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Shaili Patel, PA-C, works at our Phoenix and Chandler locations. Shaili Patel, PA-C Undergraduate College and Degree: Marquette University, Bachelor of Science in Biomedical Sciences PA School: Midwestern University Board Certified: Yes Interests: I enjoy spending time with friends and family, watching movies, hiking, being outdoors, trying new restaurants, and cooking/baking. Family: I have a boyfriend who I met in PA school. I'm also very close to my family in CO and group of friends in AZ who are like my second family. Professional Memberships: American Academy of Physician Associates (AAPA) Office Locations: Phoenix and Chandler Shaili grew up in the suburbs of Chicago and moved out to Arizona in 2022 for PA school. She loved the mountain west region so much that she decided to stay to start her career. Shaili has always had a strong passion for Pediatrics which started as early as high school. She loves building long lasting relationships with both her patients and their families! In addition to providing comprehensive pediatric care, Shaili offers Osteopathic Manipulative Medicine (OMM) as part of her practice to support the health and well-being of children.

So far, we have collaborated with: LightScalpel, PADT Inc; Phoenix Children's Hospital; and Arizona State University. Contact us to collaborate on research! Collaborate with Us The Agave Team has several ongoing research projects in collaboration with various institutions including: LightScalpel, PADT Inc; Phoenix Children's Hospital; Arizona State University The Agave team has extensive experience with NIH as well as regional and foundation funding. We would be happy to discuss collaborative projects with you. If you would like to exchange some ideas, collaborate with us, or visit us for observation, please feel free to contact us.

Michelle Hottya, IBCLC, works at our Chandler location, providing breastfeeding support. She co-chairs the Arizona Nationwide Nurse-In. Michelle Hottya, IBCLC, RLC Education: BA, Loyola Marymount University Board Certified: Yes, International Board of Lactation Consultant Examiners Professional Memberships: President, Central Arizona Lactation Consultant Association; member, USLCA; member, ILCA Interests: Crochet, reading, cooking, supporting women’s basketball Family: Married to Alex since 1997, three growing kids Office Location: Chandler Michelle is an IBCLC in private practice and has been serving the families of the Phoenix, AZ metro area for the last seven years. She has been working with pregnant and postpartum families since 2006, starting as a doula, birth assistant, and Breastfeeding Counselor with Breastfeeding USA. Michelle is currently the President of the Central Arizona Lactation Consultant Association, has served on the board of Postpartum Support International – Arizona Chapter, and was former President of the Arizona Birth Network. She is a passionate advocate for the rights of pregnant and breastfeeding parents, notably as a member of the grassroots committee who successfully lobbied for the passage of the Arizona Breastfeeding Protection Act (A.R.S. 41-1443 and 13-1402). Michelle is a 2017 graduate of Emerge AZ and co-chairs the Arizona Nationwide Nurse-In.

Current research projects being completed at Agave Pediatrics include research into the effect of tongue and lip ties on breastfeeding, bottle-feeding, and long-term developmental outcomes. Research at Agave The Agave team has several ongoing research projects in the field of tongue tie and breastfeeding and we periodically present our findings at various national and international conferences. S ome of the current research projects at Agave on various aspects of tongue tie include: Genetics of tongue ties. A large number of patients with tongue tie have other family members with diagnosed or suspected tongue ties. We are studying the inheritance patterns of tongue tie and have identified both autosomal dominant and recessive inheritance patterns. We believe that multiple genes may be involved in development of non-syndromic tongue ties. We plan on enrolling such families for further gene mapping and identification studies. Analytical studies on improvement of maternal and infant symptoms after frenectomy. A statistical modelling and analysis study in pediatric patients of different age groups has recently been performed to identify clinical correlates of symptomatic improvement in collaboration with ASU. A recent review and meta-analysis found that a small body of evidence suggests that frenotomy may be associated with improvements in breastfeeding as reported by mothers, and potentially in nipple pain, but with small short-term studies, inconsistently conducted, strength of evidence was generally low to insufficient. Agave is conducting studies to confirm these findings in one of the largest collection of tongue tie patients systematically followed at a single practice, so as to add to the strength of evidence. Development of intra-oral vacuum pressure monitoring device. A novel device is being developed in collaboration with LightScalpel and PADT Inc, that can be used to quantitatively assess dysfunctional breastfeeding associated with tongue ties and follow its improvement after the surgery. The research team at Agave is headed by Dr Rajeev Agarwal. We would be happy to discuss our current and past projects with you - p lease feel free to contact us.

What is a frenectomy like? What exercises do you do after a frenectomy? Tongue and lip tie frenectomy aftercare, pain relief, exercises and stretches. Procedure, Exercises, & Aftercare Tongue & Lip Ties - Procedure, Exercises, & Aftercare Frenectomy Handout 2025 January.pdf Frenectomy Homepathic Pain Relief

Dr Rajeev Agarwal, MD works at all Agave Pediatrics locations and performs frenectomy for tongue and lip ties at our Chandler, Goodyear, and Glendale locations. Lydia Powers, DO, CLC Undergraduate: Abilene Christian University, Abilene, TX. B.S. in Biology Medical School: Western University College of Osteopathic Medicine of the Pacific, Pomona, CA Residency: Nationwide Children's Hospital, Columbus, OH. Osteopathic Recognized Track Chief Board Certified: Yes Professional Memberships: American Academy of Physician Assistants, American Academy of Pediatric Osteopathy Interests: Paddle Boarding, hiking and camping with family and friends Family: Married with two children Dr. Powers was born and raised in Tucson, Arizona prior to traveling across the continental US to complete her medical training. Her faith and her family are at the center of her life and are her motivation in providing holistic medical care to children. She received training in both pediatrics and Osteopathic Manual Medicine(OMM) in order to provide the best care for her patients. As a specialist of OMM it gives her the skillset to assess and treat patients with the ultimate goal of restoration of the body to its original intended functionality. She believes that OMM works in combination with traditional medicine to help provide individualized and holistic care. She is passionate about helping support breastfeeding through her training as a certified lactation counselor (CLC), her own experience as a breastfeeding mother, and her hands on OMM skills to gently adjust oral/body dysfunction.

Tongue ties and lip ties can affect breastfeeding mothers, infants, and children in a variety of ways, including: breastfeeding difficulties, speech difficulties, dental problems, and more. Here we outline the signs and symptoms, consult process, treatment options, and the exercises and aftercare for if a frenectomy procedure is done. Tongue & Lip Ties While our offices are in the greater Phoenix area, the resources available on our website may be of use to any parents wondering "What is a tongue tie?", "How does a frenectomy help?", and "What should I do after a frenectomy?". Please click through to learn more about the signs and symptoms, consult process, procedure, post-procedure exercises, aftercare, and to view photos of patients who have had frenectomy procedures for tongue and/or lip ties. SIGNS & SYMPTOMS There are various signs and symptoms of tongue and lip ties. These symptoms can affect infants and breastfeeding parents, as well as older children and adults. LEARN ABOUT SYMPTOMS CONSULT The consult includes a thorough assessment of your child’s health, symptoms, and classification of tongue and lip ties. ABOUT THE CONSULT PROCEDURE & POST-PROCEDURE This page has information on the frenectomy procedure, as well as what to expect after the procedure. THE PROCEDURE AND AFTER APPOINTMENT FORMS Here you can find forms for tongue/lip tie, lactation, and osteopathic manual medicine appointments. Print and fill them ahead of your appointment to save time. DOWNLOADABLE FORMS AFTERCARE HANDOUT The aftercare handout is a downloadable PDF that discusses the frenectomy procedure, pain management with dosage chart, and post-procedure exercises. AFTERCARE PDF PHOTO GALLERY Our photo gallery shows different sorts of tongue and lip ties, pre- and post- frenectomy. Those squeamish about medical images may not wish to view the gallery! BEFORE AND AFTER

Sharon Olson, IBCLC, runs group breastfeeding classes and also provides 1:1 IBCLC services at our Glendale location. Sharon Olson, BS, IBCLC, RLC Education : BS in Communication from University of Wisconsin – Platteville, 1984; International Board Certified Lactation Consultant, 2002 Board Certified : Yes Professional Memberships : International Lactation Consultant Association, United States Lactation Consultant Association Interests : Sewing, reading, cooking Family : Married with four adult children, four grandchildren and counting! Office Location : Glendale Sharon began assisting breastfeeding families in 1992 as an accredited volunteer with an international breastfeeding mother-to-mother support organization. She earned her certification as an International Board Certified Lactation Consultant in 2002. An educator at heart, Sharon then coordinated annual conferences for the professional community while driving the carpool for her grade-school and high-school aged daughters. She has maintained her IBCLC recertification as required every 5 years, and she maintains current memberships with ILCA and USLCA. Before joining Agave Pediatrics, Sharon ran the breastfeeding program at a collaborative midwifery and ob-gyn private practice for 10 years. During that time, she developed an appreciation for the difficulties of mothers and babies who struggle with breastfeeding due to tongue tie. She is delighted to work as a member of the tongue tie team at Agave Pediatrics where she can share her knowledge and skills to support breastfeeding mothers and babies. Sharon and her husband of 30+ years have raised their four daughters in the Phoenix area. Sharon enjoys reading, sewing, trying new recipes, and playing with her grandkids who provide an endless source of fun and imagination. Spending time with her extended family in many places around the U.S. is also high on her list of priorities!

Here is the aftercare handout, information on post-procedure pain management, exercise videos, and more. Aftercare & Links Tongue & Lip Ties - Aftercare & Links Aftercare PDFs Parent Handout 2025 English Frenectomy Homeopathic Pain Relief We want to empower you with information! Here is the aftercare handout for frenectomy procedures, plus our NEW homeopathic guide. You'll find information about the consult, the procedure itself, and the aftercare and healing process. Links Agave Pediatrics Instagram Tongue Tie Facebook Group What to expect during your consultation How tongue ties affect feeding video Infant stretches and exercises video Stretches to prevent reattachment video Exercises to improve tongue function video Preventing lip tie reattachment video Lip tie healing photos Facial exercises video Toddler push-back exercise video Toddler and older kids exercises video

Dr Katie Neuer, DO, offers Osteopathic Manual Medicine (OMM) services to infants and children in Glendale and Chandler. Katie Neuer, DO Undergraduate: Arizona State University Medical School: Des Moines University Residency: Family Medicine at Mountain Vista Medical Center, Osteopathic Neuromusculoskeletal Medicine at Midwestern University Fellowship: Osteopathic Manual Medicine (OMM) at Des Moines University Board Certified: Yes Recognition: Assistant Professor at Midwestern University Interests: She enjoys hiking, and here in Arizona there is a lot to see! Any sightseeing vacation makes for a great trip! Office Locations: Glendale, Chandler Dr. Neuer is a Doctor of Osteopathic Medicine. This is a thorough and robust education in traditional medicine and an additional education in the disease and pathology of the musculoskeletal system of the human body. Osteopathic physicians can work in all areas of medicine, and can prescribe all medications. She has had the great privilege of learning from world renowned osteopathic physicians who trained her in medicine and showed her the great compassion that physicians have for their patients. She endeavors to help parents, grandparents, and families understand the wide variety of medical concerns that Osteopathic Manual Medicine (OMM) can address and the benefits every child can experience from being treated. Her goal is to increase access for patients to a physician that treats with OMM. In this regard, she has a heartfelt goal to teach medical students and residents, specifically to improve confidence in their OMM skills. As a specialist in the area of OMM, Dr. Neuer helps with restoration of the body to the original intended functionality. She has been treating patients with highly complex diseases and dysfunctions for the past seven years and has a deep understanding of the human body's innate ability to heal and restore. Many of her patients come to see her after being seen by a variety of other providers that simply have no further treatments to offer. Her greatest aspiration is to help children, who are at the beginning of life, in order to restore their body's functionality so that they may live fully and completely. She has treated all age groups of patients, and believes that treating children is a special calling.

Tongue-Tie in Kids; Agave has developed a clinically successful, evidence-based, compassionate, and thorough approach to the treatment of oral ties FLIP Breastfeeding Dysfunction Tool Dr. Rajeev Agarwal and Agave Pediatrics are proud to present a new, validated tool to assess breastfeeding and evaluate and predict the risk of breastfeeding dysfunction . This allows parents and providers to objectively quantify the severity of breastfeeding dysfunction, before and/or after any interventions (such as professional feeding or lactation support, body work or therapy, frenectomy etc). What truly sets this tool apart is not only the thorough questionnaire resulting in a research-backed FLIP score (flow, latch, injury, post-feed behavior) , but that fact that it is based on FUNCTION, not appearance. Years of work went into this research, and we cannot wait for the world to take advantage of this tool for FREE . Need an example of when this would be helpful? Let's say you have a baby with a few reported breastfeeding symptoms, but parents and/or providers are not sure if intervention is needed. Parents can fill out the Flip Tool, to get a real picture of the seriousness of breastfeeding dysfunction. The first intervention may be working with lactation consultant for a few appointments. The Tool can be filled out again to see what, if any, progress has been made. Then the need for further intervention, such as bodywork , or frenectomy , can be objectively assessed. Research PDF of tool (English) PDF of tool (Spanish) Filled-out Example

Keren is an International Board Certified Lactation Consultant (IBCLC) and Licensed Massage Therapist (LMT). Keren Giber Segev, IBCLC, LMT Education: Lactation Consultant Certificate, Assaf Harofeh Medical Center, Israel; Licensed Massage Therapist, Medisain College of Complementary Medicine; Tel Aviv Licensed Massage Therapist, ASIS Massage Education, Mesa, AZ Board Certified: International Board of Lactation Consultant Examiners Interests: Hiking in Arizona nature with my family, baking together, acting in community plays, and enjoying K-drama series. Family: Married to Elad, mother to Emma and Dor. Professional Memberships: United States Lactation Consultant Association (USLCA), IAPL – The Israeli Association of Lactation Professionals (IALP), HaManifa – Doula Organization for Birth and Postpartum. Keren is an International Board Certified Lactation Consultant (IBCLC) and Licensed Massage Therapist (LMT) who has been working with families since 1999. Her professional journey began in Israel, where she supported families through pregnancy, birth, postpartum, and early parenthood. Over the years, she has worked as a doula, childbirth educator, infant massage and developmental support instructor, sleep consultant (in the attachment theory), and multidisciplinary massage and body work therapist specializing in many different techniques. Since relocating to Arizona, Keren has been passionate about bringing her knowledge and care to families in the area. Her approach centers on empowering parents to trust themselves and their instincts while providing practical tools and compassionate support through the challenges of breastfeeding and early parenting.