Pediatric Dysphagia

Dysphagia is a term that means difficulty swallowing. It is the inability of food or liquids to pass easily from your mouth, into the throat, and through the esophagus to the stomach during the process of swallowing.

A child with dysphagia may have trouble swallowing food or liquids, including saliva. They may also experience pain while swallowing. It is difficult for a child with a swallowing disorder to receive the correct amount of nutrients into their body, which can affect their ability to grow and gain weight. 

Dysphagia can occur at different stages in the swallowing process:

Oral phase: Sucking, chewing, and moving food or liquid into the throat.

Pharyngeal phase: Starting to swallow, squeezing food down the throat, and closing off the airway to prevent food or liquid from entering the airway (aspiration) or to prevent choking.

Esophageal phase: Relaxing and tightening the openings at the top and bottom of the feeding tube in the throat (esophagus) and squeezing food through the esophagus into the stomach.

Symptoms may include:

• Coughing
• Choking 
• Difficulty breathing while eating 
• Refusal of food or liquids
• Rejecting different textured food - has strong preferences to certain textures
• Difficulty with chewing
• Food sticking in the throat
• Food or drink coming out the nasal cavity

Certain health problems can affect swallowing in children including:

• Prematurity
• Developmental delays
• Cleft lip and palate 
• Large tongue or tonsils
• Neuromuscular disease
• Irritation from being on a ventilator for a prolonged period of time
• Having a tracheostomy (artificial opening in the throat for breathing)
• Gastroesophageal reflux disease (GERD)
• Foreign bodies in the esophagus, such as a swallowed coin

How is dysphagia treated in children?

Treatment for dysphagia is based on the nature and severity of the child's feeding and swallowing problems and can range from behavioral therapy and medications to surgery. A speech-language pathologist (SLP) will help with the evaluation of dysphagia and will work with parents/guardians to determine the treatment plan right for your child. They may suggest or provide therapy to:

• Develop strength, range of motion, and coordination of the lips, tongue, cheek, and jaw muscles for efficient eating and drinking
• Help decrease oral sensitivity or oral aversion to foods and liquids
• Decrease behavioral resistance to feeding
• Work on strategies to decrease the risk for aspiration

The speech-language pathologist may also suggest:

• A change in food textures or in the thickness of liquids
• A change in the feeding equipment, such as the nipple, bottle, cup or utensils
• Strategies to help with drinking and eating 

If your child has difficulty swallowing, contact the Speech-Language Institute to schedule an appointment.