When Your Child Has Dysphagia

Normal swallowing

Swallowing of food is done in four phases. Dysphagia can occur when one or more of the four phases don't occur properly.

Oral preparatory phase: Food enters the mouth and is chewed for swallowing.

Oral phase: The tongue moves the chewed food to the back of the throat (pharynx).

Pharyngeal phase: The food is then swallowed. It passes through the pharynx (throat) into the esophagus.

Esophageal phase: The esophagus is the muscular tube leading to the stomach. The esophagus tightens and relaxes in wavelike motions to move swallowed food into the stomach.

What are the symptoms of dysphagia?

Common symptoms of dysphagia include:

• Choking, coughing, or sputtering while eating or drinking.

• Poor sucking reflex.

• Fussiness or arching of the back.

• Drooling.

• Noisy breathing.

• Not gaining weight.

• Trouble chewing and swallowing, refusing food, or taking a very long time to eat.

• Upper respiratory problems, such as pneumonia. These can come from food or drink being breathed into the lungs (aspirated).

• Occasional vomiting, or stomach contents and digestive acids flowing back into the throat (regurgitation).

What causes dysphagia?

Dysphagia can be caused by:

• Nerve or brain problems that affect control of muscles in the mouth, tongue, throat, or stomach.

• Other health problems that exist at the same time. These include having been born prematurely, GI (gastrointestinal) disorders, and heart disease present since birth.

• Problems with the shape of a child’s mouth, tongue, or throat.

• Thickening or narrowing of the esophagus (stricture).

• Structural problems such as cleft lip or palate.

How is dysphagia diagnosed?

To find out if your child has dysphagia, the health care provider may order some tests. One such test might be a swallow study. Your provider watches your child swallow a barium solution while being X-rayed. Sometimes endoscopy is used to see your child's esophagus. This is called a functional endoscopic evaluation of swallowing or FESS.

How is dysphagia treated?

Your child’s treatment will depend on where the problem is located and what is causing the problem. Treatment may include:

• Therapy to help your child learn how to move food correctly in the mouth.

• Therapy to help develop swallowing skills.

• Changes in your child's posture while feeding. This can help your child swallow, protect the airway, and help food and liquid go down more safely.

• Medicine, if reflux is a problem.

• Insertion of a feeding tube in the nose or stomach. This may be done if the problem is severe and your child needs help getting nutrition.

• Changes in diet, such as thickened foods that help your child swallow more easily.

• A procedure to make the esophagus wider if it's too narrow.

Call 911

Call 911 if food seems to get stuck in your child's mouth or throat during feeding and:

• Your child has trouble breathing, or breathing stops during feeding.

• Your child’s skin or lips turn blue when feeding.