How to Tell if Your Baby Has Swallowing Problems

Difficulty swallowing – almost anybody has experienced the horrible feeling of food "going down the wrong way". Simply some children (and adults) have to deal with trouble swallowing every day.

Just similar animate, swallowing is a reflex that's essential for life. Speech Pathology Commonwealth of australia say that humans swallow 700 times per day on average – around three times an hour during slumber, once per infinitesimal while awake and more often during meals.

According to estimates from the US Centers for Illness Control and Prevention, 0.9% of children aged 3–17 have swallowing problems – known medically every bit 'dysphagia'.  The incidence of feeding and swallowing disorders is causeless to exist increasing because of improved survival rates of children with complex and medically fragile conditions, plus the improved longevity of people who develop dysphagia during childhood.

In 2020, Speech Pathology Australia are hostingSwallowing Awareness Day onWed 18 March to bring attention to swallowing disorders and connect people with speech pathologists – the professionals who tin help.

The 2020 theme is "Dysphagia. A hard diagnosis to eat!"

On xviii March 2020 Swallowing Awareness Day highlights the people living with dysphagia

Why would a child have trouble swallowing?

Although many people take swallowing for granted, it's a circuitous process involving several pumps and valves. These move nutrient and drink from the mouth to the stomach via a tube called the oesophagus.

An important function of safe swallowing is its coordination with breathing. Speech Pathology Commonwealth of australia note that swallowing is an exquisitely timed process that uses 26 muscles and many nerves to ensure nutrient and drink goes down the oesophagus, not the breathing tube into the lungs.

Swallowing skills are needed from nativity so babies tin beverage milk from their female parent's breast or a bottle. Once solid food is introduced, children must learn to shift food to the back of the oral cavity where it triggers the swallowing reflex. Chewing also becomes important, as the food gets cleaved down and mixed with saliva to form a brawl (called a 'bolus') that'due south easy to consume.

Because swallowing is such a finely tuned process, in that location are many reasons why a child may have trouble swallowing. Anything that interferes with the structures of the head and neck, or the muscles or nerves that control swallowing, may cause paediatric dysphagia – the medical term for swallowing difficulties in children.

Common causes of paediatric dysphagia

Some of the more mutual reasons a child may have swallowing difficulties include:

  • neurological weather eg cerebral palsy, meningitis, epilepsy, traumatic brain injury
  • genetic syndromes eg Down syndrome, Prader-Willi syndrome, Rett syndrome
  • premature birth or very low birth weight, hyper- or hypotonia (high or depression muscle tone)
  • breathing and/or respiratory difficulties eg need for oxygen, chronic neonatal lung disease
  • ear, nose and throat problems eg choanal atresia, tracheostomy, song fold palsy
  • complex medical conditions such as middle or lung diseases, delayed gastric emptying, oesophageal atresia (a birth defect affecting the oesophagus)
  • side effects of medication eg lethargy, poor appetite
  • developmental disability
  • structural abnormalities eg cleft lip and/or palate and other abnormalities of the head or neck.

Dysphagia symptoms in children

A swallowing problem can stem from an issue with any stage of the swallowing process.

Signs and symptoms that your child might be having swallowing difficulties include:

  • coughing or throat clearing
  • choking or gagging on food and/or drink
  • multiple swallow attempts
  • fussy eating such every bit refusal to eat certain food types/textures
  • watery or teary eyes
  • nasal congestion
  • color alter (eg turning blueish effectually the lips)
  • wet/gurgly breathing or voice
  • increased breathing rate, stridor or wheezing
  • apnoea (longer than usual breathing pauses)
  • recurrent chest infections.

What are the problems associated with paediatric dysphagia?

Swallowing difficulties can have serious consequences, including dehydration, undernutrition, malnutrition and something known as oral disfavor – the reluctance, avoidance, or fear of eating or drinking.

One major concern with swallowing difficulties is aspiration gamble. Aspiration occurs when food, drink or other material enters the breathing tube and passes beneath the vocal cords towards the lungs. It tin can be 'silent', meaning the child has none of the usual outward signs of swallowing difficulty such every bit coughing or choking.

Aspiration tin can lead to chest infections like pneumonia and chronic lung disease.

Swallowing is a circuitous process involving several pumps and valves. This shows what's involved in swallowing a nutrient bolus, showing how the epiglottis is used to prevent inhalation of food.

How do I know if my baby has swallowing problems?

In babies, signs of a swallowing problem may include:

  • Coughing or choking during or after swallowing
  • Crying or decreased responsiveness when feeding
  • Breathing difficulties when feeding eg faster animate rate, temporarily not breathing
  • Turning bluish around the lips, nose and fingers/toes
  • Frequent stopping during feeds
  • Drooling (non related to teething)
  • Gagging, loss of food/liquid from rima oris during feeds
  • Detachment/refusal shown past grimacing, facial flushing, or turning head away
  • Frequent congestion (especially after meals), frequent respiratory illnesses
  • Noisy or moisture gurgles during and after eating
  • Vomiting (more than than usual baby "spit-upward").

What is a swallowing assessment?

If you doubtable your child has a swallowing problem, it'southward vital to get them assessed by a professional. Speech-Linguistic communication Pathologists are highly trained and qualified health professionals who deport swallowing assessments.

When assessing swallowing difficulties in children, the Spoken communication-Language Pathologist will have a holistic arroyo to your child's problem, considering factors such as their age, and whatever congenital abnormalities, disabilities, and/or chronic weather condition that may be affecting feeding and swallowing office.

A clinical evaluation of swallowing and feeding will ordinarily include taking a history of your child's trouble, any family unit history and an assessment of their overall development. Your Voice communication-Language Pathologist will conduct a comprehensive assessment of the structure and office of tissues involved in swallowing (eg their jaw, lips, natural language, difficult and soft palate etc).

The functional swallowing assessment involves observing your child eating or being fed by a family unit member or caregiver, using foods and/or drinks and feeding practices that are typical at home. Your SLP volition be looking at your child'due south head and neck control, swallowing reflexes and typical developmental skills that are age-advisable – such as sucking in infants, mastication (chewing) in older children, and manipulation and transfer of the food bolus.

They'll likewise look at skills such equally secretion management (the power to swallow saliva) and the coordination of breathing and swallowing.

The assessment will exist sensitive and tailored to your family'due south cultural background, beliefs, and preferences. Your Speech-Language Pathologist may also liaise with other professionals involved in your child'southward healthcare, such every bit surgeons, dietitians, lactation consultants, psychologists and occupational therapists.

Dysphagia treatment for children

Once an assessment has been completed, your Speech communication-Language Pathologist volition work with you to develop a direction plan. It volition exist based on the findings of the swallowing assessment and tailored to your kid'south needs and your family'south preferences.

Information technology may include changes to the textures of foods or drinks, and exercises to help improve your child'southward eat. For children with severe swallowing difficulties, your Spoken language-Language Pathologist may refer for further assessment and back up from other wellness professionals to consider other direction methods such as the utilize of a feeding tube that delivers food and drink direct to the stomach. This may exist considering your child is at high chance of aspiration and developing lung complications.

Your Speech-Language Pathologist will go on to piece of work with any related health professionals involved in your child'southward care. Your child will be reviewed regularly.

Concerned your child may have a swallowing problem?

At Growing Early on Minds, our team of qualified Speech communication-Language Pathologists can bear swallowing assessments and care for paediatric dysphagia. They are experienced in working with children who have complex needs, developmental delay or disability (including Autism) and who take experienced trauma.

We can assess your child at our dispensary in Blacktown (Western Sydney) or see your child at home, their childcare heart, school or playgroup. Nosotros can too provide telehealth services to families in remote, regional or interstate locations.

All our Growing Early Minds Speech-Linguistic communication Pathologists are certified practising members of Voice communication Pathology Australia – the national elevation body for the spoken communication pathology profession in Australia.

You lot don't demand a referral from a GP or paediatrician,although this may aid offset the cost of therapy. Nosotros'll discuss handling pathways, fees and whatsoever other important information you'll need to know. You can download our referral form directly from here and find out more on our website.

To get started, contact us today, call united states on  1800 436 436 or transport us a message.

References

https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934965&department=Overview

https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934965&section=Assessment

https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934965&section=Signs_and_Symptoms

https://www.childrens.health.qld.gov.au/fact-sheet-swallowing-difficulties-children/

https://www.speechpathologyaustralia.org.au/SPAweb/Resources_for_the_Public/Fact_Sheets/SPAweb/Resources_for_the_Public/Fact_Sheets/Fact_Sheets.aspx?hkey=e0ad33fb-f640-45b1-8a06-11ed2b73f293

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Source: https://growingearlyminds.org.au/tips/swallowing-disorders-in-children/

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