Dysphagia means difficulty with feeding and/or swallowing. It is a symptom, not a disease. Oral dysphagia refers to problems with using the mouth, lips and tongue to control food or liquid. Pharyngeal dysphagia refers to problems in the throat during swallowing. Dysphagia can affect a person at any age − from infants to the elderly.
There are many conditions that have the associated symptom of dysphagia. Any structural problem in the mouth, throat or esophagus, or condition that weakens or damages the muscles or nerves used for feeding and swallowing may cause dysphagia. Common disorders related to pediatric swallowing problems:
Gastroesophageal disorders, including reflux
Heart or lung conditions
Head and / or neck cancer
Signs & Symptoms:
Problems coordinating sucking, swallowing and breathing while bottle-feeding or drinking from a cup or straw
Color change during or after feeding
Lengthy feeding times (greater than 30 minutes)
Congestion during or after feeding
Change of breathing rate with feeding
History of pneumonia
Sensation of food being stuck in the throat
Limited intake of food or liquids
Refusal of previously accepted food or liquids
Failure to gain weight
Evidence of food or liquid in a tracheotomy tube during or after eating
What can happen: Dysphagia may result in inadequate airway protection during swallowing, causing food or liquid to get into the lungs (aspiration). Aspiration into the airway can cause frequent episodes of upper respiratory infections and pneumonia. The child may not be able to manage food or liquid well or accept an age-appropriate diet. Dehydration and malnutrition may occur if the feeding problem goes untreated. If the dysphagia is severe, another source of nutrition and hydration, such as a feeding tube, may be needed. A child with dysphagia may develop anxiety about eating or drinking.
Treatment: Treatment for dysphagia is based on the nature and severity of the child's feeding and swallowing problem. The speech-language pathologist will help with the evaluation of the dysphagia, and 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 and/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 the following after talking with the child’s medical team:
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
What can parents do:
Implement various exercises, activities and recommendations given by the speech pathologist.
Include the child in family mealtime and keep the experience positive.