Kailey Harmon has spent nearly a decade working in acute care and the NICU, building expertise in neonatal feeding, myofunctional therapy, and outpatient feeding intervention. In this conversation, she and Michelle explore the realities of NICU speech pathology, from earning the trust of nursing staff to navigating the emotional weight of supporting families through some of the most difficult moments of their lives. They also tackle the gap in care that exists when babies leave the hospital, the role of sensory regulation in feeding therapy, and practical advice for graduate students who want to break into the medical setting.
Key Takeaways
The NICU Is Not for Everyone, and That's Okay: Working with medically fragile infants requires the ability to stay calm when a baby turns gray or purple during a feed. Knowing your limits is just as important as knowing your strengths.
Trust Is Earned, Not Given: Kailey had to prove her value to the nursing team over time. Listening to the nurses who spend the most time with these babies is essential to effective, collaborative care.
Certifications That Matter: While no single certification is universally required, Kailey recommends training through the Neonatal Therapy Association (NAT), SOS Feeding (Sequential Oral Stimulation), and myofunctional therapy as foundational knowledge for anyone working in this space.
The Gap After Discharge Is Real: Many families leave the NICU without an outpatient speech therapy referral, and when developmental regressions occur, often around three to eight months, they are left without support. Kailey advocates for routine outpatient referrals for all premature infants.
Sensory Regulation Before Expectation: For children with food aversions or limited food repertoires, regulation must come before intervention. Occupational therapists are invaluable partners in building the sensory protocols that make feeding therapy possible.
Not Every Picky Eater Needs Therapy: Some children, particularly neurodiverse individuals, may always have a limited food repertoire. The real red flag is when preferred foods start disappearing and nutritional variety drops to a critical low.
Graduate Students: Get in the Door Early: Hospital settings rarely allow shadowing after graduation. Students should pursue medical placements while still in school and take full advantage of every opportunity to observe.
Chapters
00:00:00 – Introduction: Michelle welcomes Kailey Harmon, NICU SLP and fellow Southerner
00:01:15 – Kailey's background: nearly ten years with the same hospital system, part-time and PRN work, and a focus on feeding
00:02:54 – How Kailey became an SLP: a family of educators, a shadowing experience, and a calling toward the medical side
00:05:56 – The dual role of NICU SLPs: supporting babies and the families around them
00:07:16 – The hardest parts of the job: earning trust, having hard conversations, and knowing when feeding has to wait
00:09:47 – Certifications and training: NAT, SOS Feeding, and myofunctional therapy
00:11:35 – What happens after discharge: the gap in care and the case for outpatient referrals
00:15:19 – Rural access challenges and the ongoing fight to bridge the gap
00:16:11 – Food aversions and limited food repertoires: when to intervene and when to step back
00:17:28 – Sensory regulation and the critical role of occupational therapists
00:19:14 – Play therapy, behavioral approaches, and knowing when a child's food preferences are actually typical
00:22:05 – Being an SLP mom: navigating milestones, diagnoses, and a third baby born with bilateral clubbed feet
00:26:08 – Why Kailey started posting on social media and what she hopes to accomplish
00:27:41 – The number one question in her inbox: how to get into the NICU
00:29:33 – Advice for graduate students: shadow early, pursue medical placements, and be honest with yourself about the environment
00:30:38 – Closing thoughts and an invitation for Kailey to return for a deeper dive
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