to South Carolina. Now, this may be more than an annoyance. Maybe your foot is cut and your leg probably hurts, too. Simply removing the rock may not be the end of your troubles with that leg and foot after walking for a few days. Maybe you have a limp and need a little more TLC to get back to normal. Finally, let's say you have a rock in your shoe and you walk from North Carolina to California. I'd imagine over time, the rock wouldn't hurt your foot anymore. In fact, you more than likely have not just a limp but a total change in the way that you walk. After over a month, could you even remember how to walk "normally"? I would bet that even when the rock is removed from your shoe, the way you walk is forever changed. You could obviously still walk, but the new walk would have a lot more work involved in your pre-rock experience.
Now, how does this relate to tongue ties?
The tongue tie is the rock in this analogy. Many people think that removing a tongue tie solves a problem but it really doesn't for many babies! The truth is that babies start the process of swallowing and breathing while they are still in utero. They have habits that were formed many months, and sometimes years, before the rock or tongue tie is noticed. So, removing the tongue tie doesn't resolve the problems alone. It's a part of the solution, yes, but not the solution. Most likely, there may need to be some retraining of the eating, body posture or oral rest posture. Just like a re-learning of the proper way to walk in the above example. Because if you walk with a limp and off-balance for years, you put unequal pressure as your body compensates to handle tasks. And over time, problems start somewhere else. Same thing with the compensations of working with a restricted tongue.
For me, the best way to explain any "tie" is that it is a physical limitation that impacts function in a way that brings us away from normal. So, a tongue tie is a limitation under the tongue that makes it harder to do what you need to do. So, the next question is: what is the tongue and what does it do? The tongue is a network of 17 muscles (nope, not just one) that work together with our body. It's essential for breathing, eating, posture, and speech.
5. What is a frenectomy and how does one determine if it's right for their baby?
Tie revisions (called frenectomies) remove the tissue or tight frenulum under the tongue or upper lip. Dr. Elmore uses a state of the art LightScalpel CO2 laser for a safe and quick procedure that allows for greater tongue and lip mobility. In some instances, frenectomies can aid in the prevention of other health problems like dental decay or spacing, speech difficulties, and digestive issues. Dr. Elmore is laser certified by The Academy of Laser Dentistry to perform frenectomies.
While the procedure can be done with a laser or scissors, advantages of revising ties with a laser include:
A frenectomy is a complete surgical modification of the limitation or "tie" we just talked about in the previous question. It's not a quick "snip" and go. It's a procedure that takes less than a minute, but you really want to address the tension and the actual area that's structurally causing the limitation. Only a functional expert who knows and understands compensations and limitations can advise a parent on whether or not a frenectomy is right for a baby. Most importantly, a team approach is so important!
Dr. Elmore feels that post-revision care is important to the success of the revision. Essentially, the baby must learn how to use his or her tongue in a new way. Some babies need no help at all and immediately breastfeed post-procedure, while other babies may need help from additional professionals.
6. How does your practice and expertise improve the lives of infants and toddlers in the short term and long term?
Every baby deserves to breathe, sleep, and feed without limitations. Because those limitations lead to compensations. And the compensations lead to a change in the way life is lived. We should live by design, not by default. And how we live is a choice. When we choose not to accept and correct our limitations, we choose to live by default. But, when we choose to remove the obstacles so the essential things in life have clear and smooth passage, I believe that was the way life was designed to be. As an infant tongue tie specialist, it's my passion to help families help their babies reach their highest point of effortless living. Our practice helps parents choose to remove the obstacles so the essential things have clear and smooth passage. Essential things like: breathing clean air, maintaining proper balance, swallowing healthy foods, and obtaining quality sleep. A quality start leaves us best prepared for a quality finish. Here is a video that show short and long term effects.
7. What type of legacy do you hope to impart and leave for the next generation of black health care workers?
In Caribbean and African cultures, places where people who look like us prospered for centuries, health care has a different meaning. Conventional medicine focuses on a lot of tests and surgeries; most of which don't solve any real problems. If you take a look at our society, we are the land of the sick. We are not well. Just because we have gotten used to being unwell, does not make us healthy. The top ten causes of death are mainly preventable diseases and lifestyle illnesses. Conventional medicine isn't the best hope for us moving forward. Alternative medicine or holistic health care, what I like to call natural healing, is a huge part of the culture in those areas I mentioned above. There, doctors are educators not saviors. Physicians aren't the sage on the stage whose word is to be taken as gold, but rather the guide on the side to help you see that the body already has its own answers. Healers educate people on the true facts that a doctor cannot actually solve a problem for a patient with any medication or surgery. If we want to stop kicking the can down the road, we must take care of our own problems with a greater awareness of what is really happening to our bodies. When we think and speak, the body listens to us. Our future depends on the next generation of health care advocates to know and understand these principles to be a part of helping people achieve the best health outcomes.
8. Tell me about your most recent business win.
I'm excited to be working with a Pediatric Occupational Therapist in New York to create a resource for parents to get a better understanding of holistic health for their young babies. The project will be released later this year, so please stay tuned!
Dr. Jasmine Elmore is a board-certified pediatric dentist, a Certified Specialist in Orofacial Myology, and is one of a few people in the world to have a Professional Degree in the Science of Breathing Behavior. Her personal pain journey led her to airway dentistry. She has been fortunate to be trained by many of the legends in the field. She has studied in Australia and Canada, in addition to multiple states in the U.S. to understand how the entire body connects for ideal outcomes. Her “airway fairy godfather” is Dr. Barry Raphael who personally trained her in his office after she completed the Airway Mini-Residency. She’s the first dual mini-resident proctored by both Dr. Soroush Zaghi and Dr. Chelsea Pinto at The Breathe Institute. Dr. Elmore has taken courses with physical therapists, osteopaths, lactation consultants, speech language pathologists, and other essential providers to learn more about the whole patient to provide an elite level of care. Combining her studies with pediatric dentistry, airway health, restricted oral tissues and behavioral breathing has helped her holistically heal both children and adults alike.
You can learn more about Dr. Elmore and follow her here:
Personal IG: @rich_sleep
Business IG: @dr_jasmineelmore
It's Black Maternal/Perinatal Health Week and today I am sharing some tips and suggestions to help Black mothers and families thrive during pregnancy, birth and the fourth trimester.
We all know the gut-wrenching stats and realities regarding Black women and health disparities rooted in racism, ignorance and outdated healthcare methods & models. Despite the health industrial complex's somewhat acknowledgment of this in recent years, not much has changed for Black mothers or their families. In fact, the rates of Black maternal mortality have increased since the pandemic began. And while there are so many reasons why this matter in itself is an unnecessary yet ongoing plight, Black women still have a long way to go when it comes birth & health equity.
So what can you do to make sure you are protected and have the birth experience you desire? Below are some suggested things you can do to better prepare for pregnancy & birth.
Remember, when it comes to your body, your baby and your health, YOU are in control. Preparation and the right support can make all the difference.
Peripartum Cardiomyopathy (also known as Postpartum Cardiomyopathy) is an uncommon form of heart failure that happens during the last month of pregnancy or up to several months after giving birth.
Heart disease is a leading cause of death for women and kills approximately 1 in 5 women each year. However, black women are at greater risk for various reasons.
This week's guest blog comes from Charity Watkins, Assistant Professor in the Department of Social Work at North Carolina Central University, Outpatient Clinical Therapist and the Chair of Equity Before Birth's Board of Directors. A six year PPCM survivor, Mrs. Watkins shares her triumphant story to healing and advocacy.
1. Tell me about yourself.
My name is Charity Watkins and I'm a Black woman serving in numerous roles including as an Assistant Professor in the Department of Social Work at North Carolina Central University, an Outpatient Clinical Therapist, Durham resident, partner to hopefully the next U.S. Representative for NC's 4th district, and most importantly, the mom of a beautiful, inquisitive, spirited 6-year-old little girl. Through all of this, I am also a heart survivor following my heart failure diagnosis almost 6 years ago.
2. Please share your PPCM story.
Overall, I had a pretty uneventful pregnancy healthwise other than being diagnosed with gestational diabetes. I was able to manage that with a change in my diet. However, what was harder to manage were the social and interpersonal challenges I was facing throughout my pregnancy. I was a doctoral student at UNC Chapel Hill who chose to use her time as a student to not only pursue her degree, but also to pursue and promote racial equity on my campus and within my program through student activism. I was quite active in that area, participating in student protests, organizing community dialogues, coordinating efforts with various campus offices, and presenting demands for action to administration; all while dealing with the internalized self-doubt that comes from being a Black first-generation PhD student in a historically white space. And let's not talk about the normal stressors that come along with pursuing the highest degree in my field.
During my last trimester, I dealt with failing my comprehensive exam and then taking my mother-in-law to the hospital for cancer treatment for the last time before she was transitioned to hospice care. My mother-in-law, who I was very close with, died just a week before my due date--the day her first grandchild was supposed to be born. While grieving my mother-in-law, emotionally dealing with my exam failure, and then preparing to enter this new world of motherhood, my daughter decided to delay her debut for 10 days. What was planned as a natural delivery turned into the testing of almost every single delivery intervention, ultimately with my daughter being delivered via an unplanned cesarean section. I was overjoyed she was here but worried about recovery as I experienced severe bleeding in the hospital that required the manual removal of blood clots while I laid in my hospital bed with my sister-in-law holding my infant daughter and my husband holding my hand. I returned home with my baby almost a week after being initially admitted. Two days later, I was attending the memorial service of my mother-in-law--just five days after giving birth.
The first couple months of parenthood were of course tough as sleep became replaced with cluster feedings, cries, swaddling, and diaper changes. I was also still healing from my c-section. Overall, I was tired and stressed. I began to feel down, exhausted, and overall just not good. I told my OB about how I was feeling during my 6-week check-up and was told that much of what I was experiencing was normal but it also could be symptoms of the flu. With the feelings not getting better, I was then referred for counseling to address postpartum depression. I met with a nurse practitioner several times with my baby in tow but I wasn't feeling any better. My symptoms were actually getting worse as I struggled to walk up even a few steps without taking a break, had strong bouts of nausea, lost my appetite, and dealt with a stubborn cough that never would go away. Then, one night while sitting on my bed pumping, I felt an intense pain in my left arm and shoulder. I thought it was just a cramp as the pain went away about 10 minutes later. Three days later on a Saturday night, it happened again and was more intense and lasted longer. I asked my husband to take me to the ER where we went through triage and then we were directed to the waiting room. We sat in the waiting room for 5 1/2 hours before deciding to leave so I could get home to my infant daughter to feed her. My pain had subsided so I thought I was okay for the time being.
On that Monday, I called Campus Health to schedule an appointment and was seen the same day. They did a physical exam and x-rays, which revealed that my heart was enlarged. The doctor then had me rolled down to the same ER I waited in a couple days before to be further examined. After waiting another few hours, I was admitted into the cardiac intensive care unit. This is where I was told that I was suffering from heart failure. My heart was only functioning at around 5% and if just a little more time had passed before receiving treatment, I could have died. While receiving medication treatments in the hospital, I lost over 20lbs in fluid, coded after having a reaction to a heart medication, and had to have my IV administered through my neck to avoid permanent damage to my arm. I also lost precious time with my newborn baby and was no longer able to breastfeed because of my medications. I missed those sleepless nights, those cluster feedings, cries, swaddles, and diaper changes. After two weeks, I was finally discharged and on the road to recovery.
Since my diagnosis, I have completed cardiac rehab, in which I was the youngest, at least half the age of other participants. I made immediate changes to my diet to reduce my sodium intake. I'm now taking medications that I will likely be on for the rest of my life. But, I'm here.
3. What were the hardest parts of your health care journey, both personally and professionally?
The hardest parts of my healthcare journey was not getting the answers that I needed right away, which I learned later on could have resulted in me losing my life. I wasn't told that cardiovascular disease was something that could arise from pregnancy, especially among women who were diagnosed with gestational diabetes. I was showing classic signs of heart failure but wasn't diagnosed with it until it was almost too late. Personally, this was devastating especially thinking about the fact that my husband could have lost me just four months after losing his mother. My daughter could have been forced to grow up without me despite me seeking medical care for my symptoms early on. Professionally, as a researcher, I would see literature that focused on individual-level mediators of health, where blame for illness was often placed on individuals' behaviors, especially individuals who looked like me. But here I was doing everything right, communicating with my healthcare providers, being clear about the symptoms I was experiencing, using my educational background and PhD student status to advocate for myself, yet, I was so close to facing the same fate faced by Black women without the same privileges as me.
4. What did you learn about yourself and your support system while recovering and getting healthy again?
During my treatment and recovery, I learned that I am stronger than I realized. I was able to overcome what felt like insurmountable challenges to become a nurturing mom, a dedicated partner, a competent professor, and a resilient PhD candidate. I learned that my network of support was wider than I realized as well wishes, donations, meal trains, and help with household chores came from friends, family, colleagues, and faculty members. Literally, professors who were grading my papers a year before were now helping me to do laundry. I was grateful for everyone who cared enough about me to want to help me get better.
5. What do you want others to know about PPCM?
The most important points about PPCM that I want people to know are the symptoms and risks. Heart failure is one of the leading causes of maternal mortality yet birthing persons aren't provided with information about the signs, symptoms, and warning signs to look for during pregnancy, delivery, and postpartum. I want folks to know that not being able to go up five steps without taking a break is not normal after childbirth. Not being able to lay flat on a pillow is not normal after childbirth. Having extreme swelling in your body is not normal after childbirth. Pains in your chest are not normal after childbirth. And don't let anyone tell you that they are.
6. Where do you see yourself in 5 years?
In five years, I see myself continuing to thrive as a heart survivor. I see myself doing meaningful work to help other Black individuals who have faced the threat of death while giving life. I see myself conducting research with Black birthing persons to inform the development of pregnancy screening tools for PPCM to be administered during prenatal visits and developing peer support networks for Black birthing persons to address the trauma that comes along with having such serious life-threatening medical events during pregnancy, delivery, or after childbirth. I want to address the mental health needs of others like me.
7. What advice do you have for anyone who may not trust health care providers and don't receive regular check ups?
The advice I would provide to someone who may not trust health care providers and who don't receive regular check-ups is to not sacrifice your access to life-saving medical treatment because of your distrust of healthcare providers. Trust is something that must be earned but we also must demand it; not avoid it. The most effective way to change systems is to learn how they function and advocate for equity, but we must engage with these systems in some capacity to get a sense of what actually needs to change and how it can change for the better.
8. Who do you look up to or admire in the womb health and wellness community?
I look up to folx like Joy Spencer, Executive Director of Equity Before Birth, who is directly connecting with families to address the harms caused by socioeconomic equities. I admire her dedication and commitment to relying on the experiences and stories of Black birthing persons to guide her work and the mission of EBB. I am grateful to work alongside her as a member of the Board of Directors. I learn so much from her and the EBB team and look forward to supporting their work any way that I can.
9. What do you hope Black Maternal Health and health equity looks like in the future?
In the future, I hope Black Maternal Health looks like the Black women and babies being viewed as worthy of care, concern, and equal treatment. I want Black mothers to be able to focus on the gift of becoming mothers without having to worry about racial bias, discrimination, and experiencing race-based violence in the form of denial of equitable medical treatment. I hope health equity comes in the form of outcomes for Black birthing persons but also in the form of outcomes in healthcare provider racial representation, equitable healthcare policies and practices, equitable access to healthcare before and after childbirth, and effective structures of accountability for when systems do not model what is written in their missions and diversity statements.
10. Tell me about your work and role with Equity Before Birth.
I learned about Equity Before Birth a year ago after seeing Joy's amazing work in the community. When the opportunity became available for me to get involved with the organization, I jumped at it. I now serve as the Board of Directors Chair to ensure EBB realizes its mission and saves lives of Black birthing persons and infants.
To learn more about PPCM, visit www.letstalkppcm.org.
Happy New Year! How is 2022 going for you so far?
True to human nature, the new year is a time of resolution and planning. We commit to making changes, ditching old habits and shy away from what is no longer serving us. One of the biggest bandwagons of the new year (aside from the health & fitness fads) is reconsidering your job or a major career change. So many people think and talk about changing, but don't actually take the steps to leave behind the old for new beginnings. When we make room for new things and opportunities, we are asking for growth. We want better for ourselves and we seek to make that happen.
While I don't usually go around giving out advice, I will say this: If you aren't where you want to be in life, make a change. Take a class. Get involved in the community. Become a mentor. Any positive change made with intention will most certain lead to something greater. And no, it doesn't have to be big. I am not telling you to quit your job tomorrow with no prospects, okay. Start small, write down goals and begin to plan your next move. Little things can make a big impact.
So, what new things are you planing for 2022?
Are you planning to take a leap of faith?
Maybe you are called to birth work...
If so, I want to you to consider the Best of Both Worlds Doula Services Mentorship Program.
Birth work is not your average job or career. You may hear a lot of doulas, including myself, refer to their work as their "calling" and it is very true. This work requires the very best of yourself... your whole, authentic self. You have to trust our instincts and the depths of your soul because that is what will guide you above experience and education. I say all the time that birth work ain't for the faint of heart and as each year passes, it couldn't be more true. So before you dip your toe into this work, you need to really know that you are called. It could be one transformative moment in your life or a series of events that led to your calling. But you will know. And if you don't, you will be "driven" or guided to it one way or another.
The BOBWDS Mentorship Program is unique in that it is a 'mentee-led' program focused on business development specific to birth workers. I will provide simple, yet effective guidance that will assist others in determining what type of doula or birth worker they want to be and how they want to market and run their business. This rigorous 8 week program will consist of
▫️Weekly birth work & business classes held on Zoom/Google Meet
▫️Weekly homework assignments to develop each part of your business plan
▫️Researching your local community, health care system and ideal clientele
▫️A summary/overview of what you learned during the course, an outline of your business plan, a community referral list and a business resource list for networking
BOBWDS Mentorship Options:
▫️Business consultations are available to those interested in a career in birth work (recent college graduates, newly trained doulas or doulas new to the area) who may be seeking general advice or guidance. One-time 30 minute consultations are $35. One-time 90 minute consultations are $75.
▫️The BOBWDS 8-week program will explore birth work and business and help each program participant develop a unique business plan based on their interests, personalities and passions. Modules will include:
Cost for the 8-week program is $350.
▫️Ongoing mentorship is provided to mentees who have completed the 8-week program. You will receive monthly business development check ins via phone or Zoom and access to additional educational tools and business opportunities in my private Facebook group. Ongoing mentorship is $60/month.
How to apply:
▫️Fill out the application here. (Applications are now closed)
▫️Application deadline for the Spring 2022 session is January 31st, 2022.
▫️Applicants chosen for interviews will be notified in February.
Each program participant will receive a syllabus & program guide as well as a certificate of completion once the program requirements are fulfilled.
Limited spaces are available for my 8-week Spring 2022 session. Classes begin in March. Please email me at email@example.com with any questions.
Personal Note: I became a mentor to fill a need. I have learned that while fulfilling, birth work isn't for the faint of heart and I want to guide those who have a true interest in supporting families during pregnancy, birth and postpartum and how to best serve each one. I will provide the foundation to build a sustainable business, your way, while supporting families with purpose & passion.
About the Author