dysphagia awareness ribbon

When I arrive to work with a new baby, I’m almost always the recipient of a puzzled expression when I introduce myself as “Tanya from Speech Therapy.” What in the world is someone from speech therapy going to do with this little one who obviously won’t be speaking for months?? Many people, especially in the pediatrics realm, don’t know that speech-language pathologists (SLPs) are the professionals with advanced skills and training to evaluate and treat dysphagia (dis-FAY-juh) or in everyday terms “swallowing problems.” Even when folks are aware of dysphagia and the SLP’s role, they’re usually thinking of Uncle Joe who had a stroke and was told to drink thickened liquids. And while strokes are a major cause of dysphagia, babies and kids experience dysphagia too! In fact, “It is reported that the prevalence of pediatric dysphagia is increasing due to improved survival rates of children born prematurely, with low birth weight and with complex medical conditions.” (Arvedson, 2008). There are often many factors affecting a baby or child’s ability to swallow safely and efficiently and treatment needs to be individualized to the person’s specific problems. We often think of coughing as a primary sign of dysphagia, but this is actually not a common sign in babies. Instead we are more likely to observe things like

  • Frequently falling asleep at the breast or with a bottle
  • Behavioral stress cues like widened eyes, raised or furrowed eyebrows, extended arms with splayed fingers
  • Milk spilling out of the mouth
  • Gulping or hard swallows
  • Gurgling or rattling sounds in the nose or throat during feeding

In older infants and kids we might also observe excessive drooling, gagging or choking, a preference for easy to eat foods, and we may be able to look at the medical history and see more sick visits for respiratory infections than would be expected.

The good news is that dysphagia can be treated and that treatment can result in improved health and quality of life! If you have concerns about your little one’s swallowing, talk to your pediatrician about a referral to a speech-language pathologist and once you’ve been referred, make sure to ask if the therapist you will be seeing has experience in this specialty area. Training in pediatric dysphagia was not common in many speech-language pathology graduate programs until recently, but many SLP’s like myself have pursued advanced training and keep up with the latest evidence to provide the best possible care.

Has your family been affected by dysphagia? I’d love for you to share about your experience in the comments!

Reference: Arvedson, Joan C. “Assessment of pediatric dysphagia and feeding disorders: clinical and instrumental approaches.” Developmental disabilities research reviews 14.2 (2008): 118-127.