Dysphagia

Dysphagia occurs when food does not move safely from the mouth to the stomach. Caused by brain injury, congenital problems, neurological diseases, or mouth and throat surgeries, dysphagia can cause long-term health problems if not treated.

Children with dysphagia often refuse to eat or drink, have frequent respiratory illnesses, cough or choke when eating or drinking, and drool frequently.

Dysphagia is diagnosed through feeding and swallowing evaluations. Treatments include diets with safe liquids and foods, strengthening your child’s neck and facial muscles, and learning safe swallowing methods for your child.

There are several warning signs of dysphagia. Usually, a child has one or more of these symptoms:

• Weak or slow swallow
• Poor response when the mouth is stimulated
• A lot of drooling
• Coughing or choking when eating or drinking
• Weak cough
• Frequent respiratory illnesses, including pneumonia
• Food still in the mouth after swallowing
• “Wet” or gurgly voice
• Vomiting or reflux of liquids and solids
• Refusal to eat or drink

Take your child to the doctor if they are vomiting or losing weight because of problems swallowing. If you feel food is stuck in their throat or chest and they can’t provide, call 911 immediately.

Dysphagia is often caused by muscle weakness, neurological diseases, brain injury, congenital problems, or mouth and throat surgeries.

A specialist can conduct three types of studies to find out if your child has dysphagia:

• Clinical feeding evaluation
• Modified barium swallow study (MBS)
• Fiberoptic endoscopic evaluation of swallowing (FEES)

After the study, a feeding specialist will discuss your child’s eating habits with you. They will look at your child’s mouth and face and watch your child eat or be fed. The specialist will ask your child to eat a variety of foods. These depend on your child’s age, ability to eat, and any medical conditions. You may bring food from home if you want.

Clinical Feeding Evaluation

Your child will complete the clinical feeding evaluation at the therapy center. The feeding specialist will do the following:

• Talk with you about the foods your child eats and their eating habits
• Discuss the environment in your home when your child eats snacks and meals
• Look at your child’s mouth and face
• Watch your child being fed or feeding herself

By watching your child eat, the specialist can learn about your child’s mouth function, mental alertness, body control, and general ability to eat.

Modified Barium Swallow (MBS)

Your child will have the MBS in the hospital x-ray department in a feeding position. You may be able to feed your child during the study.

Your child will have a video x-ray while swallowing small amounts of thin liquid, thick liquid, or solid food (depending on age and ability to swallow). The liquid and food has some barium, a metal that can be seen with x-rays, in it. This is so the doctor can see the food on the x-ray.

Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

Your child will have the FEES study in the outpatient clinic or endoscopy room at the hospital. You will usually hold your child in a feeding position on your lap during the study. The doctor will put a small tube with a camera through your child’s nose until the doctor can see the back of the throat in the camera. Then your child will eat or drink, and the camera records them swallowing.

Children with dysphagia may work with a speech language pathologist (SLP), occupational therapist, pediatric gastroenterologist, and dietitian. For instance, the modified barium swallow studies are completed with an SLP and a doctor who can read x-ray videos.

The goal of dysphagia treatment is to find the safest, most efficient, and most enjoyable way for your child to eat. Dysphagia treatment will help your child swallow safely and be less likely to swallow food into the lungs. With treatment, eating can be more enjoyable for your child and family.

There are various ways to treat dysphagia. Treatments may include:

• Choosing different positions when eating that make up for weakness
• Diets with safe liquids and foods
• Swallowing methods that help your child swallow safely
• Learning to eat varied liquids and foods
• Training for you, your child, and their caregivers about safe swallowing methods
• Waiting for your child to increase overall strength and endurance
• Exercises to strengthen your child’s neck and facial muscles for swallowing

Dysphagia can’t be prevented. However, you can help your child avoid any difficulty swallowing by encouraging them to chew food well and eat slowly.

• Intermountain Health Library
• KidsHealth.org (for parents)