Pediatric dysphagia (swallowing disorder)

What is pediatric dysphagia (swallowing disorder)?

A child with dysphagia may have trouble swallowing food or liquids, including saliva. The child may also experience pain while swallowing. It is difficult for a child with a swallowing disorder to get the correct amount of nutrients into their body, which can affect the child’s ability to grow and gain weight. 

It takes about 50 pairs of muscles and six cranial nerves working together for human beings to swallow. If anything goes wrong anywhere in the process, it may cause a disorder known as dysphagia.

Swallowing and feeding disorders are common in children. It's estimated between 25% and 45% of normally developing children have some form of the condition. 

What are the phases of pediatric dysphagia (swallowing disorder)?

Swallowing has four phases. The first two phases are voluntary, while phases three and four occur involuntarily in a child’s body. A child has dysphagia when one or more of these phases fail to occur properly:

• Oral preparation phase is when food and liquid are prepared in the mouth for swallowing (chewing).

• Oral phase is when the tongue starts the swallowing response by pushing the food and liquid to the back of the mouth.

• Pharyngeal phase is when food and liquid are passed through the pharynx (throat) and into the esophagus (swallowing tube).

• Esophageal phase is when food and liquid goes from the esophagus into the stomach.

What are the signs and symptoms of pediatric dysphagia (swallowing disorder)?

While symptoms of dysphagia vary by child, in general, the main symptom is a child’s inability to swallow correctly while eating or drinking.

Symptoms in infants (birth to 1 year) and toddlers (1-3 years old)

• Arching back 

• Coughing

• Choking 

• Difficulty breathing while eating 

• Excessive crying 

• Vomiting (more than spit-up) 

• Weight loss/lack of weight gain 

Symptoms in children older than 3 years

• Coughing 

• Choking 

• Difficulty breathing while eating 

• Drooling 

• Eating slowly 

• Feeling like there is food stuck in throat 

• Weight loss/lack of weight gain 

• Voice sounds different

What are the causes of pediatric dysphagia (swallowing disorder)?

There are a variety of illnesses, diseases and congenital (present from birth) defects that can cause dysphagia in a child.

A few of the most common include:

• GERD (gastroesophageal reflux disease) 

• Cleft lip or cleft palate 

• Vocal cord paralysis

How is pediatric dysphagia (swallowing disorder) treated?

Treatments can range from behavioral therapy and medications to surgery. Your speech-language pathologist (SLP) will work with you and other specialists to determine the treatment plan that is right for your child.