Dysphagia means difficulty swallowing. This condition happens when food or liquids can’t pass easily from your child’s mouth into the throat, down the esophagus, and into the stomach when swallowing.
Dysphagia can be chronic (long-term) or it may come on suddenly. If your child’s swallowing issues start suddenly and your child is normally healthy, this could mean something is stuck in the esophagus. This is a medical emergency and you should get medical help right away.
If your child has trouble swallowing and a fever, the dysphagia may be due to an infection. This also warrants a visit to the doctor right away.
Chronic swallowing problems are often related to another health problem, discussed in the next section.
Regardless of the reason for your child’s dysphagia, it’s important to know that expert diagnosis and treatment is available from the Division of Otolaryngology – Head and Neck Surgery at Cooper University Health Care. Our ear, nose, and throat (ENT) specialists and speech-language pathologists work together to provide comprehensive, age-appropriate care for children with swallowing problems.
Risk Factors for Dysphagia in Children
These health problems make it more likely for a child to have problems swallowing:
- Being born prematurely
- Cleft lip or cleft palate
- Compression of the esophagus by other body parts
- Dental problems, such as an overbite
- Developmental delays
- Diseases that affect how the nerves and muscles that control swallowing work
- Eosinophilic esophagitis, an allergic condition that affects the esophagus
- Gastroesophageal reflux disease (GERD, or acid reflux)
- Narrowing of the esophagus (esophageal strictures)
- Having a foreign object stuck in the esophagus, such as a coin
- Having a tracheostomy (an artificial opening in the throat for breathing)
- Large tongue
- Large tonsils
- Oral sensitivity or vocal cord irritation, which can happen if the child has been on a breathing machine (ventilator) for a long time
- Problems with how the bones of the skull and the structures in the mouth and throat form (craniofacial anomalies)
- Problems with how the digestive tract forms
- Vocal cord paralysis
- Tumors or masses in the throat
Symptoms of Dysphagia in Children
Symptoms of dysphagia can occur differently in each child, and can include:
- Arching or stiffening of the body during feedings
- Chest congestion after eating or drinking
- Coughing or choking when eating or drinking, or right after
- Eating slowly
- The sensation that food or liquids are sticking in the throat or esophagus, or that there’s a lump in the throat
- Gagging during feeding
- Frequent respiratory infections
- Having food or liquids come out of the nose during or after a feeding
- Trying to swallow one mouthful of food several times
- Trouble sucking and swallowing
- Spitting up or vomiting often
- Irritability or not being alert during feedings
- Wet or raspy sounding voice during or after eating
- Weight loss due to not being able to eat enough
How Dysphagia in Children Is Diagnosed
- Your child’s doctor will ask about your child’s health history, and give your child a physical exam. You’ll also be asked about how your child eats and if you notice any problems during feedings.
- Your child may need a blood test if your doctor thinks there’s an infection. Diagnostic imaging or other tests may also be recommended, including:
- Barium swallow (also called an upper GI series): Your child is given small amounts of barium to drink; this is a chalky liquid that coats the inside of organs, helping them show up on x-rays better. A series of X-rays is taken to see what happens as your child swallows the liquid.
- Endoscopy: A small, flexible tube (endoscope) with a light and camera at the tip is used to look inside your child’s digestive tract. During the test, the doctor may remove tissue samples from the throat, esophagus, and stomach to test for certain diseases. Your child is sedated for this test.
- Esophageal manometry: A small tube with a pressure gauge is guided through your child’s mouth and into the esophagus to check the pressure in your child’s esophagus. This can tell how well food moves through your child’s esophagus. Your child will be sedated for this test.
- Laryngoscopy: A tube is placed into your child’s throat to see if it is narrowed or other problems are present. Your child will be sedated for this test.
How Dysphagia in Children Is Treated
Treatment will depend on your child’s symptoms, age, general health, how severe the dysphagia is, and what’s causing it. Treatment options may include:
- Dietary changes: Your child may be able to swallow thick fluids and soft foods better than thin liquids. Some babies who have trouble swallowing formula or breast milk do better when they’re old enough to eat baby foods.
- Therapy from a speech-language pathologist: Your child will learn exercises and feeding techniques for better swallowing
- Medications: Certain drugs may be prescribed to treat conditions such as infection, GERD, or eosinophilic esophagitis
- Surgery: Surgery may be required to remove an object stuck in your child’s esophagus. Children with scarring or narrowing of the esophagus may need a procedure to widen (dilate) the esophagus. Surgery may also be necessary to correct a structural deformity that is causing swallowing problems.
Why Choose Us to Treat Dysphagia in Children
Effectively treating dysphagia in children often requires a team of healthcare providers who specialize in feeding and swallowing issues. As South Jersey’s only tertiary-care, academic medical center, Cooper University Health Care is home to an array of highly trained experts, including:
- Otolaryngologists (ear, nose, and throat specialists, or ENTs)
- Speech-language pathologists
- Occupational therapists
This ensures that your child receives the high-quality, comprehensive care he or she needs, all in one place.
To learn more about the services available in the Division of Otolaryngology—Head and Neck Surgery or to schedule an appointment, please call 856-342-3113.