https://www.nurturemomandme.com/

Nurture Development & Lactation, LLC, 1204, El Paso, TX (2026)

02/17/2026

Feeding in the NICU is not something we do TO infants. It is something we do WITH them 👏🏼

This is WHY we should take infants out of the isolette or bassinet to feed. Because feeding is more than nutrition and holding offers benefits.

Skin-to-skin contact and close holding support physiologic stability, including improved heart rate variability, oxygenation, thermal regulation, and behavioral organization. When infants are held during feeds, we may see these same benefits of improved state control, more organized suck swallow breathe coordination, and better feeding endurance. It also allows for us to respond quicker to stress and provide support.

Feeding is a social interaction and continues to be for life. For infants oral feeding is one of the earliest repetitive relational experiences a they have. Holding during feeds contributes to attachment, communication, and trust.

For parents, feeding is often one of the first ways they feel like parents in the NICU. When medically appropriate, removing physical barriers between infant and caregiver strengthens bonding, increases parental confidence, and reduces stress. Letting them hold also ensures they can see, feel, recognize, and respond to their infants cues. Feeding becomes an activity parents and infants do TOGETHER!

Are there situations where an infant might need to be fed in the bed? Yes. There are times when medical acuity, lines, instability, or surgical precautions require modification.

But those situations are typically few and far between. Typically If a baby is developmentally ready for oral feeding, they should also be appropriate to be held for that feeding.

If feeding absolutely must occur in the bed, we can still support safe and neuroprotective feeding by feeding in a side-lying position, providing containment, pacing, and protecting regulation.

As providers, this is especially important for us to model because parents are learning from us by watching. Let’s model appropriately. Every baby deserves our attention and to not be rushed to feed as fast as they can. We have schedules… but they are developing neuropathways that impact how they perceive the world around them for life!

02/01/2026

WHY we use side lying for infant feeds 🤍

Side lying feeding is not just a preference. It is a physiologically supportive position, especially for infants who struggle with coordination, reflux, apnea, or oxygen desaturations.

Research shows that side lying feeds support:

• Fewer apnea and oxygen desaturation events during feeding
• Better heart rate stability
• Improved suck swallow breathe coordination
• Safer airway protection with reduced pe*******on and aspiration vs upright feeds
• Greater infant control of milk flow and less choking episodes
•Increased milk intake

Why?

In side lying, gravity is no longer pulling directly on the jaw, tongue, and oral structures. This reduction in gravitational load allows for more organized jaw stability, improved oral motor patterns, and smoother coordination of suck swallow breathe.

Milk flow is no longer pulled straight toward the back of the throat. Flow is slowed, giving the infant slightly more time to manage milk intentionally, so they can breathe, rather than being forced to hold their breath and swallow rapidly. When there is too much milk, it moves toward the cheek and can be directed out of the mouth when needed, supporting swallowing safety and respiratory coordination.

Side lying feeding supports regulation, autonomy, and safety, allowing the infant to lead the feed rather than gravity.

01/27/2026

Paced bottle feeding is a term that I see used a lot used on social media.

Especially in lactation. It typically refers to holding the bottle more horizontally to slow milk flow and reduce the effect of gravity pushing milk too quickly into an infant’s mouth so they have more control.

While this strategy is helpful, maintaining a bottle horizontal during feeding is only one piece of the puzzle. Bottle position alone does not make a feed safe, supportive, or stress free for an infant, especially preterm or medically fragile feeders in the NICU.

When I work with infants both in the NICU and after discharge, I focus on three key elements:

1. Infant behavior and cues

I closely observe the infant’s responses throughout the feed. Every eyebrow raise, blink, swallow, breath, pause, or lack of pause. I’m watching to see:
•Are they breathing comfortably?
•Are they pausing on their own?
•Are they holding their breath or swallowing too rapidly?
These cues tell me whether the feeding experience is organized and safe or becoming stressful. They also guide when and how I need to intervene.

2. Co-regulation during the feed

Feeding is a shared activity. Holding the bottle horizontally alone does not provide a co regulated activity. Even with reduced flow, infants can quickly become overwhelmed. My role is to co-regulate by adjusting pacing, timing, and support in response to the infant’s cues to help them stay organized and regulated throughout the feed.

3. Positioning to support control
Full body positioning matters. In many cases, side-lying feeding provides more support than upright feeding with a horizontal bottle. I often recommend a side-lying position to give the infant more control over milk flow and swallowing. Especially if an infant continues to struggle despite external pacing and flow adjustments in a more upright position.

While these three elements don’t encompass every part of what I look for during feeding, they are a major part, and should always be considered when it comes to infant feeding.

pacedbottlefeeding

01/21/2026

Respiratory Coordination 🚩

What do you notice in this video?

Do you hear the hard swallows that turn into big gulps?

Do you notice that baby is holding their breath?

Do you hear and see the increased work of breathing ?

Do you see the shoulder hiking during breathing because baby is using their accessory muscles to help breathe?

Do you notice that for some of breath breaks, there isn’t a full recovery before the next sucking burst begins?

Do you notice the shallow latch and pursed lips?

This is a stressful feed.

All you of these things are signs that baby needs some help.

-Help to coordinate the milk easier by slowing down.
-Help learning where to place a breath before running out of air.
-Help by maybe moving into more supportive positioning.
-Help to make this feed less stressful and more coordinated & comfortable.

This is what poor respiratory coordination looks like. This is what too much milk too fast sounds like?

And continued feeding in this pattern can lead to fatigue, physiological decline, feeding aversion, shutdown, and maladaptive strategies.

It’s not enough for a baby to eat, how they do it matters.

Because feeding should be enjoyable, safe, stress free, and sociable.

At every age.

01/20/2026

5 things I look for before increasing ni**le flow in the NICU 🍼

Many infants begin feeds on very slow flows and for some, that remains the safest and most effective option, even at term or term equivalent age. For others, we may trial a faster flow, such as moving from an ultra preemie to a preemie ni**le or assessing a slightly faster bottle a family plans to use at home, always with careful monitoring in the NICU.

Before we trail however, here’s what I watch for 👇

1. Physiologic stability with feeding
Stable heart rate, respiratory rate, and oxygen saturations throughout the feed. If a baby is already struggling to maintain vitals during feeding, increasing flow can increase stress and risk.

2. Activity tolerance for a full feed
Can baby remain alert and engaged for 25 to 30 minutes? Feeding is hard work in the NICU, regardless of age. Fatigue is rarely caused by a ni**le being too slow. More often, it reflects limited respiratory endurance. Increasing flow in a baby who already fatigues quickly will usually shorten endurance rather than improve efficiency.

3. Independent self pacing
Baby is able to pause and breathe on their own without loss of vital sign stability. This shows emerging maturity and reduced reliance on external pacing to remain safe.

4. Consistent tone and organization
Not just awake, but present. Baby maintains appropriate muscle tone, midline orientation, and postural stability from the beginning to the end of the feed.

5. Efficiency is the only missing piece
Baby demonstrates all of the above but milk transfer remains slow. Maybe feeds consistently extend beyond 30 minutes or volume is left behind. This is the baby where we may carefully ask, “Can they handle a slightly bigger bite?”

Any time flow is increased, we monitor response over the next 24 to 48 hours. We want baby to maintain volume or start slowly increasing.

If baby isn’t keeping up with the change, we revert back to a slower flow. No harm. No failure.

These are guidelines, I have found work the best. Increases should always be guided by the baby, not the clock, the volume, or gestational age.

09/04/2025

✨ This mama saw me in her home at 4 days postpartum.

Baby had lost >7% of birth weight, milk was just beginning to come in, and latch was painful. Baby’s diapers showed mostly dark stools that were beginibg to transition.

Here’s what we worked on together:
✅ Achieved a deeper, more comfortable latch
✅ Discussed strategies to support milk transfer
✅ Completed pre- and post-feed weights to see how much baby transferred
✅ Initiated hand expression/manual pumping and gave expressed milk after breastfeeding to support intake and protect supply
✅ Encouraged family to share our plan with the pediatrician at their follow-up right after our visit
✅ Scheduled a follow-up to keep tracking progress

Supporting families through these early days is about balancing baby’s intake, protecting supply, and helping feeding feel more comfortable for mom. 💛

What was your postpartum journey!!

08/24/2025

Coming September as a 4 week series!
Sep 13th
Sept 20
Sept 27
Oct 4th

A mommy & me class that targets one of the most common issues I see as a pediatric occupational therapist!

Flat Head Syndrome!

This 4 week series class is designed with moms and babies in mind.

I’ll teach you the same tips and tricks to fix flat spots, that I teach my clients, and have personally used as a mom of 4.

Not ready to commit? 1 Drop in class: $35

Ready to round? Full 4 week series $160 + Free FDA cleared head shape positioning hat. A 50 dollar value!!! (Tortle)

* Optional add on!! $45 1 PediaMetrix SoftSpot head scan & consult: (Digital scan of your baby’s head to assess degree of flatness and 15 minute consult with the OT)

Spots are limited! Drop a comment or send a DM, or text register!

Nurture Development & Lactation, LLC

02/17/2026

02/01/2026

01/27/2026

01/21/2026

01/20/2026

09/04/2025

08/24/2025

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