The Untethered Podcast™

In this solo episode, Hallie Bulkin dives deep into the "noise" of complex feeding therapy. When a child presents with multiple overlapping issues, it’s easy for clinicians to feel stuck. Hallie explains why the secret to better outcomes isn't working harder or using more strategies - it’s prioritization.

By breaking feeding down into four essential layers, Hallie provides a framework for identifying the "primary limiter" and building a treatment plan that actually moves the needle. Whether you’re a seasoned therapist or new to the field, this episode will help you trade confusion for clinical confidence.

Key Topics & Takeaways

The Four Layers of Feeding: Understanding the hierarchy of physiological stability, oral motor skills, sensory processing, and behavior.
Cutting Through the Noise: Why treating every issue at once often leads to plateaued progress and clinician burnout.
Identifying the Primary Limiter: How to determine which factor is actually holding the child back from reaching their next milestone.
The Foundation First Approach: Why skipping foundational stability for high-level skills is a recipe for failure.
Clinical Confidence: How mastering decision-making skills changes the way you show up in the therapy room.

Soundbites

"The problem isn't effort, it's prioritization."
"Not everything is equally urgent. If we treat everything like a priority, nothing is a priority."
"Clarity in your plan builds confidence—not just for you, but for the families you serve."

Timestamps

02:09 – The Real Problem: Effort vs. Prioritization
03:19 – The Confusion Loop: Why Feeding Cases Feel Complex
04:22 – Identifying the Primary Limiter in Feeding
05:05 – Layer 1: Physiological Stability
05:54 – Layer 2: Oral Motor Skills
06:25 – Layer 3: Sensory Processing
07:01 – Layer 4: Behavior and Learned Patterns

If you’re feeling unsure where to start in pediatric feeding, Screen The Peds to Feed The Peds is the perfect next step.
Join me for this free 3-day training, where I’ll show you how to screen feeding cases clearly, confidently, and with intention — so you know what to do next.

👉 Join the free 3-day Screen The Peds to Feed The Peds training

WORTH A LISTEN: CONTINUE YOUR JOURNEY

Why Two Therapists Get Different Feeding Outcomes (And How to Fix It)
Why Pediatric Feeding Therapy Feels So Hard and What’s Been Missing

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If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!
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In the ever-evolving world of motherhood, the journey through breastfeeding can often be fraught with challenges. In this episode, Hallie Bulkin and Tamari Jacob (CLC, founder of One With The Pump) share their personal experiences with exclusive pumping—a path less traveled but deeply impactful for many moms.

Moving beyond traditional nursing expectations, Tamari opens up about the reality of the "hot mess express," from the initial confusion of latch struggles in 2017 to the emotional weight of grieving the nursing journey she thought she’d have.

Whether you are a parent feeling isolated in your feeding choices or a professional seeking to provide more compassionate care, this episode sheds light on the emotional and practical pivots required to navigate infant feeding when the "natural" path doesn't go as planned.

Key Topics & Takeaways

The Unforeseen Challenges of Nursing: Why we must normalize the shift from nursing to exclusive pumping when reality doesn't match our expectations or a baby struggles to latch.
A Community of Support: How connecting with others—through online groups and social media—provides the validation and specific pumping education that is often missing from traditional healthcare.
The Shift to Creating Change: How a personal project during the 2020 pandemic turned into a global platform to fill the gap in pumping-specific resources.
The Emotional Toll of Feeding Struggles: Addressing the grief, guilt, and "triple feeding" trauma that occurs when feeding becomes a source of stress rather than bonding.
The Professional Gap: A look at why many training programs fail to provide adequate lactation education, leaving parents to "drive the boat" in their own advocacy.

Soundbites

"I assumed that I would nurse because why wouldn't I? But when it didn't work, I found myself on the 'hot mess express,' grieving the journey I didn't have."
"Exclusive pumping is essentially a second full-time job. We didn't just need the equipment; we needed to know we weren't alone in the middle of the night."
"We have to stop chasing a 'perfect' ideal and start aligning our feeding choices with our values—bonding, flexibility, and mental health."

Timestamps
00:00 – Introduction: The Ever-Evolving Journey of Motherhood
03:15 – The "Hot Mess Express": Navigating Latch Struggles and Confusion
08:42 – Grieving the Goal: Processing the Emotional Toll of Feeding Challenges
14:10 – Finding Your Village: The Rise of the Exclusive Pumping Community
21:30 – COVID-19 & The Content Gap: Creating the Resources You Needed
29:45 – Advocacy & Education: Why Compassionate Support is Non-Negotiable
38:20 – Aligning Values: From "Perfect" Feeding to Mental Health Sanity

WORTH A LISTEN: CONTINUE YOUR JOURNEY

Episode 164: Lactation Consultants Journey Into Tethered Oral Tissues
Episode 82: Bottle Refusal Is Not Always A Feeding Disorder With Jill Rabin M.S. CCC-SLP/L IBCLC

STAY CONNECTED & GROW YOUR PRACTICE

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Connect with our guest, Tamari Jacob:
Follow One With The Pump on Instagram | TikTok | YouTube Visit onewiththepump.com

If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!
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Is a thumb-sucking habit just a "phase," or is it a survival mechanism? In this episode, Hallie Bulkin breaks down the often-misunderstood world of oral habits in infants and toddlers.

Moving beyond the traditional "just make them stop" approach, Hallie explores how frequency, duration, and intensity act as a roadmap to a child’s underlying airway and developmental health. Whether you’re a therapist or a parent, this episode will change how you look at pacifiers, fingers, and oral fixations forever.

Key Topics & Takeaways

Decoding the "Why": Why we must stop viewing habits as behaviors to be eliminated and start seeing them as symptoms to be investigated.
The Compensatory Connection: How thumb sucking often masks underlying airway issues or tongue-tie restrictions.
The Triple Threat: Understanding the "Frequency, Duration, and Intensity" framework for assessing when a habit becomes a developmental red flag.
Sleep & Behavior: The hidden link between poor sleep quality and the "behavioral" concerns that often land children in therapy.
The Professional Path: Why specialized credentials in pediatric feeding and myofunctional therapy are non-negotiable for lasting results.

Soundbites

"We have to stop asking how to stop the habit and start asking: What is this habit trying to tell us about this child's system?"
"If a child is biting through a pacifier or sucking their thumb aggressively, they aren't just seeking comfort—they might be seeking an airway."
"Frequency, duration, and intensity. If you don't look at all three, you're missing the full picture of a child’s development."

Timestamped Chapters

00:00 – Introduction to Oral Habits: More Than Just a "Phase"
02:29 – Defining Oral Habits: From Pacifiers to Fingernails
04:30 – The Red Flags: Identifying When a Habit Becomes Problematic
07:50 – Why Credentials Matter: Finding the Right SLP or OT
10:25 – The Airway Connection: Is the Habit a Compensation?
12:19 – Root Cause Resolution: Moving Beyond Habit Elimination

WORTH A LISTEN: CONTINUE YOUR JOURNEY

Ep 363: Tongue Ties, Oral Habits & the Future of Airway Health (with Dr. Casey Jones)
Mouth Breathing in Toddlers: Why It Matters

STAY CONNECTED & GROW YOUR PRACTICE

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If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!
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The world of myofunctional therapy is currently seeing a surge in "preformed appliances"—ready-made mouthpieces designed to guide dental growth and improve breathing. But are they a silver bullet or a systemic shortcut?

In this episode, Hallie Bulkin is joined by the legendary Autumn Henning to pull back the curtain on these tools. From hygiene concerns like mold growth to the physiological risks of "cookie-cutter" treatment, this conversation is a must-listen for any therapist or parent considering an appliance-based approach.

They dive deep into why a multidisciplinary team and a holistic view of the "Integrated System" are the only ways to achieve lasting functional outcomes.

Key Topics & Takeaways

The "Cookie-Cutter" Limitation: Why a one-size-fits-all appliance can lead to compensation rather than correction.
The Hygiene Factor: A frank discussion on mold growth, dyes, and sensitivities in pediatric appliances.
Airway First, Always: Why comprehensive imaging and evaluation must precede any device being placed in a child's mouth.
The Multidisciplinary Team: Understanding the roles of SLPs, myofunctional therapists, and airway-aware dentists in a successful "Integrated System."
Financial Reality: Assessing the cost, durability, and true clinical value of these devices versus functional therapy.

Key Soundbites

"Kids can bite through these appliances in 24 hours. We have to look at the durability and the 'why' behind that force."
"We can't treat in silos; the system is integrated. If you move the jaw without looking at the airway, you're missing the big picture."
"Don't dismiss treatment based on a diagnosis alone. Early intervention and the right team can change a child's entire facial development trajectory."

Timestamped Chapters

00:00 – Introduction and Guest Credibility
01:54 – How Preformed Appliances Work vs. Case Selection
06:16 – The Hidden Issues: Mold Growth and Appliance Hygiene
10:01 – The Necessity of Comprehensive Evaluation and Imaging
16:34 – Building a Multidisciplinary Team for Holistic Success
27:20 – Sleep Disordered Breathing and Neurodevelopmental Impacts
41:26 – Autumn Henning’s Program Updates: TOTS Gold & Feed the Peds

WORTH A LISTEN: CONTINUE YOUR JOURNEY

Why We Can’t Ignore the Airway in Pediatric Feeding Therapy
Episode 309: 5 Airway Health Tips for Children with Hallie Bulkin

STAY CONNECTED & GROW YOUR PRACTICE

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If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!
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The foundation of health isn't just how we move or eat—it’s how we breathe.

In this milestone episode, Hallie Bulkin is joined by certified practitioner Kaitlyn Shrum to pull back the curtain on the Buteyko Method. While many view breathing as a passive act, this deep dive reveals how functional breathing is the literal bedrock of speech, feeding, and cognitive development.

From addressing the root causes of sleep apnea to navigating the "Physiological Pyramid," Hallie and Kaitlyn discuss why speech pathologists and myofunctional therapists must look beyond the mouth and into the airway to achieve lasting clinical results.

Key Takeaways

The Buteyko Blueprint: Understanding the science behind Dr. Konstantin Buteyko’s method and how it recalibrates the body’s breathing patterns.
The Physiological Pyramid: Why airway and breathing form the base of the pyramid, supporting sleep, feeding, and—finally—speech at the very top.
Beyond the Mask: How breathwork addresses physiological triggers like pharyngeal critical closing and arousal thresholds that CPAPs or surgery alone might miss.
The "Stalled" Patient: Why children often plateau in traditional speech therapy when an underlying airway or tongue-tie issue remains unaddressed.
A Holistic Shift: Moving from treating symptoms to managing the "Root Cause" of speech and developmental disorders.

Key Soundbites

"Breathing is the foundation. If the base of the pyramid is crumbling, everything above it—sleep, feeding, speech—is at risk."
"We have to stop treating the mouth in isolation and start treating the human being as a respiratory system."
"Proper airway management is the difference between a child struggling for years and a child finally finding their voice."

WORTH A LISTEN: CONTINUE YOUR JOURNEY

Why We Can’t Ignore the Airway in Pediatric Feeding Therapy
Airway First: The Pediatric Dentist's Essential Role in Treating Tongue Ties and Growth Issues

STAY CONNECTED & GROW YOUR PRACTICE

💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips on
Instagram | Facebook | LinkedIn

⭐ Help us celebrate 365 episodes!!!

If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

Want to learn more about the Myo Method? Check it out here
Hosted on Acast. See acast.com/privacy for more information.