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Infants and children must be able to consume enough energy and nutrients on a consistent and safe basis in order to reach their linear and neurological growth potential. Swallowing problems (dysphagia) are any disruptions in the swallow sequence that jeopardize the safety, efficiency, or adequacy of nutritional intake.

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According to the ASHA, a child suffering from dysphagia has trouble swallowing food or liquids, including saliva. Chronic reflux of stomach acids into the esophagus can irritate your child's throat and can lead to dysphagia. Scar tissue can develop in your esophagus. The scar tissue can narrow your esophagus.The child can feel pain when swallowing. A child with a swallowing problem can have difficulty getting enough nutrients into their body, limiting their ability to develop and gain weight. 

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Children's swallowing and feeding difficulties are fairly common. Swallowing problems are thought to affect about 1% of the general population's children. Failure to thrive, aspiration pneumonias, gastroesophageal reflux (GERD), and/or the inability to develop and sustain adequate nutrition and hydration may occur if these problems in infants and children are not addressed. For assessing these disorders and initiating effective care as soon as possible, a multidisciplinary approach is needed.

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Difficulty swallowing in infants is described by the infant's inability to articulate the difficulties he experiences while swallowing, as well as his inability to make necessary adjustments to the swallowing process. Furthermore, if there is a problem, the baby has trouble synchronizing breathing and swallowing. As a consequence, a problem in the swallowing process can manifest as a breathing condition as a result of inhaling food into the respiratory tracts, which may result in obstruction.

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Swallowing difficulties can have a negative impact on dietary intake and, as a result, growth and development. Because feeding children is such an important part of family interaction, as well as success or failure as parents and what happens to the children. As a result, the sooner we can recognize babies and children who have eating or swallowing problems, the greater our chances of assisting them in improving their work.

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Normal Swallowing

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• Coordination of the muscles of the lips, tongue, mouth, throat, upper esophagus, and neck is required for proper swallowing and drinking. Swallowing is divided into four stages. The first two phases are voluntary, while phases three and four occur involuntarily in the body of a child. Dysphagia occurs when one or more of the following phases do not occur properly in a child:

 

• Oral preparation phase

When food and liquid are prepared for swallowing in the mouth (chewing).

 

• Oral phase

Oral phase is when the tongue starts the transportation of the food towards the pharynx

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• Pharyngeal phase

Pharyngeal phase is when food and liquid are passed through the throat and into the esophagus .

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• Esophageal phase

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

In neonates and young babies, all four elements of swallowing are reflexive and involuntary. The oral phase becomes voluntary later in infancy, but it is mandatory for children to begin masticating solid food. When proper sensory registration of the food source is combined with a synchronized motor response guided by cognitive thought processes, mastication is safe and efficient.

Swallowing difficulties in children can quickly lead to energy loss, and the condition can be life-threatening. Continuing to eat a meal for more than a half-hour puts so much pressure on the newborn and child, resulting in the development of a life-threatening threat that needs to be clarified and treated.

 

Signs and symptoms of Dysphagia 

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The principal signs are the child’s inability to swallow properly while eating or drinking, while symptoms of difficulties in children may take different forms. The following are also possible symptoms:

 

• Choking and Coughing

• Difficulty breathing ,excessive crying

• Do not tolerate foods of different textures 

• lack of weight gain 

• Drooling 

• Feeling like there is food stuck in throat 

• Voice sounds different

• Difficulty or spasm in the body during breastfeeding

 

Causes and risk factors of Pediatric Dysphagia 

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Populations at particular risk of dysphagia include children born preterm or with c gastrointestinal disease as well as children with cerebral palsy, traumatic brain injury, other neuromuscular disorders, craniofacial malformations, airway malformations, and congenital cardiac disease.

Difficulty swallowing can sometimes indicate the presence of diseases that may be dangerous and difficult, and early diagnosis is necessary. A variety of illnesses, diseases or congenital defects can cause dysphagia in a child.

 

A few of the most common include:

• gastroesophageal reflux disease

• Cleft lip or cleft palate 

• Vocal cord paralysis 

 

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Diagnosis of Pediatric Dysphagia

 

Early identification and treatment of feeding and swallowing problems will help your child's health and quality of life while also preventing or reducing complications. Interventions for swallowing problems must target the source of the problem in order to be successful. Consequently, any intervention must be directed by a comprehensive evaluation.

Common assessment techniques include formal clinical evaluation tools and quality of life measures, as well as a range of instrumental evaluation tools, such as VFSS, FEES, cervical auscultation, accelerometry, ultrasound, manometry, and impedance testing.