Dysphagia in Children

Dysphagia means difficulty swallowing – when food or liquids don’t move easily from the mouth to the throat, down the esophagus, and into the stomach.

Dysphagia can be long-term (chronic) or start suddenly. If swallowing trouble begins suddenly in an otherwise healthy child, something may be stuck in the esophagus. This is a medical emergency and you should get medical help for your child right away. If trouble swallowing occurs with a fever, see a doctor promptly, as the dysphagia may be due to an infection.

At Cooper University Health Care, our head and neck surgery specialists work closely with speech-language pathologists to provide comprehensive, age-appropriate evaluation and treatment.

Risk Factors

Conditions that make swallowing problems more likely include:

• Premature birth
• Cleft lip or cleft palate
• Compression of the esophagus by nearby structures
• Dental problems (e.g., overbite)
• Developmental delays
• Diseases affecting the nerves and muscles that control swallowing
• Eosinophilic esophagitis (allergic condition of the esophagus)
• Gastroesophageal reflux disease (GERD)
• Esophageal narrowing (strictures)
• Foreign object in the esophagus (e.g., coin)
• Tracheostomy
• Large tongue
• Large tonsils
• Oral sensitivity or vocal cord irritation (e.g., after prolonged ventilator use)
• Craniofacial anomalies
• Abnormal development of the digestive tract
• Vocal cord paralysis
• Tumors or masses in the throat

Symptoms

Dysphagia symptoms vary by child and may include:

• Arching or stiffening during feeds
• Chest congestion after eating or drinking
• Coughing or choking when eating or right after
• Drooling
• Slow eating
• Feeling of food/liquid sticking or a “lump” in the throat
• Gagging during feeding
• Frequent respiratory infections
• Food or liquids coming out of the nose during/after feeding
• Needing multiple swallows for one mouthful
• Trouble sucking and swallowing
• Frequent spit-up or vomiting
• Irritability or not being alert during feeds
• Wet or raspy voice during or after eating
• Weight loss from not being able to eat enough
   

Diagnosis

Your child’s doctor will review health history, perform a physical exam, and ask about feeding patterns and any problems you observe. If an infection is suspected, a blood test may be ordered. Additional tests may include:

• Barium swallow (upper GI series): Your child drinks a small amount of barium; X-rays show what happens during swallowing.
• Endoscopy: A flexible tube with a light and camera examines the digestive tract; tissue samples may be taken. Your child is sedated.
• Esophageal manometry: A small tube with a pressure gauge measures how well food moves through the esophagus. Your child is sedated.
• Laryngoscopy: A tube is used to view the throat for narrowing or other problems. Your child is sedated.
   

Treatment options

Treatment depends on your child’s symptoms, age, overall health, severity of dysphagia, and the cause. Options may include:

• Dietary changes: Thickened fluids and soft foods may be easier to swallow. Some infants who struggle with formula or breast milk do better once they are old enough for baby foods.
• Speech-language pathology therapy: Exercises and feeding techniques to improve swallowing
• Medications: To treat conditions such as infection, GERD, or eosinophilic esophagitis
• Surgery: To remove a foreign object; to dilate (widen) a narrowed esophagus; or to correct structural problems causing dysphagia.

Why Choose Cooper to Treat Dysphagia in Children

Effective care often requires a team approach from specialists in feeding and swallowing. As South Jersey’s only tertiary-care, academic health system, Cooper brings together:

• Otolaryngologists (ENTs)
• Gastroenterologists
• Speech-language pathologists
• Allergists
• Nutritionists
• Occupational therapists
• Psychologists

This coordinated team ensures your child receives high-quality, comprehensive care in one place.