Dysphagia (Feeding and Swallowing Problems)

What is dysphagia?

The word dysphagia simply means "difficulty swallowing." While swallowing seems simple, swallowing is a complicated act involving communication between the brain and many nerves and muscles. It involves both voluntary acts (i.e. swallowing uses muscles we control) and involuntary acts (i.e. some muscles act on their own without our instruction, just as they do when we breathe.) Dysphagia causes your child to be unable to easily pass food and liquids into the throat, down the esophagus, and into the stomach. This can lead to inadequate nutrition and failure to gain weight and grow properly.

What causes dysphagia?

There are many conditions that can involve dysphagia, including cleft lip and palate (PDF), gastroesophageal reflux disease, muscular dystrophy, brain and nerve injuries, tumors or masses in the throat. Dysphagia can occur in children who were born with large tongues, craniofacial abnormalities, dental problems, and large tonsils. It also can be a problem for children who have been on ventilators for prolonged periods of time, have tracheostomies (PDF), were born prematurely, and/or have developmental delays.

What are the symptoms of dysphagia?

Children's symptoms vary, but many babies with dysphagia:

  • Eat very slowly
  • Try to swallow the same mouthful of food more than once
  • Gag while eating
  • Drool excessively
  • Have difficulty coordinating sucking and swallowing
  • Become blue or pale while feeding
  • Spit up frequently
  • Frequently have food or liquids come out of the nose during or after a feeding
  • Lose weight

Older children may have some of the symptoms above. Because they can communicate their problems, they also may tell you about other symptoms, such as:

  • Feeling pain or discomfort in their throat or chest
  • Feeling as if something is stuck in their throat or chest
  • Getting tired or short of breath while eating or drinking

How is it treated?

Often, the first step in treating dysphagia is tests to help determine the extent of the problem. These tests can include:

  • Video fluoroscopic swallow (PDF)
  • Endoscopy (PDF)
  • Laryngoscopy. During laryngoscopy, your child is under anesthesia. A tube is inserted in your child's throat is used to examine narrowed areas and other problems.

When your medical team has a clear picture of the extent of the problem, they can use this information to help make recommendations on what kinds of treatments may work best. Speech or occupational therapy may be recommended. Medications may be an option. In some cases, where structural problems inhibit breathing, eating, or swallowing, surgery may be the best option.

About surgery for dysphagia at Children's

The ENT surgery team at Children's provides next-generation care to neonatal infants, newborns, children, and adolescents from throughout the Upper Midwest. This multidisciplinary team provides some of the most cutting-edge, delicate treatments available, including newborn surgery and minimally invasive surgery. Otolaryngology surgery is performed at Children's - Minneapolis, Children's - St. Paul, and Children's West.

If you are a family member looking for a Children's ENT specialist, visit Find a Doctor.

If you are a health professional looking for a consultation or referral information, please call Children's Physician Referral at 1-866-755-2121 (toll-free).

Return to Children's ENT surgery home page.