Breastfeeding Unplugged
Breastfeeding Unplugged
Tongue-Tie and Other Common Breastfeeding Roadblocks
One of the most common misconceptions we hear at Nest Collaborative is how natural and effortless the feeding bond between mama and baby is supposed to be. But more often than not, it simply isn’t the case. Here we are at the beginning stages of breastfeeding - awkwardly fumbling through, trying to figure it all out. But after a few days and weeks, it should get better right? In theory, yes. But what if it doesn’t?
You may have heard the term “tongue-tie”, which seems to be the phrase du jour for breastfed babies who can’t quite get a grasp on the latch. Believe it or not, up to 37% of babies are diagnosed with tongue-tie, so the problem is more common than many of us realize.
So what exactly is tongue-tie, how do you know if your baby has it, and what can you do about it? On the show today is the amazing Dr. Scott Siegel, President of the Northeast Oral & Maxillofacial Surgery Center for Tethered Oral Tissues in Manhattan and Long Island. Dr. Siegel has over 25 years of experience and has devoted the past 18 years to the treatment of issues related to tethered oral tissues, and to date, he has performed over 30,000 tethered oral tissue surgical procedures. To say he is an expert is quite the understatement!
We look forward to having you join us for our chat today on Breastfeeding Unplugged.
[Intro] Breastfeeding Unplugged. Welcome. Welcome. Welcome mamas and mamas-to-be. A podcast dedicated to helping moms navigate their way through the tricky world of breastfeeding. Breastfeeding Unplugged. Breastfeeding Unplugged. Welcome to the podcast mamas and mamas-to-be. I'm your host Amanda Gorman of Nest Collaborative. And this week's episode is one that I know will resonate with so many of you. As you know by now at Nest, we help moms all over the country through their breastfeeding journey. And more often than not, that first call can be full of confusion, and sometimes fear. After all, breastfeeding is supposed to be easy, right? Not all the time. So one of the most common misconceptions we hear is how natural and effortless the feeding bond between mama and baby is supposed to be. But more often than not, it's simply not the case. For most moms, the first few days and weeks of breastfeeding is hard, harder than we ever thought it might be. Sure, there are a few cases where the baby latches and everything is A-okay. But for many of us, it isn't smooth sailing from the start. And that's if mama and baby are both willing and able to start this journey together. So here we are at the beginning stages of breastfeeding, awkwardly fumbling through, trying to figure it all out. But after a few days and weeks, it should get better, right? In theory, yes, but what if it doesn't? You may have heard the term tongue tie, which seems to be the term de jour for breastfed babies who can't quite get a grasp on the latch. Believe it or not, up to 37% of babies are diagnosed with some sort of tongue or lip tie. So the problem is more common than many of us realize. So what exactly is tongue tie? How do you know if your baby has it? And what can you do about it? With me today is the amazing Dr. Scott Siegel, president of the Northeast Oral and Maxillofacial Surgery Center for Tethered Oral Tissues in Manhattan and Long Island. Dr. Siegel is a double board certified, dual degree MD DDS, oral and maxillofacial surgeon who has over 25 years of experience and has devoted the past 18 years to the treatment of issues related to tethered oral tissues. To date, he has performed over 30,000 tethered oral tissue surgical procedures. So to say he is an expert, is an understatement. Dr. Siegel. Welcome. We're absolutely thrilled to have you with us today.
Dr. Scott Siegel:Oh, thank you so much, Amanda. It's it's an honor and privilege to be here with you today, and I give you so much praise for what you're doing and help- helping with education and moving things forward.
Amanda Gorman:Yep, we love it. We love working with you. So let me jump right in. Can we start off with a quick definition of tongue tie?
Dr. Scott Siegel:Sure. You know, and and it's, you know, the first thing is that there's so much confusion out there, we're still trying to clarify this for, for the general masses and moms and pediatricians of the like. So, you know, in simple terms, a tongue tie is, you know, when you look under the tongue, the little string that we often see under the tongue, and it's normal to have a little string under there. But we define it as a tie or a restriction when when that little string is too tight for function. And, you know, basically, in simple terms, that's what it is. And it's not the inability to stick the tongue out, but it's to elevate and lift the tongue up to the roof of the mouth, it's often restricted. And that can impact feeding, it can impact breastfeeding, it can impact bottle feeding. So I kind of keep it simple. And you know, that's the quick, quickest definition I can give you.
Amanda Gorman:No, that's, that's helpful. So for parents of newborns, what should they be looking for? Or are there any real telltale signs if their baby has a tongue tie?
Dr. Scott Siegel:Right, I'd say that, you know, what we have found in the United States anyway, but sometimes even worldwide, is that there's not a uniform way of screening babies in the hospitals for these things. So and there's different types of tongue ties. Some are really easy to see like this little web at the tip of the tongue, and some are a little further back. But I'd say one of the quickest things that happens if especially you know, as breastfeeding rates are climbing up worldwide, is sometimes the almost immediate inability to latch or painful latching on breastfeeding is one of the earliest signs that we'll see. But trying to assess under the tongue is not such an easy thing to do. And unfortunately, most pediatricians aren't really trained in this area. We do find that majority of lactation consultants are, so one of the first things we will recommend is seeing a lactation consultant, you know, like yourself for an early assessment.
Amanda Gorman:Yes, absolutely. And then, the women we do see, often will bring the information back to their pediatrician. But we do find sometimes pediatricians and other pediatric providers can tend to dismiss tongue tie when they do bring it up. Why is there such a disconnect on the issue?
Dr. Scott Siegel:We find there's a big disconnect and the majority of the issues really have to do with education and experience in this area. One of the biggest I guess voids in medical education is about what we consider normal eating, normal breastfeeding, oral infant anatomy, or infant oriental anatomy inside the mouth and what's in- what we consider normal and not normal. And there's really a lack of education or consensus among pediatricians. And that comes down to the education in not only medical school, but also in the residency program. The American Academy of Pediatrics really doesn't give many guidelines to pediatricians about what they're looking for inside the mouth, or what really constitutes normal breastfeeding, or normal feeding that should be occurring on a 24 hour cycle. So most pediatricians will look at something and call it mild in their eyes, when it's actually not and a baby's really struggling with feeding or painful breastfeeding. And we find that a lot of it gets dismissed, because the pediatrician's primary goal is to look at weight gain on their healthy visits. And we see that or hear that a lot that the pediatrician says my baby's gaining weight, so they're okay. But they're not asking the mom, well, how is feeding going on a 24 hour basis, mom's dying, they're in so much pain, the baby is constantly popping off the breast or falling asleep at the breast commonly or you know, non stop. And feeding is a big struggle. And they might be gaining weight because of the increase in frequency of the feed. Or mom has the pump and you know, give the baby more milk through a bottle or double or triple feed in her baby. So a pediatrician may often say, oh, that's great, you know, or switch them to formula, we hear all these different things. So there's really inconsistency with education. And that's really where it stems from.
Amanda Gorman:One question we get additionally from from parents is whether tongue tie is hereditary? Do we think that's the case?
Dr. Scott Siegel:So in some cases, yes. And there are genes that have been isolated for a long time. And some of them actually run, you know, more on the male side. So there's like a little bit more of a predominance on in the, in the males of the boys. But so you know, when you start to talk about it, you will see some that come into my office anyway and say yes, you know, dad has it or mom had it, or in the family, we, you know, it's a generational thing. And then there are some that just seem to come out of the blue. You know, and there's other reasons that we may be developing the ties and we're not exactly sure. There's the research and some experience looking at even the amount of folic acid or folate that's being put into prenatal vitamins may have there may be a linkage to that. Not been proven, but we may be protecting against, you know, bigger, bad things like neural tube defects. But having a trade off of a tongue tie or lip tie or ties in the mouth may be secondary to that. Kind of the short answer is like yeah, there are genetic predisposition, but not in all cases.
Amanda Gorman:So there can be more than one type of tie in the mouth. Is that true?
Dr. Scott Siegel:That is true. Now, most everybody talks about, you know, ties or tongue ties as as you know, the be all and end all but I'd say the most prevalent or the one that seems to impact the breastfeeding the most or feeding seems to be the tongue tie. But there's basically up to seven spots that we check for the ties or we commonly also call as tethers or tether oral tissues, or T.O.T a lot of people will call it. So kind of lifting them in in order prevalence we see the tongue tie number one as probably the more common one, but lip ties are either the upper lip or the lower lip are very common. And you can also have them in the cheek, which are also called buccal or "buccal" buccal ties. And you can have those on the upper, or the lower cheeks on the right and left side. So basically, there's seven spots that we generally will screen for. And the majority of the babies will have, you know, either the tongue, tongue and lip, or maybe upper buccals. So it's but on a on occasion we'll see all seven spots that are tied.
Amanda Gorman:I had no idea. A lot of potential issues other than tongue tie can affect a baby's ability to breastfeed, no?
Dr. Scott Siegel:When we look at these things, and you know, unfortunately, sometimes people will really kind of say, won't you get the tongue tie fixed, and everything's gonna be fine. We look at these as a piece of a puzzle. And there could be definitely other issues that are going on with feeding. And you know, from my perspective, as a surgeon, it's really important to have these babies assess, you know, from a functional standp-, standpoint by an International Board Certified Lactation Consultant, IBCLC, because they, you guys really understand what's going on from a functional standpoint. And there could be other issues going on. So we always look at, you know, what's going on with mom, mom's anatomy, mom's supply, and other issues going on, on that end. We look at the baby, we look at baby's function, we look at baby's anatomy, you know, so we're looking at structure, structure and function. And putting those pieces of the puzzle together. Then we look at the baby as a whole. Some babies will have other issues going on, whether it's neurologic, whether it's like a structural issue with where a baby is requiring some sort of p.t, maybe they have some neck issues, torticollis or other body issues, though, you know, the the broad picture that where we say there's little pieces of a puzzle, and we're trying to trying to take all of these and look at the big picture. I don't know if that kind of answers that.
Amanda Gorman:Yeah, no, absolutely. It's good to kind of take a look at all all potential variables.
Dr. Scott Siegel:Right. Kind of look at what's going on. And then you say, well, if the baby does have a tie, and it goes in, you know, with that picture, then we just go back to kind of, you know, risk versus benefit of treatment of the tie.
Amanda Gorman:So a lot of moms want to know if their baby feels pain, if they have a tongue tie or any other related issue.
Dr. Scott Siegel:So you know, if, you know, if they're for the procedure itself, is that the question or-?
Amanda Gorman:No, just when they-
Dr. Scott Siegel:Just in general just having a tie?
Amanda Gorman:Yeah.
Dr. Scott Siegel:Yeah, I mean, you know, when we see, I can't tell what a baby's feeling, but we see it when we have older kids come in, that can tell us what it feels like. And a lot of kids will actually come in complaining that things feel tight. Sometimes we'll have you know, kids that are very restricted, when they're trying to function it is uncomfortable. We would just kind of assume that a baby would, you know, maybe tire out quickly, when they're trying to feed with these things, because they're really kind of using up so much energy, we call it beating efficiency. So many times, they'll fatigue faster, they may get a little more sore in certain spots, because of excess pull, you know, of the soft tissues when they're trying to feed. So we can kind of say they're probably not maybe not in severe pain, but they're probably uncomfortable, they're probably tiring out quickly. You know, so that's kind of what I would assume, you know, from the baby's standpoint.
Amanda Gorman:And perhaps, maybe you can take us through what a procedure looks like for a tie revision.
Dr. Scott Siegel:So when we talk about, you know, procedures and surgery and risk versus benefit, it's very overwhelming for, you know, parents, for mom, for the whole family. And we always say we're treating the whole family, we're not just treating a baby here. So we're treating the whole family. And when we- when I consult with my families, when they come in, and I really kind of sit there and talk with them, I talk about risk versus benefit. And I talk about you know, an actual procedure as far as the procedure itself is such a very quick, easy surgical procedure in my office. That and the, the amount of pain that is actually felt is, seems to be minimal. And I can say that only because when I do older kids who can tell me what it feels like, they will not complain much of pain. It's more scary than anything else. The actual procedure to release the tongue or lip tie or multiple ties and in my office, I use a laser for it. So we just wind up using a topical anesthetic. So the risk of the procedure from an anesthesia standpoint is minimal. There are some doctors that will put you know, babies under general anesthesia and that is in my mind, the risk of the anesthetic outweighs the risk of the procedure. So when we look at these procedures, we want to keep things as minimal risk as possible, as easy as possible for the baby and for the mom and for the whole family. And the actual procedure itself, I do allow families to stay in the room so they can witness what's going on with their child and their baby. So that baby's not taken from them, they actually will be able to touch their baby, while it's going through any sort of procedure. And, you know, we feel that's important. Because we do, we do expect, you know, there is a degree I don't like to say pain, but it hurts a little bit, you know, so we do numb the area up. There are some doctors out there who won't use any form of either topical anesthetic because they feel it's so quick that it won't hurt them. But we say any, any baby or any person can still feel pain. So we want to try to make it as easy and pleasant as possible for everybody.
Amanda Gorman:I'm sure that's relieving for the moms to be able to be in there and just more informed.
Dr. Scott Siegel:Yeah, and it's, you know, I always tell them, the moms, you know, your baby's gonna cry, and you're gonna cry more and, and then it's gonna be done. And as soon as we are done, they pick them right up, we go into a private room so they can get right on skin to skin, and get them on the breast. And we do have a lactation, or TLC with us, that just helps them moms with latching and whatnot, right afterwards. Just to kind of help, you know, get things moving along faster, because the biggest thing, it's not so much the procedure, but it's just helping holding hands. And I think that's the biggest thing is, you know, trying to get- it, we always talk about taking a village it take it does take a village to help these babies feed, you know, we talked about, many moms will come in with a preconceived thing, you know I thought it was gonna be so much easier than it is, like you said in your intro. And it's not and they, and it's even when we do these procedures, it's not, you know, something that you do the procedure and everything's fixed immediately. There is a process to it.
Amanda Gorman:That's great. You know, so when mom and the family is in the room for the procedure, how do you keep baby still, when you're-
Dr. Scott Siegel:So the babies are kept still by swaddling 'em. So we swaddle them and pretty tightening in a receiving blanket. And actually, you know, we have either one or two surgical assistants in with me holding the baby. I'm back basically controlling, you know, the mouth and the head. There is a little retractor that comes underneath the tongue to hold the tongue up and keep it still. And I usually will hold the lip myself with the-, you know, with my, my fingers. And then you know, the procedure itself is very quick. I get a lot of questions, well, what happens if the baby moves or you slip. And I will jokingly tell them that it's not like I'm using a lightsaber that's just kind of slices right through everything it's touching. The actual laser is a very delicate instrument. And it's only basically taking cell layers off at a time. And you kind of have to, you know, with the years of experience and knowing how to do it, that's how you become very quick and adept at it. But it's a very safe and meticulous and precise, you know, way of doing the procedure. So it's not like I'm, you know, working on a moving target the whole time. The other thing from a surgical standpoint is that I use magnifying loops. So I'm actually looking at things, either three to five times magnification. So it's like, you know, very large in my eyes, that I see.
Amanda Gorman:So you mentioned laser but some procedures use more of a cut or a clipper. So what is the difference between those two?
Dr. Scott Siegel:So the difference between what you call quote unquote clipping or cutting and laser is that the clipping or cutting is using either a scissor or a scalpel. And if you kind of look worldwide at the doctors that are, you know, providers that are- been doing this for a long time or see the most [unknown] of baby or babies or really doing the researches, majority of us are using lasers. And reason we like laser is that it, it helps stop bleeding or coagulates or cauterizes as we cut. So we find that we get a lot less bleeding, we get bitter- better visualization of the surgical site. And what we consider more of a complete relief, you know, less bleeding, so in theory you have less reattachment and other issues afterwards. So for me, my instrument of choice has been laser for 20 years. And it's been 20 years, I know in the intro that 18 years, but I'm doing it 20 years at this point. And there's many doctors out there who clip or snip with scissors and they sometimes can get very good results. But we find when we look at these side by side, and we're trying to get the research out there we do find that there's better wound healing, less bleeding for sure, maybe some less pain. So that's the biggest differences that we see between the two.
Amanda Gorman:Okay. And you mentioned, you know, looking at the big picture and the puzzle pieces. So I assume then there are some cases of tongue tie that might not need revision, or are there other options, than a revision?
Dr. Scott Siegel:Right, so when we, when we talk about tongue ties, the biggest thing we're looking at is what's going on from what we call symptoms or function. And I have some babies that will come in, and they're actually feeding pretty well, they're gaining weight pretty well. You know, it's not painful on mom, and we kind of just will kind of, almost take a wait and see approach. Like, "Well, my baby's doing pretty well. But you know, I just want to get it screened." And we'll say, on exam, I feel a bit of restriction, maybe there's some issues going on. And in some cases, we'll actually, you know, do some other forms of therapy first. We'll either do some oral suck training therapy with a lactation consultant, or in combination, we will work with what we call a body worker, which is either physical therapist, occupational therapist, chiropractor. Things that would kind of work on what we call your body tension and tightness, because there's a lot of connections between these areas. And sometimes we'll give we'll go that route before even considering a surgery.
Amanda Gorman:That makes sense. Least invasive first. So if a mom elects not to do a procedure, are there any potential longer term effects for baby?
Dr. Scott Siegel:Yeah, so when we look at these things, many of us, you know, especially if a baby is coming in with a functional issue. And we we talked to the parent, we identify that there are obvious ties, and we'll we'll review them with the family, like, we go back to the risk versus benefit. And we're really- is kind of emerging research in this area coming out, even in the past few years looking at untreated ties, and making kids more predisposed for developing other issues as they get older. And we have found that, although this is not a lot of hard science and research, although those come kind of coming down the pike, there are risks of untreated ties. Now, when we go back to, you know, what we see in our experience, in my 20 years of experience, is a lot of these kids follow patterns. And we see a lot of these kids, when I see a lot of these kids coming in with speech issues or solid food feeding issues or longer down the road with either sleep disordered breathing, orthodontic issues. You go back in their history, many of them started off with a breast or bottle feeding issue, and then they kind of just progressed down the line. So when I actually do my consult, you know, we talk about the long term impact and prevention. So, you know, when I kind of talk as a as a complication, and I know it's one of the questions in this kind of ties in pardon the pun, it kind of ties in, when a mom elects not to do a procedure, I will kind of tell them, what we usually will see long term. And usually we'll start to see when a tongue is restricted in its elevation, one of the things that happens, it's not allowing the roof of the mouth to kind of flatten out and spread out. So what we have found, and a lot of that research has come out from the oral myofunctional community speech therapy community is normal resting posture for a tongue should be resting on the roof of the mouth, and we start to see that in the babies. So in my consultation, I'll say,"Well, you know, if the baby can't elevate its tongue and rest on the roof of the mouth, that's going to start to affect how they grow and develop long term." And what will happen during during the growth and development of the babies instead of the roof of the mouth flattening out and spreading out. It starts to get narrowed, it arches up higher. That does a couple of things, it makes it more difficult for the tongue to get up to the roof of the mouth for feeding. But it also makes it more difficult for the baby to breathe, and they start to become more mouth breathers. As the kids continue to grow and develop, oftentimes, that'll start to lead into difficulties with eating solid foods because they can't get the tongue elevated. They can't get this good wave like motion of the tongue going on. And we just see them coming back in. I can see them coming back in at the next stage with solid food feeding issues. After that is usually a speech and articulation issue. And then longer term after that they can cause issues with the growth and development of the jaws, teeth, airway. So that's kind of you know, what we see with untreated ties and that's what I talk about my consultation with the families. Not to overwhelm them, but kind of give them you know, all of the information so that they can make an informed decision.
Amanda Gorman:I agree 100%. You know, talking about your consultations, what is the process kind of from when mom and baby first come in to consult with you through the actual procedure?
Dr. Scott Siegel:Right. So it, you know it all starts from the first phone call. And the majority of moms and families are, you know, extremely anxious. And so my staff deals with this all day long. And we just number one want to tell them that, you know, you come in, as soon as you know, they're, they get that first phone call, we try to be warm and inviting, and make them feel safe and secure. So that, you know, starts when the first phone call. When they come in the actual consultation, the majority of it is listening. I really need to sit there and listen, because even when I'm training pediatricians and pediatric dentists and others, like the parents, and the mom will tell you the diagnosis, as soon as you're sitting there and listening to the full story of, you know, tell me what's going on. What's bringing you here, tell me about your feeding and your feeding experience. And you know, what, what is it like on a 24 hour cycle. And that's really, the majority of my time is spent listening. A small majority of my time is then you know, taking a look at the baby and doing my exam. I typically don't need to really sit there and look at the baby feeding because the majority of what's told to me kind of make that assessment. And when I say, you know, a vast majority of these babies already have been assessed by a lactation consultant as well. So I look at the baby, we swaddle them up, and I look at them. And I examine them from behind, because it's really the best way to kind of get in there and look at you know, lift up the lip, get underneath the tongue, do a full oral exam. And I will kind of, you know, if I see something in the mouth, and if I see ties, I bring the parents right over and show them what they- what I see, that this is what I see, this is what I don't see. And then I talk about each area and how it's impacting their feeding. And as, as I said earlier, pieces of a puzzle. And then I talk about the actual procedure, which I kind of described before, and I go over the risk and benefit. And in my experience with these procedures, the actual risk is very low. The biggest issues I find and I don't really like the word- to use the word risk, is that they can heal back together. And many people call it quote unquote reattachment, or you know, meaning those areas healing back together a little scar tissue. And that's really, you know, from a surgical standpoint, what I see. In my own practice in those 30,000 cases or whatnot, I have not even seen an infection from this. And that's what I tell the parents. We're not near any major anatomy for the procedures, as long as you're doing it with somebody who's experienced. So we're not seeing any issues with nerve injuries. We're not seeing any issues with you know, salivary gland, injuries. There are reports in the literature of certain things. So if you look at those risks, and those get listed on a consent form, so it can sometimes be scary for a family to see that. But then we say no, this is not what we see. In my experience, the reattachment is the thing that we battle. So to prevent that, we have to do some stretching exercises at home, which are pretty easy to do. And we show you how to do that. And you know, where I will have my families check in with me weekly with pictures and in between any texting to know if there's any questions or concerns. So that's the consultation. That's what I am basically telling you exactly what I tell the family and my consultation.
Amanda Gorman:Okay, and then would mom and baby expect to have the procedure done on the same day?
Dr. Scott Siegel:They are, you know, when we always build the time in, so when I present everything to them, and go over that- what I said to you- and we're at the end of the consultation, I'll say, "And it really it's up to you that those are indications we would recommend the procedure and it could be done today if you wanted to. If you don't, there's absolutely no pressure, you can think about it, you can come back." I would say probably about 99% of the families have already made up their mind even before coming into the office and say, you know, if you see something, and it's there that we want to go ahead and get it done. So it can be done. And I'm right then and there. And the parents are welcome to stay right in the room. As I stated before, I welcome that. I prefer it so that they can actually still maintain contact with their baby and touch them and then scoop them up as soon as we're done.
Amanda Gorman:Great. And so you mentioned the aftercare exercises and that you check in with photographs. Is there any- anything specific that you want parents to be looking out for or to know about post-op other than the exercise?
Dr. Scott Siegel:The biggest thing is post-op while again we go over big in a lot of post op instructions. We're always talking about pain management, you know, right off the get go and trying to keep things as minimal and I find the majority of babies don't have much pain. But the newborns, I do find that they're pretty fussy the first day, the first six to eight hours or so. So we do a lot of hand holding, we recommend mom's a warm bath, skin to skin, you know tons of skin to skin, and getting, you know, back in touch with, with you guys as soon as possible, you know, make making sure that they have the lactation support. From a, from a wound care standpoint, aftercare is what we call it, or active wound management. There's a series of stretching exercises that we have families do, they're easy. And basically, the goal is to just open up the wounds, by little gentle stretches, just especially over the first two weeks, we do it on like a five times a day basis. So it's usually like at a diaper change or, or around a feeding time. And that is, you know, really, we kind of really show them the families what to do. As far as the stretches, we have them videotape how to stretch, we actually have them practice how to stretch before they leave so that they feel comfortable with understanding, you know what they need to do. As far as what to look for, there's really not much. The wounds will will turn color as it's healing. It's kind of like a scab inside their mouth, it will kind of turn yellow, maybe a little gray looking. And it takes about two weeks for the wound to kind of look pink and normal, or what we call normal coloring of the mouth at that point. The biggest things we kind of say what to expect. And again, when when I see my families if they if there's any questions or concerns or you're not sure what it's supposed to look like, you can text me, you can take pictures and text it to me in the meantime. So we the biggest goal is to make sure that they're not feeling all alone. You know, they have that support system in place.
Amanda Gorman:Absolutely. Well, I really can't tell you how informative this has been. You know, we at Nest Collaborative are firm believers that an educated mom is the best kind. And it sounds like that is your support and your mission as well. So Dr. Siegel, we're really grateful that you took the time to speak with us today. And how can listeners get in touch with you if they have questions or want to book a consult?
Dr. Scott Siegel:Right, the the easiest thing to do is either, you know, you can go onto my website, which is www.drscottsiegel.com. "dr scott, scott siegel, siegel.com". My email is on there. That's an easy way to contact us. My phone number is on there too. That's probably the best way just even for general questions. Contact me directly.
Amanda Gorman:Excellent. Well, thank you so much again, we can't wait until you visit us next time. And we certainly would love to have you back.
Dr. Scott Siegel:It's my pleasure. And you guys are doing an amazing job. And again, you know, you're educating, we're educating, and you know, one one baby at a time, one mom at a time, and it's helping everybody move forward.
Amanda Gorman:Yeah. Well, mamas and mamas-to-be that is all that we have time for today. Don't forget to check us out on Facebook and Instagram where we will provide you with links to a full transcription of today's podcast so you don't miss a beat. As always, we do want to hear from you. So if there's a topic you'd like to explore, we are all ears. Until next week, it's me Amanda wishing you well on your breastfeeding journey. Boo bye. [Outro] Breastfeeding Unplugged. Breastfeeding Unplugged.