Dysphagia (Feeding and Swallowing Difficulties)

Dysphagia means difficulty in swallowing. Swallowing happens in three phases. A child with Dysphagia can have a problem in either of these stages:

  1. Oral stage 
    Transporting food or liquid to the mouth and into the throat. (e.g. chewing, sucking)
  1. Pharyngeal stage
    Swallowing begins and the food is squeezed down the pharynx (throat). The epiglottis closes off the passage to the windpipe so food doesn’t go into the lungs.
  1. Esophageal stage
    The esophagus (tube that goes from the mouth to the stomach) squeezes food down to the stomach.

Dysphagia can cause inability of food and liquids to pass from a child’s mouth to the throat and through the sophagus to the stomach. 

Causes

Dysphagia is caused by structural problems and weak or damaged muscles/nerves in the mouth, throat, or esophagus. Dysphagia is most commonly associated with:

  • Brain damage and defects
  • Nervous system disorders e.g. Meningitis
  • Neuromuscular disease 
  • Premature birth or low birth weight
  • Prenatal malformations
  • Heart or lung diseases
  • Head or neck problems
  • Gastroesophageal disorders (reflux or other stomach problems)
  • Cleft palate or lip
  • Autism
  • Foreign bodies in the esophagus
  • Large tongue or tonsils
  • Tumors or masses in the throat

Signs and symptoms

Symptoms may present differently in every child. Some common symptoms of dysphagia are as follows:

In infants:

  • Difficulty in sucking and swallowing
  • Gagging during feeding
  • Drooling
  • Food or liquid coming out of the nose during or after feeding
  • Frequent spitting up or vomiting
  • Irritability while feeding

In children:

  • Trying to swallow a mouthful of food several times
  • Eating slowly
  • Feeling like food or drink gets stuck in the throat or feeling like there’s a lump in the throat
  • Coughing or choking while eating or drinking
  • Chest congestion after eating or drinking
  • Feeling like food or liquids are sticking in the throat or esophagus or feeling like there’s a lump in the throat
  • Prone to respiratory infections 
  • Voice changes (Wet or raspy sounding voice) during or after eating during or after eating
  • Frequent respiratory infections
  • Weight loss

Treatment:

The treatment plan usually depends on a child’s age and severity of the symptoms. Specialists such as Speech-language therapists, occupational therapists, gastroenterologists, pulmonologist and pediatricians most commonly treat children with dysphagia.

An SLP or feeding team may suggest:

  • Medical treatment
  • Feeding therapy
  • Changing feeding/eating position
  • Changing texture, temperature or type of food intake
  • Changing feeding equipment or utensils 
  • To get your child to try new foods 
  • Seeing another professional, like a psychologist 

What role can you play:

  • Ask questions from an SLP/OT in order to understand the problems your child has.
  • Accompany your child during treatment.
  • Follow the suggestions your therapist makes .
  • Discuss your child’s situation at their school and with family members.
  • Discuss your child’s progress with the therapist.

If you child suffers from Feeding and swallowing difficulties and you want to learn more about how you can support them please do get in touch with our skilled occupational therapists and speech-language pathologists.

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