It seems like the most natural thing for a child to do – swallow the milk or food you place in her mouth. But for some infants and children with a swallowing disorder, difficulty eating can lead to a variety of physical symptoms.
Although any child can have a swallowing disorder, children with certain medical conditions including premature birth, nervous system disorders, and cleft lip or palate are more likely to have swallowing difficulties.
Swallowing disorders, also known as dysphagia, can occur in any of three stages in the swallowing process:
• Oral phase – sucking, chewing, and moving food from the mouth into the throat
• Pharyngeal phase – starting the swallow, which includes moving the food down the throat and closing off the airway so the food goes to the stomach and not into the lungs
• Esophageal phase – relaxing and closing off the openings at the top and bottom of the esophagus (the tube food travels through to reach the stomach), as well as squeezing the food down the tube to the stomach
Children who have swallowing disorders are at risk for a number of potentially serious conditions:
• Dehydration – children may be under nourished or dehydrated because they cannot consume enough food or liquids
• Aspiration – food may “go down the wrong way” and enter the airway, which can cause choking
• Respiratory infections – food in the airway can cause recurrent respiratory infections, pneumonia, and sometimes chronic lung disease
Symptoms of Swallowing Disorders
Infants and children with swallowing disorders may show one or more of these symptoms:
• Arching or stiffening the body during feeding
• Lack of attention or alertness during feeding
• Refusing food or liquids
• Refusing foods of different textures (such as only wanting crunchy foods)
• Taking a long time to feed (30 minutes or longer)
• Difficulty breast feeding or chewing
• Coughing or gagging while eating
• Swallowing repeatedly
• Food or liquid leaking from the mouth or nose
• Spitting up during meals
• Gurgly, hoarse, or breathy voice quality
• Difficulty coordinating breathing with eating and drinking
• Weight loss, or lower than normal weight gain or growth
• Frequent respiratory infections
If your child repeatedly shows any of these symptoms, contact your pediatrician to have your child evaluated. Your doctor may refer you to a Speech-Language Pathologist (SLP) who specializes in treating children with swallowing disorders. The SLP may perform specialized tests to watch the swallowing process:
• Modified barium swallow – as your child swallows food or liquid containing barium, a special x-ray tracks the swallowing process as the food travels to the stomach
• Endoscopic testing – a lighted camera scope is inserted through the nose and into the throat so the doctor can watch how the child swallows
The SLP can also look at the strength and movement of the muscles used in swallowing and check your child’s posture, behavior, and mouth movements during eating and drinking in order to create a plan to for improvement.
Sources:
American Speech-Language-Hearing Association
Mayo Clinic