Podcasts about Weaning

Dr. Amel Havkic, founder and Managing Director of EvoMed Consulting and a practicing physician, unpacks why so many amazing medtech solutions never reach the patient bedside, along with advice on how to change that. Driven by frustration from frontline care, Amel built EvoMed to guide companies from development through real-world clinical adoption, and shares how his MBA research became the StarMap framework: seven success factors spanning workflow alignment, implementation friction, ecosystem fit, quality of care, and economic viability. He explains why staying in clinical practice matters as medical knowledge rapidly evolves, offers a real example of digitalization increasing clinician burden, and discusses AI as “augmented intelligence” that supports—not replaces—human decision-making.  Guest links: https://evomed-consulting.eu/ | https://www.linkedin.com/in/a-havkic/ | https://www.instagram.com/evomed_consulting?igsh=aTlyaGVmeXYybGt3 Charity supported: Save the Children Interested in being a guest on the show or have feedback to share? Email us at theleadingdifference@velentium.com.  PRODUCTION CREDITS Host & Editor: Lindsey Dinneen Producer: Velentium Medical   EPISODE TRANSCRIPT Episode 082 - Amel Havkic [00:00:00] Lindsey Dinneen: Hi, I'm Lindsey and I'm talking with MedTech industry leaders on how they change lives for a better world. [00:00:09] Diane Bouis: The inventions and technologies are fascinating and so are the people who work with them. [00:00:15] Frank Jaskulke: There was a period of time where I realized, fundamentally, my job was to go hang out with really smart people that are saving lives and then do work that would help them save more lives. [00:00:28] Diane Bouis: I got into the business to save lives and it is incredibly motivating to work with people who are in that same business, saving or improving lives. [00:00:38] Duane Mancini: What better industry than where I get to wake up every day and just save people's lives. [00:00:42] Lindsey Dinneen: These are extraordinary people doing extraordinary work, and this is The Leading Difference. Hello, and welcome back to another episode of the Leading Difference podcast. I'm your host, Lindsey, and today I'm delighted to welcome my guest, Amel Havkic. Amel is founder and MD of EvoMed Consulting, Department Head for Weaning and Home Ventilation. Dr. Amel is also a consulting medical director for many companies, apart from being an educator, mentor, author, and currently working physician. All right. Well thank you so much for being here. Welcome to the show. I'm delighted to talk with you today. [00:01:23] Amel Havkic: Thank you so much. It's a pleasure being here, and thank you for having me. [00:01:27] Lindsey Dinneen: Of course. I'd love if you wouldn't mind starting off by sharing just a little bit about yourself, your background, and what led you to medtech. [00:01:37] Amel Havkic: Okay, so my name is Amel Havkic. I am still a practicing physician. But on top of that, I'm a advisor in medtech. I am in medtech since something like six, seven years, and it actually came from the frustration that I had in everyday work on the patient bedside. I was already consulting some medtech companies on specific topics. And I've seen this huge gap between amazing medtech solutions which, however, for whatever reason, never made it to the bedside. So I ended up, I ended up fund founding EvoMed Consulting consultancy, which helps medtech companies with clinical adoption, pretty much helps them guide from the development all the way to the patient bedside. The solutions really getting adopted, really having an impact. We've had quite some success with this. We've been named best Market Access Consultancy in '25 in medtech. I personally also celebrated recently award for Best Rising Star of the industry. And yeah, all of this came from the idea that I wanted to see a world where no patient is left behind and independent of geography or economy or economic status. Every patient gets the best care imaginable. And yeah, what better way to deliver that than medtech, right? [00:03:05] Lindsey Dinneen: Yes, that was the perfect plug for medtech right there. That was excellent. So first of all, congratulations on all of your success and these recent achievements. That is really exciting and incredible and I, I know that your motivation goes obviously so much deeper than that, but I love the fact that you're getting recognized and it's, it's nice to have those moments of affirmation, so. [00:03:31] Amel Havkic: Yes, it is. I said it on the interview, which I got after the, after the award. It's not even about the award itself. It is actually about what I stand for and that is the human side of medtech. I mean, it is technology, but we're still doing it for humans. And as a doctor getting recognized and not as a founder, it is something it, it is a signal. So that's the, I think that's the positive, the good part about it, and that's what makes me proud. [00:04:03] Lindsey Dinneen: Yeah. Yeah, absolutely. So did you always have an interest in medicine? Did you always think you were gonna go this route? [00:04:11] Amel Havkic: In medicine, yes. I think as far as I can remember, thinking I wanted to be, I wanted to be a doctor. I was trying to cater to wounded animals as a, as a kid with, I don't know, four or five, six years old. Then I went to med-- no, before I went to med school, I was doing basically nursing school. I grew up in Bosnia, in Sigovina There it's after eighth, eighth grade, you decide what you actually want to do. So I decided I wanted to go into medicine and at that time, Dr. House came out and or house MD in, in the English, English terminology. And I was a huge fan. So that was pretty much my, my route was set from that. I was al also always tech savvy, so if I wouldn't have done medicine, I would've probably done IT. And at one point it kind of merged. [00:05:09] Lindsey Dinneen: Wow. Okay. All right. So Dr. House, I can totally understand why that became an, an inspiration. Do you have any examples that you could share that are like, is, is the medical world ever as wild as some of those stories on Dr. House? [00:05:27] Amel Havkic: Oh yes. Oh yes. It is specifically. So besides working in the hospital, I work in a private practice, and funny enough that private practice is focused on difficult to diagnose and rare diseases of, obviously for, for that reason. I was also working in a hospital department, which was working with with or in discovering rare diseases specifically when it comes to, to respiratory diseases. So, yeah, it is like that. I can share a story of one patient, which came to me because she had thoracic pain every now and then. And it was reoccurring, came again and again. I did an ultrasound, and so she was at a cardiologist, she couldn't find anything. The, the whole thing. And it, I did an ultrasound of the chest and I found a, a little a little mass, which is not supposed to be there. So I sent her to a CT. Funny enough, the CT came back negative because it was so small that you couldn't see it on a ct. However, when you know exactly where to look, you could still like see outlines of it. And then in the, in the discussion came out that she had an endometriosis at one point. So, we said, "Okay, this might be somehow connected." We took a tissue sample, so in the end it was indeed an endometriosis, which got discovered after 20 plus years of or, or 10 years of, chest pain every now and then. So, it's just one of the examples of the, of the, so yeah, it's Dr. House specifically is quite realistic. [00:06:57] Lindsey Dinneen: Oh my goodness. That is wild. I, wow. Okay. That is, that is really cool. So, so do you also have these these moments, I could just imagine you just feel like you've solved a mystery and you can help this patient and you know exactly how, is that just like the best feeling? [00:07:13] Amel Havkic: For, for me it is, for me, it is, I always have to describe or, or tell to my assistants in a or, or not assistants, my residents. Please don't misunderstand me. I get excited by this, not because I want the patient to be sick, but because first of all, we find a way to help after so many people could not. And yeah, just for the pure love of the game, so to say. [00:07:37] Lindsey Dinneen: That's amazing. Okay, so, well, I feel like we can go off on many tangents, but I'll, I'll try to, I'll try to stay focused because I, but I love that. I love that. So you're a practicing physician and you're, you're seeing these instances of medical technology that I imagined isn't getting adopted in the way that you know it should, that would have clients or patient impact. So you're, you're seeing this for a while. So did that lead to direct opportunities to consult for some of these companies that needed a physician's perspective or how did, how did that go from, "Hey, I, I, gosh, I'm seeing this gap" to, "Okay, I know where to go from here." [00:08:19] Amel Havkic: So, it exactly like that. So I was brought into a medtech company to consult them as a clinical medical expert on, at that point, risks associated to their solution. Of course it makes sense to have someone who is still in the trenches, so to say, because the logic behind certain workflows in hospitals or in healthcare environment is not the same logic that it guy would have when talking workflows similar. So that's how it started. And then a pattern started emerging. When I did my MBA thesis, I basically took, took these two, these two, that, that gap that I saw and made it a topic of my MBA thesis. I was looking specifically on success factors in healthcare and what makes a solution gets adopted or delivery system healthcare path, what makes it get adopted in the real world and what does not. And what emerged was basically knowledge graph constellation, so to say, of seven success factors. And that constellation also showed how they're connected with each other, so, and how they interact how they impact one another. So I put that to the, to the to the test, the findings, running multiple times the most profitable hospital unit in basically every hospital I went to, starting my private practice, which got profitable from day one. Consulting clients on the same on the same, framework who were able to triple their, their revenue from 30 to 90 million. And so on, so forth. And ultimately then just about half a year ago, I made the framework public, and that's the StarMap framework which is the moment when everything kicked off. So everything I I said after all the awards and all the recognition came after I shared what I've been holding back up until that point. [00:10:25] Lindsey Dinneen: Okay. Alright. Wow. All right. Can you share a little bit about this framework and what makes it so unique and impactful? [00:10:34] Amel Havkic: So what the eye recognized is that it works because it's basically backwards engineered. I had the benefit of hindsight and had the benefit of seeing the solutions, which really made it to, to the patient bedside. So this is a challenge that many medtech companies, specifically the medtech startups face. You know, they come actually from the other side trying to pick one of the hundreds, if not thousands of ways to to, to navigate, to come to that one point where they want to be. For me, it was exactly the other way around. I was already where they want to be and was able to backwards and engineer those factors. And it is, when you think about it or when you read through it, it's almost common sense. Factors like specialization, cooperation and ecosystem fit, workflow alignment, predictability of services. But also implementation, friction digitalization, quality of care, and specifically economic viability. So pretty much a 360 view on the, the, on the solution because when you, when you come to think of it, for something to get adopted in the clinic, there is a lot of different stakeholders involved. So it's not just the doctors, it's not just the clinics, it's the insurance companies, it's the the procurement, IT. Does this at all integrate into my ecosystem and so on so forth as a whole bunch of stakeholders and questions that need to be answered. And the StarMap is the first framework, which basically has a, a structured way of looking through all of these. [00:12:16] Lindsey Dinneen: Okay. Yeah. So this is, this is a framework that you have, I imagine, developed and refined over time as you've been consulting. So when you first started consulting, what are some of maybe the lessons that you learned in terms of being able to really help these companies succeed? [00:12:35] Amel Havkic: This is a bit more of a personal one because, I founded a consulting company. So my thought I had, I have no clue about marketing. I have no clue about those things. I'm a doctor, right? So, I imagined that what I should be is a consultant, right? After all, I'm consulting. It turns out that the, the biggest impact I could make, in fact as a doctor, because in the end, that's what I am, it's what is most natural to me, and that is what is bringing most impact to the clients. And then there's one specific thing which I have, which many other consultants in healthcare, also good consultants, don't have. And it is the fact that I'm still practicing. Fact is that today medical knowledge doubles every 73 days. In theory, that means if you are out of the healthcare delivery for 73 days, your knowledge is almost obsolete. It was way less, it was a few years when I studied. And now it's, it's became so exponentially big. What that means is that if you would take a doctor, and make him a consultant, drag him out of the hospital, he would be an expert for 73 days, and that's where it would stop. And this is the, this is pretty much the, the mindset that I adopted and everyone consulting in the EvoMed is still a practicing, practicing healthcare practitioner. So yeah, that's what makes EvoMed specifically different and that's how I saw the world before and how I see it now. [00:14:09] Lindsey Dinneen: That's incredible. Okay. Yeah. And, and it makes so much sense that if you're practicing then you're, you're needing to keep up on all that. But just on a very practical level, how do you stay on top of so much new information coming out so regularly? I mean, it's not like, you know, you don't have three major career things going on right now. [00:14:33] Amel Havkic: Yeah, I think by now it's a flywheel, and luckily I, I am the very, in the, in the very lucky position that my, that my hospital knows and accepts what I'm doing outside of the hospital and also supports this. So, I get updated regularly through through people talking to me, reaching out to me, showing their solutions, asking for my opinion. And on the other side, so, so that's, that's what keeps me updated on a regular. And on the other side, I still I still see the challenges that you would have in a hospital implementing those solutions. So, recently the one specific thing happened, just as an example. We, I, I was involved or I'm involved in a digitalization pro project of an ICU and of operating room. For that they have now from, from paper, from from paper notes, they're switching to digital. Problem is the paper notes they could fill out within five minutes while the digital have all kinds of mandatory fields. And, and it's kind and, and the time it takes a physician to fill out those, those digital forms is six times... [00:15:47] Lindsey Dinneen: Hmm. [00:15:47] Amel Havkic: ...More, so it's 30 minutes roughly if you're fast. So although you would think that something which gets digitalized is automatically better, this specific thing proves that just because someone thought, okay, I need this information, it need, this needs to be mandatory. But because the system maybe doesn't communicate with other parts of the system, legacy systems, legacy data from somewhere, it makes the job of the doctor living hell. So you, you can imagine how it is when you have like one person doing, I don't know, 40, 50, 60 pre-medication a day, and then from like five to 10 minutes pre-medication, it goes to 30 minutes, 60 minutes. That's, that's a problem. [00:16:31] Lindsey Dinneen: Yeah. So yeah, that is, that's, that is so interesting. It's, it's kind of, I suppose that goes into a lot of innovation. There are sometimes, you know, the things that we think, "Oh, well, this is, this is progress" and, and it might be, but just because you can doesn't mean it's always perhaps the most efficient or we should at least stress test it and decide, you know, how to make it the best it can be. So, all right, what are some, what are some trends and innovations that you're seeing that you're really excited about in terms of the future of medical care? [00:17:08] Amel Havkic: Well, obviously AI is a, is a great trend. I am really hoping that it'll take the, the proper route. I am, I've, I've been saying this a lot and I will repeat it again. When I say AI in healthcare context, I don't like AI as artificial intelligence, but as augmented intelligence, because what it's supposed to do, it's supposed to support our natural decision making process. And a decision in a high stakes environment like healthcare still needs to be in the hands of humans because there's much more to it than just a simple yes or no, or a statistic, or it's most probable that and that is a trend. So, so that is a technology which has huge potential. But so far, I must say oftentimes I see it implemented in the wrong way. It's trying to automate certain things either not good enough, or at certain points, or in such a way that it's not a livable in daily life or meets resistance. Specifically in healthcare, it's a very inert system because innovation in healthcare is perhaps dangerous is, it introduces new risks. That's why healthcare evolved to be a very inert system and to resist changes unless those changes are definitely proven to be better than what we have right now. So as an example, we had IBM Watson Oncology, huge player, huge possibilities. But somehow the, the way that Watson Oncology did things was not the way that clinicians wanted to use it. So in the end, they ended up selling it off. And that is just one example of many, many. So what I would really like to see for the future is AI is augmented intelligence, which really is positioned at the right places in a workflow of healthcare practitioners and help support their decisions rather than trying to automize or making them obsolete. [00:19:24] Lindsey Dinneen: Yeah, that makes a lot of sense. And it's, it's something that of course we hear a lot about, you know, and, and a lot of times I think that what I've been hearing, exactly like you said is, you know, if it can help, if it can help minimize some workflows or make something more, a process more efficient or those kinds of things, that is great help. But I don't think anyone wants AI to replace the expertise and the hands on learning that you do. And, and you obviously every 73 days, like you said, you're constantly building up your, your knowledge bank. And literally having been in the, in the medical setting for so long, you've, you've gotten to see this play out in real life and AI can't do that. So yeah, that's really interesting. [00:20:12] Amel Havkic: True. What, what it can do however, is just like every other job, healthcare also has a bell curve. So you have 5% or a percentage of the practitioners who are massive under performers, a percentage which are massive over performers, and then there's an average in the middle. And what, what AI can do is it can help even out the bell curve and move it as far to the expertise side as possible. There's also other repetitive tasks which, which can be taken over. So I do see potential in the, I do see a lot of potential in that technology specifically. But just as another example in my private practice, I have a. I have a AI scribe. It is specific for medtech. It's not something that I misuse, foreseeable misuse, for all the regulatory people. But it is an AI scribe. Still, most of my colleagues are not using it because they say, "Okay, this does not fit our needs. And it is not that specific scribe that we use." You cannot tweak the way how it gives you the output. It's preset. You can optimize certain things, but you cannot, for instance, train on your on the way you like your letters to look, for example. Then there's errors. So although you think, "Okay, you save a lot of time typing," right? You add at another point another a few work steps with the solution and ending up being shelved again because it's not really helping. Although from the, from the first glance, on the first glance, you would think, "Okay, this is revolutionary." [00:21:55] Lindsey Dinneen: Hmm. Yeah. Yeah. Okay that. Yeah. So it's gonna be interesting to see how it evolves and how it becomes hopefully even more useful in the future. So are there any moments that along your journey, either as a physician or even as a consultant, are there any moments that really stand out to you as affirming, "Wow, I am in the right place at the right time." [00:22:23] Amel Havkic: So it happened on, so speaking of the doctor part, yeah. It happened to me quite often. And I was first thinking of it as having bad luck. But ultimately maybe I was supposed to be there. So for some reason I run on a regular, into, into big car accidents happening. And car accidents or motorcycle accidents or so on, so forth, at least maybe 6, 7, 8 of them through, throughout my life with people really being injured and me being there as a first responder. So, so those were for instance, moments where I thought, "Okay, well, I understand this happens once or twice," but now and, and keeps keeps getting more. It's a bit maybe I wouldn't say well, it, it seems that I am supposed to be there at that time. That's how it feels to me. On the, the consulting side as well, specifically now that medtech is gaining more traction and more impact, and also with the award recently and similar things happening, that also made me feel like, "Okay, maybe I can with this make impact on more lives than just the lives I treat directly." Because if you manage to help a medtech startup launch a revolutionary idea and then survive and really make it all the way to the market and then thrive there, you impact thousands hundred, thousands, maybe millions of lives. And the, it being accepted the way it is right now is for me as well a similar sign. [00:24:05] Lindsey Dinneen: That's really cool. Yeah. I, I think, you know, I, I talk about it a lot. My role within medtech industry, you know, is, is small. I don't have that same level of impact at all. I'm, I'm helping, I'm, I'm in marketing, so I'm helping people tell their stories and get the, the word out. But I think getting to even just think about the fact that no matter kind of where you fit into the ecosystem you're helping hopefully impact patients' lives for the better and it's, it's so special getting to feel like even though it's a small role, I got to play a role. Yeah. [00:24:42] Amel Havkic: It is a, i I wouldn't even downplay it that much to be honest, because if no one hears about the solution, if no one knows that it exists there's more and more and more we're getting overloaded with all kinds of information. So, marketers who help certain things break through and reach the right people are doing their share just as anyone else in the industry is. It's maybe just as important. So yeah, I, I would encourage you to continue what you're doing up until now. [00:25:12] Lindsey Dinneen: Well, thank you. That's, that's, that is very encouraging. Okay, so, pivoting the conversation a little bit. Just for fun. Imagine that you were to be offered a million dollars to teach a masterclass on anything you want. It could be within your industry, but it doesn't have to be. What would you choose to teach? [00:25:31] Amel Havkic: Oh, that's a relatively easy one for me. I would teach clinical adoption masterclass and clinical adoption simply for the reasons we already mentioned. I would really like to help good solutions survive the reality of everyday clinical life. [00:25:50] Lindsey Dinneen: Amazing. [00:25:51] Amel Havkic: I think survive is the right, right word for this. [00:25:54] Lindsey Dinneen: Yes, I think so too, especially in having conversations with startups that are currently in the midst of this and, and trying to navigate the best approaches. So, yeah. That's incredible. Okay. And how do you wish to be remembered after you leave this world? [00:26:11] Amel Havkic: Well, that's a more difficult one. How do I wish to be remembered? Well, I would like to be the, so I would like to be the guy who everyone thinks left the world a better place than I found it. Maybe, quite short, not that extensive, but the implications are huge. You know, you can make the world better in many different ways. I do have certain skills and talents which naturally got me to where I am today. But it ultimately doesn't matter how much better the world is after I'm gone as long as it is better and this became clear to me also recently. So, while the, the awards night was going on, my wife couldn't come with me because our kid got sick, so she stayed in a hotel and, but they were watching the live stream and in the amidst of it all, when, when I came up and I went front to get the award, the little one got up, although she was sick and she was like laying in bed all day and couldn't get up. She went to the screen and pointed to the screen. So yeah, ultimately I want also my my daughter to think of me as someone who made this world a better place one way or the other. [00:27:29] Lindsey Dinneen: Yeah. I love that. That's a beautiful legacy and yeah, you're, you're doing just that, so that's amazing. That is so amazing. Okay. Okay. And then final question, what is one thing that makes you smile every time you see or think about it? [00:27:48] Amel Havkic: Oh, that's also an easy one for me. It's definitely my daughter, also my wife. It's, yeah, it's an amazing it's, it's amazing just seeing her growing up and develop all of these new skills and all of the new things that you didn't, that she didn't know how to do the day before. Also the way she goes through the world. She's fascinated by everything. Everything around is somehow magical and new and, yeah, so she can just like sit, sit in a, in a baby carriage and look around and everything is so, so awesome. She doesn't even need more. And that makes me remember that we actually should be more, way more, way more aware of the world around us and maybe not so, rushing all the time. [00:28:39] Lindsey Dinneen: Mm-hmm. Yes. I, I love that. I think I think about this sometimes of the idea of everyday magic, and those are just those moments of, I don't know, a butterfly, you know, flying by and you just see how beautiful its wings are or, you know, nature is, is very much that way for me in general. I, I, you know, you go on a walk and you go, "Oh my gosh, you know, those, those daffodils weren't there yesterday, and how beautiful are these things?" And to me, that's everyday magic. [00:29:09] Amel Havkic: Well, it, it is, and we, I, I do think that we don't take enough time to appreciate it. With always being busy with what's in the future, where we have to be and what we still have to do, that we maybe forget sometimes to appreciate what's right in front of us. [00:29:25] Lindsey Dinneen: Yeah. Yeah. I love that. Well, this has been a wonderful conversation. I'm so thankful you joined me today. Thanks for sharing your time and your experience and your stories. We are so honored to be making a donation on your behalf as a thank you for your time today to Save the Children, which works to end the cycle of poverty by ensuring communities have the resources to provide children with a healthy, educational, and safe environment. So thank you so much for choosing that charity to support, and also thank you for continuing to work to change lives for a better world. We're grateful, and I wish you the most amazing continued success. [00:30:06] Amel Havkic: Thank you so much. It was a pleasure being here and looking forward to part two. [00:30:12] Lindsey Dinneen: Yeah. There you go. Alright, well thanks again and we'll talk again later. [00:30:20] Dan Purvis: The Leading Difference is brought to you by Velentium Medical. Velentium Medical is a full service CDMO, serving medtech clients worldwide to securely design, manufacture, and test class two and class three medical devices. Velentium Medical's four units include research and development-- pairing electronic and mechanical design, embedded firmware, mobile app development, and cloud systems with the human factor studies and systems engineering necessary to streamline medical device regulatory approval; contract manufacturing-- building medical products at the prototype, clinical, and commercial levels in the US, as well as in low cost regions in 1345 certified and FDA registered Class VII clean rooms; cybersecurity-- generating the 12 cybersecurity design artifacts required for FDA submission; and automated test systems, assuring that every device produced is exactly the same as the device that was approved. Visit VelentiumMedical.com to explore how we can work together to change lives for a better world.

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In this episode of the Grazing Grass Podcast, Cal visits with Richard Popham about raising registered Katahdin sheep in Kentucky using practical grazing systems and portable electric fencing. Richard explains how he successfully manages sheep with two strands of polywire, why fence training matters, and how good grazing management helps keep sheep content and productive. The conversation explores: Using two and three strand polywire systems for sheep  Why sheep must be trained to electric fence  Managing sheep with portable fencing and reels  Selecting productive and efficient ewes  Why buying better sheep matters more than buying more sheep  Building low-stress handling systems  Using records to improve flock genetics  Parasite resistance and culling decisions  Weaning strategies and lamb management  Grazing sheep on small acreage near neighborhoods  Managing sheep without livestock guardian dogs  Portable fencing tools and equipment recommendations  Rotational grazing timing and parasite management  Why Richard prefers moderate-sized ewes  The role of NSIP and flock performance records  Selecting rams and improving flock genetics over time Richard also shares practical advice for new sheep producers, including starting small, focusing on quality animals, and building systems that fit your lifestyle and available time.Find out moreCircle P Farm on Youtube | https://www.youtube.com/@circlepfarm3776 Looking for grass-based breeders? Explore the Grass Based Genetics directory.Visit our Sponsors:Noble Research InstituteRedmond Agriculture Grassroots CarbonGrazing Grass LinksWebsiteCommunity (on Facebook)Original Music by Louis Palfrey

In this episode of The Dairy Podcast Show, Dr. Margret Vonholdt-Wenker, postdoctoral researcher at the Friedrich Loeffler Institute, explains prolonged cow calf contact systems and their implications for dairy production. She discusses housing models, calf and cow welfare outcomes, management requirements, milk production impacts, weaning challenges, and practical adoption considerations across Europe. Listen now on all major platforms!“Calves in contact systems can drink according to natural intake patterns and develop within a social herd environment.”Meet the guest: Dr. Margret Vonholdt-Wenker is a postdoctoral researcher at the Institute of Animal Welfare and Animal Husbandry of the Friedrich Loeffler Institute in Germany. Her work focuses on animal behavior and developing housing systems that support natural behavior while maintaining health. With more than ten years of experience in cow-calf contact systems, she also received the 2024 IGN Research Award for her research on dairy welfare. Listen to The Dairy Podcast Show featuring Dr. Margret Vonholdt-Wenker on all major platforms.Liked this one? Don't stop now — Here's what we think you'll love!What you'll learn:(00:00) Highlight(01:32) Introduction(02:58) Prolonged cow calf contact(04:53) Welfare and health(07:53) Housing management(16:00) Foster cow systems(21:42) Weaning challenges(28:20) Final QuestionsThe Dairy Podcast Show is trusted and supported by innovative companies like:* Agri-Comfort* Adisseo* Afimilk* Evonik* Priority IAC* CowManager- dsm-firmenich- AHV- Natural Biologics- DietForge- Agrarian Solutions- Chemlock- Protekta- BoviSync

This week, we have the return of the brilliant Carly Facius, Midwife, IBCLC, Women's Circle Facilitator and Aware Parenting Mentor. She's joining me to answer your questions about weaning and natural term breastfeeding in two back-to-back episodes. In part 2, we delve into question topics ranging from night weaning and bedtime routines to dealing with biting, hitting and kicking. To find a list of questions, please consult the transcript of this episode.You can find out more about Carly at www.seedpodfamilies.com or follow her on Instagram @‌seed_pod_My picture book on how breastfeeding journeys end, The Story of Jessie's Milkies, is available from Amazon here -  The Story of Jessie's Milkies. In the UK, you can also buy it from The Children's Bookshop in Muswell Hill, London. Other book shops and libraries can source a copy from Ingram Spark publishing.You can also get 10% off my books on supporting breastfeeding beyond six months and supporting the transition from breastfeeding at the Jessica Kingsley press website, by going to https://bit.ly/JKPbooks and using the code MMPE10 at checkout.Follow me on Instagram  @emmapickettibclc or find out more on my website www.emmapickettbreastfeedingsupport.com This podcast is presented by Emma Pickett IBCLC, and produced by Emily Crosby Media.

"Nervous System" talk is definitely in the parenting ziegist. It's something I talk a lot about, and it's a corner stone to my approach for coaching and supporting families. AND - I have seen how the way it is often framed and discussed in the parenting space can actually *backfire* and leave you feeling worse than when you started. In this episode, I highlight 3 different beliefs about nervous system regulation that are easy to pick up, but aren't very helpful... and I share the real thing that I know to *always* work! Belief #1: "You are the problem" - You need to regulate so you can regulate your kids... which often also means, "if you're kids aren't regulated, it's your fault." Belief #2: "Do more" - you and your kids need better routines, diet changes, more movement, less screens, meditations etc...  which means - you have to add *more* to your plate so that you can all be "regulated" Belief #3: "Self-regulation is the key" - you (and your kids) need to learn how to self-regulate.  That's the end game.  That's what's most important.  That's what nervous system regulation is all about.... or is it? Tune in to hear why I don't think these common beliefs are helpful, and what might be true instead. Also - doors are open to Moms & Milk Village intil May 26th, 2026 at 11:59pm EDT.  Multiple pricing options are available.  If you would like to join - you can check it out here. Also, you can text me (1-289-272-5027), email me (jenna@ownyourparentingstory.com) or DM me (own.your.parenting.story) at any time.   Grab your free guide to say "No" to the feed while still saying "yes" to the need at www.ownyourparentingstory.com/guideLove this episode?! Shoot me a DM over on Instagram @own.your.parenting.story and tell me all about it.

This week, we have the return of the brilliant Carly Facius, Midwife, IBCLC, Women's Circle Facilitator and Aware Parenting Mentor. She's joining me to answer your questions about weaning and natural term breastfeeding in two back-to-back episodes. This is Part 1.We delve into question topics ranging from weaning a toddler while tandem feeding, coping with a distressed child at night, and what normal sleep even is! To find a list of questions, please consult the transcript of this episode.You can find out more about Carly at www.seedpodfamilies.com or follow her on Instagram @‌seed_pod_My picture book on how breastfeeding journeys end, The Story of Jessie's Milkies, is available from Amazon here -  The Story of Jessie's Milkies. In the UK, you can also buy it from The Children's Bookshop in Muswell Hill, London. Other book shops and libraries can source a copy from Ingram Spark publishing.You can also get 10% off my books on supporting breastfeeding beyond six months and supporting the transition from breastfeeding at the Jessica Kingsley press website, by going to https://bit.ly/JKPbooks and using the code MMPE10 at checkout.Follow me on Instagram  @emmapickettibclc or find out more on my website www.emmapickettbreastfeedingsupport.com This podcast is presented by Emma Pickett IBCLC, and produced by Emily Crosby Media.

Factors for Sorghum Planting Conditions Early Weaning for Calves Looking for Bagworms   00:01:05 – Factors for Sorghum Planting Conditions: A conversation about grain sorghum planting considerations with Lucas Haag, agronomist in-charge at Tribune, and Logan Simon, K-State Extension agronomist, begins today's show. Sorghum Planting Considerations: Planting Date and Hybrid Maturity Sorghum Planting Considerations: Seeding Rate and Row Spacing   00:12:05 – Early Weaning for Calves: Justin Waggoner, K-State Extension beef cattle specialist, keeps the show rolling as he talks about why early weaning could be an option for cattle producer's drought management plan.   00:23:05  – Looking for Bagworms: Ending the show is K-State Extension horticulture expert, Matt McKernan, as he recommends those with conifers start scouting for early signs of bagworms on trees and shrubs.      Send comments, questions or requests for copies of past programs to ksrenews@ksu.edu.   Agriculture Today is a daily program featuring Kansas State University agricultural specialists and other experts examining ag issues facing Kansas and the nation. It is hosted by Shelby Varner and distributed to radio stations throughout Kansas and as a daily podcast.   K‑State Extension is a short name for the Kansas State University Cooperative Extension Service, a program designed to generate and distribute useful knowledge for the well‑being of Kansans. Supported by county, state, federal and private funds, the program has county Extension offices statewide. Its headquarters is on the K‑State campus in Manhattan. For more information, visit Extension.ksu.edu. K-State Extension is an equal opportunity provider and employer.

For this week's Kids Clinic, Ciara is joined by Ollwyn Moran, Neuro Development Therapist & Founder of Cogni Kids to discuss how to best handle weaning with your child.

In this episode of The Night Feed, I explore how baby sleep differs around the world and why there's no single “right” way to do it. From sleep training in the US to co-sleeping and slower-paced parenting in places like Sweden and Spain, this conversation is a reminder that cultural norms shape how we parent more than we realise.I also talk about the pressure millennial parents are under; raising children in a more isolated, expensive, and information-heavy world, while still trying to be deeply present and connected.Plus, I answer two listener questions:• The anxiety spiral of Googling baby milestones• Fear of choking during weaning and how to navigate it safelyIf you've ever felt overwhelmed, unsure, or like you're doing it wrong this podcast is here to reassure you that you're not.Support the showTikTok: https://www.tiktok.com/@thenightfeed

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastSPONSORSNursing Queen. Stylish nursing clothes that will make your life easier and that you'll want to wear long after your nursing days are over. Use promo code BADASS for 10% off your purchase at www.nursingqueen.com.Original Sprout. Original Sprout carries safe and effective styling, body and hair care products that are safe for babies and great for adults. Use code BADASS26 at www.originalsprout.com for 25% off of your purchase.Are you still waiting for your period to come back? One of the benefits ofbreastfeeding is the delayed return of your period. But what if you are hoping toget pregnant again and it hasn't returned yet? What's normal? Dianne and Abbyasked the internet, and responses are all over the place! Listen in today to learnmore!If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Question from an internet listener [8:15]Periods! [14:50]The hormones [15:30]Comments from the internet – IG [17:19]Having another baby and listening to your body [25:12]More comments from the internet- FB [27:08]Comments from Patreon [34:47]Ovulating first [36:25]Continuing to breastfeed after your period returns [36:57]Things we talked about or Episodes we think you should check out!https://badassbreastfeedingpodcast.com/episode/body-changes/https://badassbreastfeedingpodcast.com/episode/090-your-period-and-fertility-while-breastfeeding/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Today  I'm talking to the lovely Isabella from near Vienna, Austria, about breastfeeding her two sons, Jonathan (2½) and Valentin (1). Isabella describes generally good breastfeeding support and mixed feeding norms in Austria, and how her early postpartum pain settled with midwife help. She became pregnant unexpectedly when Jonathan was 10 months old while using natural family planning, and assumed she should wean. She made several attempts but didn't feel committed to a process that was complicated by bottle refusal and a lack of weaning information. After hearing positive tandem-feeding stories from this podcast, she resumed breastfeeding late in pregnancy when Jonathan was distressed and ill, then tandem fed after Valentin's birth. This time lactation started easily and she managed nights with family bed-sharing and support from her husband. Isabella eventually weaned Jonathan gradually at 2, starting with night weaning and dropping “set” feeds, while continuing to breastfeed Valentin to this day.My picture book on how breastfeeding journeys end, The Story of Jessie's Milkies, is available from Amazon here -  The Story of Jessie's Milkies. In the UK, you can also buy it from The Children's Bookshop in Muswell Hill, London. Other book shops and libraries can source a copy from Ingram Spark publishing.You can also get 10% off my books on supporting breastfeeding beyond six months and supporting the transition from breastfeeding at the Jessica Kingsley press website, by going to https://bit.ly/JKPbooks and using the code MMPE10 at checkout.Follow me on Instagram  @emmapickettibclc or find out more on my website www.emmapickettbreastfeedingsupport.com Resources mentioned - Loving Comfort book in English (und auf Deutsch) https://www.juliedillemuth.com/loving-comfort This podcast is presented by Emma Pickett IBCLC, and produced by Emily Crosby Media.

Dr. Michael Lanspa chats with Dr. Ewan Goligher about his article, "Temporary Transvenous Diaphragm Neurostimulation for Weaning from Mechanical Ventilation (RESCUE-3)."

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastSPONSORSNursing Queen. Stylish nursing clothes that will make your life easier and that you'll want to wear long after your nursing days are over. Use promo code BADASS for 10% off your purchase at www.nursingqueen.com.Original Sprout. Original Sprout carries safe and effective styling, body and hair care products that are safe for babies and great for adults. Use code BADASS26 at www.originalsprout.com for 25% off of your purchase.Today Dianne and Abby are talking about combo feeding. Combo feeding can bea feeding choice for some families. What does it look like? Why do some familieschoose to combo feed and how do you do it? Listen in today for answers to thesequestions and more!If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:We will be in Detroit at Babies and Bumps! [5:45]Combo feeding [10:54]What combo feeding looked like for us [11:40]Combo feeding is not feeding failure [22:10]How to combo feed [29:20]Paced bottle feeding [33:24]Watching for cues [34:39]Things we talked about or Episodes we think you should check out!https://badassbreastfeedingpodcast.com/?s=paced+feedinghttps://badassbreastfeedingpodcast.com/episode/hunger-cues-of-breastfeeding-babies/https://www.nuvancehealth.org/health-tips-and-news/how-pregnancy-rewires-your-brain-for-motherhoodSet up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Klinisch Relevant ist Dein Wissenspartner für das Gesundheitswesen. Drei mal pro Woche, nämlich dienstags, donnerstags und samstags, versorgen wir Dich mit unserem Podcast und liefern Dir Fachwissen für Deine klinische Praxis. Weitere Infos findest Du unter https://klinisch-relevant.de

Today, we talk with Tiffany Belanger of @cosleepy about some of the challenges that may arise for co-sleeping families, whether you're trying to reduce night feeds, prepare for another baby, or simply want your bed back. We discuss how these transitions often unfold, including moving a child into a crib or floor bed, and why the experience can look completely different from one family to the next, depending on lifestyle, a child's temperament, and the parents' mental and emotional states, like guilt, anxiety, exhaustion or embarrassment.This is a free-flowing, honest conversation, not a set of rules to apply. The goal of this episode is to prepare you for these transitions, normalize some of the challenges parents face, and offer a range of ways to move from one stage to the next that most resonate with you and your family.Tiffany on Instagram @cosleepy**********Send us Fan Mail Needed

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastSPONSORSNursing Queen. Stylish nursing clothes that will make your life easier and that you'll want to wear long after your nursing days are over. Use promo code BADASS for 10% off your purchase at www.nursingqueen.com.Original Sprout. Original Sprout carries safe and effective styling, body and hair care products that are safe for babies and great for adults. Use code BADASS26 at www.originalsprout.com for 25% off of your purchase.Follow Danielle  https://www.tiktok.com/@nickanddani?_r=1&_t=ZP-95gSHW6BBF9Milk Donation Challenge https://share.conceiveabilities.com/thebadassbreastfeederBecome a Surrogate https://share.conceiveabilities.com/thebadassbreastfeederrafToday Dianne and Abby have a really interesting interview with Danielle who talksto us about being a surrogate and blessing another family with a baby. Abby alsotells us more about the milk bank challenge going on right now. You don't want tomiss this informational interview!If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Comment from spotify [9:54]Danielle the surrogate [13:00]How Danielle became a surrogate [15:00]How did her family feel about it? [21:22]Touch bracelets [26:39]How was birth [32:50]Contact with the family now [36:43]Common questions [37:55]Payment [41:22]Being postpartum [43:11]When the milk comes in [44:14]Milk donation challenge [47:11]Things we talked about or Episodes we think you should check out!https://badassbreastfeedingpodcast.com/episode/breastfeeding-nicu-and-separated-babies/https://badassbreastfeedingpodcast.com/episode/crushing-breastfeeding-myths-in-2023/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

We are back with another breastfeeding-only Q&A episode. In today's conversation, we respond to several listener questions related to nursing, sleep, and fertility after breastfeeding. One mother who is co-sleeping with her 15-month-old, who wakes three to five times per night to nurse, asks how she can help her toddler sleep longer stretches without abruptly stopping breastfeeding. Another listener with a 4.5-month-old who has never taken a bottle is planning to attend a bachelorette party when her baby will be about nine months old and asks how best to prepare. We also hear from a mother who recently weaned her two-year-old and then experienced a very early miscarriage, often called a chemical pregnancy, and wonders whether she should consider hormonal support before trying to conceive again.As for our Quickies: Is it concerning if a 12-week-old drops slightly on the growth curve while still gaining weight, what the issue is with the Boppy pillow for breastfeeding, and can you continue breastfeeding while taking antibiotics for mastitis? We also discuss healing cracked nipples after a tongue-tie release, whether milk will come in normally if you breastfeed during pregnancy, and whether lactation cookies or brewer's yeast actually increase supply. As also cover oversupply with a second baby, postpartum chills when milk comes in, storing breast milk and keeping pump parts clean on long drives, preventing recurrent mastitis from oversupply, whether a mild tongue tie should be released if breastfeeding is going well, what a “nursing holiday” is and whether it can help supply and latch, and how to help a bottle-fed newborn latch to the breast.Just us on Patreon for our upcoming all-Quickies episode, exclusive to patrons-only.Controversial article we discussed in this episode:My Decision Not to Breastfeed with Elise Hewitt#239 | The Cost of Breastfeeding Versus Formula Feeding with Dr. Rhonda Trust, PhD**********Send us Fan Mail Needed

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastSPONSORSNursing Queen. Stylish nursing clothes that will make your life easier and that you'll want to wear long after your nursing days are over. Use promo code BADASS for 10% off your purchase at www.nursingqueen.com.Original Sprout. Original Sprout carries safe and effective styling, body and hair care products that are safe for babies and great for adults. Use code BADASS26 at www.originalsprout.com for 25% off of your purchase.Pumping. Are you finally done with pumping? If the answer isYES…congratulations! But how do you stop pumping? Is there a trick to weaningfrom the pump? Does weaning from pumping mean weaning from breastfeeding?Listen in today as Dianne and Abby answer all these questions about weaningfrom the pump.If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Listener questions [14:04]Hormones from lactation come from the pituitary [15:25]Weaning from pumping [18:35]Stopping pumping does not mean stopping breastfeeding [19:25]Things to consider [19:50]Exclusive pumpers may need to consider it differently [27:18]Feeling full in between [28:45]Plugged milk ducts [29:50]Takeaways [32:20]Congratulations! [34:00]Things we talked about or Episodes we think you should check out!https://badassbreastfeedingpodcast.com/episode/tying-to-conceive-while-breastfeeding/https://badassbreastfeedingpodcast.com/episode/breastfeeding-after-1-year/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Give us a break, we recorded this in early February and we were struggling through the annual Frigid Freakout. We also review the different ADHD struggles and habits we've been indulging in before getting into this week's topic - how your native language shapes the neural pathways your brain creates, and what that can mean for your adaptability later in life. In a recent study comparing the brains of German-language native speakers with Arabic-language native speakers, scientists found significant differences. What could this mean for understanding how our brains work? Listen in to find out - because the Bar is Ankle High!Make sure you're following us on IG @thebarisanklehigh on Tiktok @anklehighpod - and don't forget to leave us a 5-star review anywhere you listen to us! We love you!

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastSolid Starts - 25% off first year of annual subscription with code BADASS or use this link with coupon auto-applied: http://www.solidstarts.com/app?coupon=badass Terms & Conditions: Receive 25% off an annual subscription to the Solid Starts app when you start your membership on solidstarts.com/app. Use code BADASS at checkout.To redeem the offer, sign-in or create an account, select the yearly plan. Offer is valid for first-time customers only. Does not apply to gift cards. Cannot be combined with other offers or applied to previous purchases. Subscription auto-renews at the regular annual price after first year unless canceled before renewal date. You can cancel or change your plan anytime by signing into your account on solidstarts.com.Are you ready for a crash course in breastfeeding? Today on the podcast, Dianne and Abby are discussing things parents should know about breastfeeding. Things like how often babies eat to pumping. Listen in today and let us know if there is anything we missed!If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Listener question [4:36]Breastfeeding is a learned skill [12:20]Breastfeeding and walking [14:00]How frequent babies eat [15:58]Breastfeeding and sleep [18:48]How to find podcast episodes! [24:15]Pumping does not = supply [25:06]Flange size [26:30]Pain [28:13]Things we talked about or Episodes we think you should check out!https://badassbreastfeedingpodcast.com/episode/cluster-feeding/https://badassbreastfeedingpodcast.com/episode/normal-baby-behavior-or-breastfeeding-problem/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/Scott Holmes

Hello, Puzzlers! Today: A.J. & Greg present puzzling puzzles to each other.Join host A.J. Jacobs and his guests as they puzzle–and laugh–their way through new spins on old favorites, like anagrams and palindromes, as well as quirky originals.Subscribe to Hello, Puzzlers! wherever you get your podcasts! And come join our growing puzzle community over on Patreon, where you can find bonus episodes and other exclusive content!Our executive producers are Neely Lohmann and Adam Neuhaus of Neuhaus Ideas.The show is produced by Claire Bidigare-Curtis.Our Chief Puzzle Officer is Greg Pliska. Our associate producer is Andrea Schoenberg.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastSolid Starts - 25% off first year of annual subscription with code BADASS or use this link with coupon auto-applied: http://www.solidstarts.com/app?coupon=badass Terms & Conditions: Receive 25% off an annual subscription to the Solid Starts app when you start your membership on solidstarts.com/app. Use code BADASS at checkout.To redeem the offer, sign-in or create an account, select the yearly plan. Offer is valid for first-time customers only. Does not apply to gift cards. Cannot be combined with other offers or applied to previous purchases. Subscription auto-renews at the regular annual price after first year unless canceled before renewal date. You can cancel or change your plan anytime by signing into your account on solidstarts.com.Does your baby spit up? Could it be reflux? Spitting up is really common forbabies. Listen in today as Dianne and Abby discuss reflux – what it is, how ithappens and how you can help your baby if they are dealing with reflux.If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:What is reflux [6:26]Risk factors [9:40]Red flags for reflux [12:17]Reflux/overfeeding [14:00]Helping your baby – meds [20:54]Avoid overfeeding [23:15]Up right positions [24:15]Watch for cues [25:12]Laid back positions [25:55]Things you might hear [29:32]What helps [32:50]Things we talked about or Episodes we think you should check out!https://badassbreastfeedingpodcast.com/episode/cows-milk-protein-allergy/https://badassbreastfeedingpodcast.com/episode/when-baby-is/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

This week on Two Parents & A Podcast, we're in the middle of some BIG transitions over here… including officially saying goodbye to the pacifier (BEBE)

What is the science behind early allergen introduction? In Part 2, Debbie Palmer explains the immunological basis of oral tolerance, addresses persistent myths, and outlines best practices for introducing allergens, especially in high-risk infants. Timestamps: 00:56 – Allergen introduction 02:03 – Non-breastfeeding approaches 02:54 – Biggest myth 03:49 – Tolerance versus sensitisation 04:48 – High-risk patients 05:25 – Weaning diet 06:49 – Prohibited foods

Charles and Heather Maude are 5th generation ranchers in South Dakota running a direct-to-consumer beef and pork operation built on land their family has worked for over 115 years. This tour covers the full operation - cattle, hogs, grain storage, equipment, and the irrigated river bottom at the center of a federal land dispute that drew national attention. Watch this alongside the full-length podcast episode for the complete story behind what you're seeing on the ground.Key TopicsDirect-to-consumer beef and pork - how it actually worksCattle finishing and feeder calf productionFarrowing crates - the honest case for and againstWhy feed quality determines meat quality in hogsGrain storage, forage systems, and matching stocking rate to grassThe disputed river bottom and the federal land disputeWhat You'll LearnHow a small ranch runs multiple livestock enterprises on limited acresWhy weaning date is a range management decision, not just an animal oneWhat farrowing crates are actually for and why a skeptic changed her mindHow monogastric and ruminant digestion produce fundamentally different meatWhat 115 years of private land management looks like - and what happens when it's challengedWhy boundary disputes in the rural West are common, and criminal indictments are notConnect with Charles & HeatherWebsiteInstagramFacebookTimestamps00:00:00 — Introduction and context 00:02:00 — Cattle paddock: finished beef and this year's steer calves 00:04:00 — Weaning early — a drought and range management decision 00:06:00 — Grain bins: what they store and how they work 00:08:00 — Farrowing facility: why the crates exist 00:13:00 — Hog nutrition: simple stomach vs. ruminant digestion 00:15:00 — Pasture-raised pork: why quality and finish time differ 00:18:00 — Legacy equipment: grandfather's tractors and the 1948 truck 00:24:00 — The fence line: terrain, flooding, and where fences actually go 00:25:00 — The Forest Service dispute begins 00:27:00 — No written violation, no due process, criminal charges 00:28:00 — Working toward resolution: the Small Tracks Act 00:30:00 — Secretary Rollins, the temporary use agreement, and what changed 00:33:00 — The survey stakes, the crop damage, and the escalation 00:37:00 — What the land trade proposal was and why it was rejected 00:39:00 — What this case means for ranchers and private landowners 00:41:00 — Final reflections

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastOriginal Sprout. Original Sprout carries safe and effective styling, body and hair care products that are safe for babies and great for adults. Use code BADASS26 at www.originalsprout.com for 25% off of your purchase.Solid Starts - 25% off first year of annual subscription with code BADASS or use this link with coupon auto-applied: http://www.solidstarts.com/app?coupon=badass Terms & Conditions: Receive 25% off an annual subscription to the Solid Starts app when you start your membership on solidstarts.com/app. Use code BADASS at checkout.To redeem the offer, sign-in or create an account, select the yearly plan. Offer is valid for first-time customers only. Does not apply to gift cards. Cannot be combined with other offers or applied to previous purchases. Subscription auto-renews at the regular annual price after first year unless canceled before renewal date. You can cancel or change your plan anytime by signing into your account on solidstarts.com.Have you ever considered the mental load of breastfeeding? Thinking about feeds,tracking what your baby is doing, coordinating life around you…what is yourmental load like? Today Dianne and Abby talk about the mental load ofbreastfeeding and how you can make it easier on yourself.If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Listener question [6:40]What is the mental load [9:59]Tracking [15:30]Sleep [24:08]Ways partners can help [25:52]The Apps [27:35]Timing of feeds [28:10]Simplifying pumping routines [33:22]Things we talked about or Episodes we think you should check out!https://badassbreastfeedingpodcast.com/episode/what-do-our-partners-go-through/https://badassbreastfeedingpodcast.com/episode/all-those-baby-and-breastfeeding-apps/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastToday on the podcast, Dianne and Abby have stories from listeners about exclusive pumping. Listen in today to get tips, information and to just learn more about why people made the very personal choice to EP. Don't miss it!If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Weaning is part of breastfeeding [7:35]Exclusive pumping stories [10:57]Patreon story [11:18]FB comments [17:40]Benefits [18:07]EP after a cesarean [25:09]Colostrum doesn't pump well [27:44]EP is breastfeeding! [28:59]EP due to pain and lack of support [31:18]Things we talked about or Episodes we think you should check out!https://badassbreastfeedingpodcast.com/episode/100-tips-to-pump-more-milk/https://badassbreastfeedingpodcast.com/episode/pumping-myths/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Why do calves often crash about three weeks after weaning or shipping?  Today Dr. Blaine Ellison of Applied Bio Technologies, Inc joins us to explain the 21-day cortisol surge in cattle — a stress response that can suppress immune function, shut down weight gain, and increase sickness risk. In this episode we discuss: • Why cattle often stall out during the first 21–28 days after stress • The evolutionary biology behind the cortisol surge • How the immune system shifts metabolism during stress • Management decisions that may unintentionally make the problem worse • What producers might consider doing differently to reduce stress and improve performance Understanding what happens during this critical window could help producers improve health outcomes, performance, and profitability across the industry. #workingranchmagazine #WorkingRanchRadio #ranchlife #ranching #cattle #livestock #beef #BeefCattle #CowCalf #CattleManagement #CattleHealth #BeefProduction #RanchProfitability #Ranchers #AgPodcast #RuralAmerica #CattleHealth #AnimalHealth #BRD #CattleStress #FeedlotManagement #Preconditioning #Stockmanship #LivestockManagement

There are so many all or nothing messages about night feeds. Pressure to night wean early. Pressure to be 100% consistent. In this episode, I'm sharing my thoughts and some practical tips for how you can reduce night feeds without night weaning. I'm sharing some general night feeding norms  because that's always the best starting place. I also share some thoughts around the decision to reduce feeds as it's not always a straight forward decision.   Connect with Kim Instagram: instagram.com/intuitive_parenting_dcFacebook:  facebook.com/intuitiveparentingdcLearn more about working with Kim: https://intuitiveparentingdc.com/

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastSPONSOROriginal Sprout. Original Sprout carries safe and effective styling, body and hair care products that are safe for babies and great for adults. Use code BADASS26 at www.originalsprout.com for 25% off of your purchase.Solid Starts - 25% off first year of annual subscription with code BADASS or use this link with coupon auto-applied: http://www.solidstarts.com/app?coupon=badass Terms & Conditions: Receive 25% off an annual subscription to the Solid Starts app when you start your membership on solidstarts.com/app. Use code BADASS at checkout.To redeem the offer, sign-in or create an account, select the yearly plan. Offer is valid for first-time customers only. Does not apply to gift cards. Cannot be combined with other offers or applied to previous purchases. Subscription auto-renews at the regular annual price after first year unless canceled before renewal date. You can cancel or change your plan anytime by signing into your account on solidstarts.com.Today on the podcast, Dianne and Abby discuss some current trends, from socialmedia to wearable pumps to freezer stash. Have you fallen into any of thesetrends? Listen in today to hear more about the latest breastfeeding trends!If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Email story [6:00]Listener question [8:40]Social media info trends [11:10]Myths about feeding on social media [19:20]Wearable pumps [24:40]Why people like them [25:50]Why they aren't good [27:00]Freezer stash obsession [31:30]The measurable society we live in [33:10]How much milk should you save? [34:10]Things we talked about or Episodes we think you should check out!https://badassbreastfeedingpodcast.com/episode/oversupply-2/https://badassbreastfeedingpodcast.com/episode/returning-to-work/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Thanks to sponsor Wild Nutritionist!Use code MOTR to save 35% off Mama Baby Biome Method AND First Foods PlanIn this solo, I discuss why I chose to nightwean each of my children when I did and how I returned to my "why" when staying committed to nightweaning felt hard in the middle of the night.I explain which strategies worked vs. which didn't. Why I nightweaned my son at 21 months old vs. my daughter at 17 months old and what it meant for each of their breastfeeding relationships with me.Each of my children, as I'm sure each of yours, have such different temperaments. There is no one-size-fits-all nightweaning blueprint. A lot of it is a mix of your maternal intuition coupled with some trial and error. There are general guidelines of definitive nos and yes's with the process, but there is no bypassing the hard parts. Like with any other challenging milestone, it must be met head on. This is something I kind of learned the hard way.I explain when I believe it is developmentally inappropriate vs. appropriate to night wean and when the benefits of nightweaning outweigh the benefits of night nursing. I also talk about how and when your husband can get on board with helping.For more support with nightweaning, join dozens of other women in the private Moms Off The Record community. We have an active nightweaning thread within the forum with other first-hand accounts and success stories!Use code MOTR to save 35% off Mama Baby Biome Method AND First Foods PlanSupport the showStay Connected With Me: Subscribe to Moms Off The Record on YouTube JOIN THE MOTR PRIVATE COMMUNITY here Book a potty training 1:1 consult with me here Discount codes & links to my favorite courses and products here Love Moms off the Record? You can directly support the show here Thank you for leaving a rating and written review on Apple and Spotify! This is the best, free way to support the podcast. Follow MOTR on instagram here

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastTODAY'S SPONSORSOriginal Sprout. Original Sprout carries safe and effective styling, body and hair care products that are safe for babies and great for adults. Use code BADASS26 at www.originalsprout.com for 25% off of your purchase.Solid Starts - 25% off first year of annual subscription with code BADASS or use this link with coupon auto-applied: http://www.solidstarts.com/app?coupon=badass Terms & Conditions: Receive 25% off an annual subscription to the Solid Starts app when you start your membership on solidstarts.com/app. Use code BADASS at checkout.To redeem the offer, sign-in or create an account, select the yearly plan. Offer is valid for first-time customers only. Does not apply to gift cards. Cannot be combined with other offers or applied to previous purchases. Subscription auto-renews at the regular annual price after first year unless canceled before renewal date. You can cancel or change your plan anytime by signing into your account on solidstarts.com.Today Dianne and Abby tackle the topic of cow's milk protein allergy. Do youknow the signs and symptoms of CMPA and how your baby might be reacting ifthey have it? Learn more about this, and how to help your baby if you determinethat they have CPMA. But don't jump to conclusions! There are other things itcould be! Tune in today!If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Nursing strike message [6:20]Allergy or intolerance [10:42]Symptoms [13:20]Guilt [22:54]Oversupply [24:20]Things to consider [25:15]Reflux [29:42]Difference between allergy or intolerance [30:46]Takeaways [33:52]Things we talked about or Episodes we think you should check out!https://badassbreastfeedingpodcast.com/episode/125-reflux-in-breastfeeding-babies/https://badassbreastfeedingpodcast.com/episode/when-baby-is/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastToday Dianne and Abby are talking about the recent opinion article from the NewYork Times about equality and formula feeding. Don't miss this episode today asDianne and Abby talk about how feeding a baby does not amount to equality. Didyou read the article? We'd love to hear your thoughts!If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:The NYT Article [6:00]Everything comes down to breastfeeding [9:52]It's just “lovely” [14:40]No benefits to breastfeeding- it's baseline [15:38]“Breast is best” [23:57]Does equality in a marriage come down to bottle feeding? [28:10]Sharing the load/families work it out [32:44]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/combination-feeding-breastmilk-or-formula/https://badassbreastfeedingpodcast.com/episode/010-bottle-feeding-101/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastTODAY'S SPONSORSSimple Wishes. Simple Wishes offers hands-free pumping and nursing bras as well as a wide range of nursing clothing. Owned by badass breastfeeding moms in California. Use code BADASS for 50% off at www.simplewishes.com.Original Sprout. Original Sprout carries safe and effective styling, body and hair care products that are safe for babies and great for adults. Use code BADASS26 at www.originalsprout.com for 25% off of your purchase.Today Dianne and Abby are talking about late preterm babies. Why? Becauselate preterm babies can sometimes lead to breastfeeding struggles early on. Wewant to help with that. Do you have a preterm baby? We'd love to hear yourstory. Feel free to share it with us!If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Fresh or frozen milk? [7:43]Late preterm babies are misunderstood [12:30]Such, swallow, breathe coordination [14:10]Why were they early? [16:18]Delayed milk coming in [18:30]Things you can do [23:14]Supplementing [25:25]Tools you may need to use [30:00]Talk to a lactation consultant [33:30]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/triple-feeding/https://badassbreastfeedingpodcast.com/episode/breastfeeding-intervention-tools/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastThis week's episode is also brought to you by Nursing Queen; stylish nursing clothes that will make your life easier and that you'll want to wear long after your nursing days are over. Use promo code BADASS for 10% off your purchase at www.nursingqueen.com.Being a working parent is hard. But what about returning to work as abreastfeeding mother? Listen in today as Dianne and Abby hear from Patreonlisteners and offer some tips for pumping and returning to work.If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Patreon stories [5:49]A difficult co-worker [16:20]Consistency is important [21:50]Logistics of returning to work [23:18]Stay relaxed [26:50]Pumping hack [27:35]Set up prior to returning to work [28:32]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/returning-to-work/https://badassbreastfeedingpodcast.com/episode/tips-for-pumping-at-work-2/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastToday on the Badass Breastfeeding podcast, Dianne and Abby are discussing whatis a normal baby problem and what is a breastfeeding problem. Listen in today tolearn more about your baby's behavior and why they are doing what they aredoing!If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Question about gas [4:50]Cluster feeding [11:05]Distraction [18:39]Shallow latch [24:48]Sleepy babies [28:27]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/sleepy-breastfeeding-babies/https://badassbreastfeedingpodcast.com/episode/latch-regression/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

🧭 REBEL Rundown 📌 Key Points 💨 HFNC met criteria for non-inferiority to BPAP for preventing intubation or death within 7 days in four of the five ARF subgroups.🧪 Bayesian dynamic borrowing increased power across subgroups but created variable certainty, especially in smaller groups such as COPD.🫁 The immunocompromised hypoxemia subgroup did not meet non-inferiority, leading to early trial stopping for futility.️ Rescue BPAP use, subgroup-specific exclusion criteria, and non-standardized BPAP delivery are important contextual factors that influence how subgroup results should be interpreted. Click here for Direct Download of the Podcast. 📝 Introduction Bilevel Positive Airway Pressure (BPAP) has long been a foundational modality in the management of acute respiratory failure (ARF), particularly in COPD exacerbations and cardiogenic pulmonary edema, where it can rapidly reduce work of breathing and improve gas exchange. It remains a core tool in our respiratory support arsenal.High-flow nasal cannula (HFNC), however, has expanded what we can offer patients by delivering many of the same physiologic benefits through a far more comfortable interface. With high flows, modest PEEP, and effective dead-space washout, HFNC can improve oxygenation and decrease work of breathing while preserving the ability to talk, cough, eat, and interact with staff and family. This combination of physiologic support and tolerability makes HFNC especially attractive in patients where comfort, anxiety, or cardiovascular stability are key considerations, and in settings where prolonged noninvasive support may be needed. Rather than competing with BPAP, HFNC broadens our options in ARF and allows us to better match the modality to the patient and their underlying disease process.The RENOVATE trial set out to answer a high-impact question across five distinct etiologic groups: Is HFNC non-inferior to BPAP (NIV) for preventing intubation or death in acute respiratory failure? 🧾 Paper Azoulay É, et al. High-Flow Nasal Oxygen vs Noninvasive Ventilation in Patients With Acute Respiratory Failure: The RENOVATE Randomized Clinical Trial. JAMA. 2025 PMID: 39657981 🔙Previously Covered On REBEL: HFNC: Part 1 – How It WorksHFNC: Part 2 – Adult and Pediatric IndicationsFLORALI and AVOID TrialFLORALI-2: NIV vs HFNC as Pre-Oxygenation Prior to IntubationThe Pre-AeRATE Trial – HFNC vs NC for RSI ️ What They Did CLINICAL QUESTION Is HFNC non-inferior to BPAP for rate of endotracheal intubation or death at 7 days in patients with acute respiratory failure due to a variety of causes? STUDY DESIGN Multicenter, randomized non-inferiority trial33 Brazilian hospitalsNov 2019 – Nov 2023Adaptive Bayesian hierarchical modeling with dynamic borrowingOpen label, outcome adjudicators blindedPatients were classified into 5 subgroups SUBGROUPS 1. Non-immunocompromised hypoxemiaSpO₂ < 90% on room air orPaO₂ < 60 mm Hg on room air plusIncreased respiratory effort (accessory muscle use, paradoxical breathing, thoracoabdominal asynchrony) orRespiratory rate > 25 breaths/min2. Immunocompromised hypoxemiaDefined as:Use of immunosuppressive drugs for >3 monthsOR high-dose steroids >0.5 mg/kg/dayOR solid organ transplantOR solid tumors or hematologic malignancies (past 5 years)OR HIV with AIDS / primary immunodeficiency3. COPD exacerbation with acidosisHigh clinical suspicion of COPD as primary diagnosisRR >25 with accessory muscle use, paradoxical breathing, and/or thoracoabdominal asynchronyABG: pH 454. Acute cardiogenic pulmonary edema (ACPE)Sudden onset dyspnea and rales± S3 heart soundNo evidence of aspiration, infection, or pulmonary fibrosisCXR consistent with pulmonary edema5. Hypoxemic COVID-19 (added June 2023)Added due to deviations between expected and observed outcome proportionsAny patient across the other 4 groups with PCR-confirmed SARS-CoV-2 infection in any of the above groups POPULATION Inclusion Criteria:≥18 yrs with ARF* in one of 5 pre-defined subgroups excluding COPD was defined by the following:Hypoxemia with SpO₂

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastThis week's episode is also brought to you by Nursing Queen; stylish nursing clothes that will make your life easier and that you'll want to wear long after your nursing days are over. Use promo code BADASS for 10% off your purchase at www.nursingqueen.com.No one is happy when a nursing strike happens. But what causes them? Listen inas Dianne and Abby discuss nursing strikes, what causes them and how you canget through them. Tune into this episode today!If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Nursing strikes are developmentally normal [8:49]Weaning -vs- nursing strike [9:53]Illness [10:50]Developmental stuff [12:33]Parental reasons [13:30]Don't force the feeds [15:50]Feeding in a dark room [19:45]Protect the milk supply {20:36}Things that warrant a medical assessment [21:24]Emotions [27:16]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/071-overfeeding-paced-bottle-feeding/https://badassbreastfeedingpodcast.com/episode/maintaining-milk-supply/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastThis week's episode is brought to you by Simple Wishes. Simple Wishes offers hands-free pumping and nursing bras as well as a wide range of nursing clothing. Owned by badass breastfeeding moms in California. Use code BADASS for 50% off at www.simplewishes.com.Today's episode is brought to you by Original Sprout. Original Sprout carries safe and effective styling, body and hair care products that are safe for babies and great for adults. Use code BADASS26 at www.originalsprout.com for 25% off of your purchase.Toddler breastfeeding. Two listener questions for today's episode about toddlerbreastfeeding. There's so much to consider when breastfeeding a toddler, and it'sall good stuff. Listen today as Dianne and Abby discuss boundaries, nutrition andmany more aspects of breastfeeding a toddler.If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Where this episode came from [6:49]Nursing aversion [10:46]Boundaries [14:06]Nutrition [21:11]Abby quotes herself (from her blog) [26:40]Breastfeeding when pregnant and tandem nursing [34:18]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/nursing-aversion-with-melissa-morns/https://badassbreastfeedingpodcast.com/episode/how-breastmilk-changes-with-your-child/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastThis week's episode is also brought to you by Nursing Queen; stylish nursing clothes that will make your life easier and that you'll want to wear long after your nursing days are over. Use promo code BADASS for 10% off your purchase at www.nursingqueen.com.Birth interventions can make breastfeeding challenging in the beginning. Listen intoday as Dianne and Abby discuss different interventions and how you can getthrough this difficult time.If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Birth interventions-Revisited [4:48]Medicated delivery [6:25]Vacuum or forceps delivery [12:40]Fast (precipitous) birth [16:20]Cesarean delivery [16:46]Things that can help [19:55]Pitocin and latch issues [22:00]Mother / Baby separation [27:52]Episiotomy and perineal repair [32:40]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/jaundice-myths-and-breastfeedinghttps://badassbreastfeedingpodcast.com/episode/breastfeeding-nicu-and-separated-babies/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring, https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastHave you ever wondered what breastfeeding was like through the ages? Listen intoday as Dianne and Abby talk about the history of breastfeeding, share somehilarious stories and some really interesting facts from long ago. Don't miss thisepisode!If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Spotify comments [9:11]The idea behind the episode [12:13]Hospital instructions from the 1960's [14:50]Hospital instructions from 1948 [23:12]Hospital instructions from 1070's [25:20]Wet nursing [29:40]Links to information we discussed or episodes you should check out!https://pmc.ncbi.nlm.nih.gov/articles/PMC2684040/https://badassbreastfeedingpodcast.com/episode/5-tips-to-breastfeeding-success-infant-edition/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastThis week's episode is also brought to you by Nursing Queen; stylish nursing clothes that will make your life easier and that you'll want to wear long after your nursing days are over. Use promo code BADASS for 10% off your purchase at www.nursingqueen.com.Today Dianne and Abby are discussing breastfeeding tools, what is useful andwhat you may not ever need for breastfeeding. Are all the tools necessary? Findout on today's episode!If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about: Breastfeeding pillows [6:25]Nipple creams [11:39]Breast pads [13:37]Breast pumps [15:20]Abby needs photos! [21:30]Storage Bags [21:58]Nipple shields [23:08]Supplemental nursing system [26:08]Supplement tools [28:37]Pumping bra and nursing bra [31:29]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/nipple-shields/https://badassbreastfeedingpodcast.com/episode/infant-sleep-with-rebecca-michi/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastThis week's episode is brought to you by Simple Wishes. Simple Wishes offers hands-free pumping and nursing bras as well as a wide range of nursing clothing. Owned by badass breastfeeding moms in California. Use code BADASS for 50% off at www.simplewishes.com.Get ready to laugh today as Dianne and Abby share more myths they have about breastfeeding.  You don't want to miss this episode!  Do you have any breastfeeding myths that you have heard?  Send them to us!  We would love to use them on the next Myths episode!If you are a new listener, we would love to hear from you.  Please consider leaving us a review on iTunes or sending us an email with your suggestions and comments to badassbreastfeedingpodcast@gmail.com.  You can also add your email to our list and have episodes sent right to your inbox!Things we talked about:Abby's first myth – 2nd night syndrome [7:35]2nd night syndrome is normal [15:26]Blaming everything on breastfeeding [16:52]Abby needs photos! [22:07]Dianne's myth- taste buds?[ 23:04]Abby's next myth – rickets [25:54]Dianne's myth – baby eyes [29:35]Abby's last myth – all the apps [32:45]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/myths-about-starting-solids/https://badassbreastfeedingpodcast.com/episode/more-breastfeeding-myths/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/  Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/  Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc,  http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012) courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastDianne and Abby are qt it again! It's trivia time! How much do you know aboutbreastfeeding? Tune in today to play along and see how many trivia questionsyou get right.If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:% of parents in the U.S. who breastfeed 6 months [10:50]Hormones [16:00]How many calories? [17:34]Witches Milk [20:58]What's a good indicator of low milk supply [24:02]What does breastmilk make? [26:26]Successful breastfeeding [27:46]Can babies smell your milk? [30:54]Latch [31:20]Do breasts make the same amount of milk? [33:50]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/breastfeeding-trivia/https://badassbreastfeedingpodcast.com/episode/more-trivia/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastThis week's episode is brought to you by Simple Wishes. Simple Wishes offers hands-free pumping and nursing bras as well as a wide range of nursing clothing. Owned by badass breastfeeding moms in California. Use code BADASS for 50% off at www.simplewishes.com.Do you want to try baby led weaning but are afraid of how that will go? Listentoday as Dianne and Abby discuss the ins and outs of baby led weaning so you canconfidently and safely start solids with your baby.If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:What baby led weaning really is [9:20]Babies control their feeding [10:45]When is your baby ready for solids? [12:00]Breastmilk is main source of nutrition [17:10]Choking [18:47]Things not to give your baby [19:37]Allergens [24:06]Doing a mix of both [27:27]BLW myths [31:25]Nurse the baby first [34:09]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/myths-about-starting-solids/https://badassbreastfeedingpodcast.com/episode/129-balancing-solids-with-breastfeeding/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastThis week's episode is also brought to you by Nursing Queen; stylish nursing clothes that will make your life easier and that you'll want to wear long after your nursing days are over. Use promo code BADASS for 10% off your purchase at www.nursingqueen.com.A night in the life….what is happening with babies at night? Feedings, diaperchanges, sleep…how do we deal with it all? Today Dianne and Abby discuss whatthe nighttime might look like if you have a new baby.If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:What night looks like [8:19]What evening might look like [11:33]You're not failing [16:40]Hormones [17:03]Nighttime can equal anxiety [23:35]Appreciating the night feedings [28:53]What to watch for [29:40]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/feeding-during-the-night/https://badassbreastfeedingpodcast.com/episode/nighttime-milk-supply/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/Scott_Holmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastThe first 72 hours with your newborn can be a confusing time. Lots of skin to skin,lots of feeding…what else should you expect? Listen today as Dianne and Abbydiscuss what to expect in the first 72 hours with your new baby.If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:New travel law [7:00]Programming milk supply [14:00]Lots of skin to skin [14:28]2 nd night clusterfeeding [18:33]Feeding frequency [22:25]Hand expression for colostrum [24:35]Recovery for you [28:14]Wet and dirty diaper count [32:44]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/the-first-days-home/https://badassbreastfeedingpodcast.com/episode/005-first-days-home/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/Scott Holmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastThis week's episode is also brought to you by Nursing Queen; stylish nursing clothes that will make your life easier and that you'll want to wear long after your nursing days are over. Use promo code BADASS for 10% off your purchase at www.nursingqueen.com.Sore nipples. What can you do if you are experiencing soreness or pain withbreastfeeding? Don't suffer through it, listen to this episode and get an idea ofwhy it could be happening. Pain is a sign that something isn't right! Listen intoday and learn more about what may be causing your nipple pain.If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Normal soreness [8:48]Latch basics [9:56]Tongue ties [13:20]Reynaud's Phenomenon [16:15]Pumping [25:00]What to do for nipple pain [29:25]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/getting-a-good-latch/https://badassbreastfeedingpodcast.com/episode/pumping-myths/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/Scott Holmes

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastThis week's episode is brought to you by Simple Wishes. Simple Wishes offers hands-free pumping and nursing bras as well as a wide range of nursing clothing. Owned by badass breastfeeding moms in California. Use code BADASS for 50% off at www.simplewishes.com.It's the holidays. Are you ready for it? How do you handle the holidays with a breastfeeding baby? What if you or your baby is sick during the holidays? Listen in today as Dianne and Abby tackle the subject of holidays, family, and battling illness during it all.If you are a new listener, we would love to hear from you.  Please consider leavingus a review on iTunes or sending us an email with your suggestions and commentsto badassbreastfeedingpodcast@gmail.com. You can also add your email to ourlist and have episodes sent right to your inbox!Things we talked about:Abby went away and got sick over Thanksgiving [5:38]Breastfeeding around family [6:55]Do what is right for you [11:37]Things you eat or drink during the holidays [13:02]Holidays can bring you off your regular routine [16:05]Getting sick during the holidays [20:14]Breastfeeding while you are sick [23:18]Rest as much as you can [27:04]When babies are sick [27:37]Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/024-alcohol-consumption/https://badassbreastfeedingpodcast.com/episode/dealing-with-family-during-the-holidays-listener-stories/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012)courtesy of Scott Holmes at freemusicarchive.org/music/Scott Holmes