How to deal with swallowing issues in children: Thought for food from a doctor | City Big News

By Dr S Thirunavukkarasu

“My child doesn’t eat well doctor...” is the most frequently encountered complaint in any paediatric clinic. A sizeable population of children are brought to hospitals with various feeding issues.

On one hand and perhaps most common are the children, whose parents predetermine what foods their child must be eating also the quantity and frequency of feeding. Research has firmly established that in comparison to adults, children have far more sensitive intuition about when and how much they should eat. However, the power we wield as parents allows us to control and dictate a child’s relationship with food, making it a miserable experience in many households. In these cases, it is the parents who require guidance and counselling to trust their child’s judgement. This will enable a happy relationship with food for the entire family.

On the other end of the spectrum are the families of children who suffer serious feeding issues due to various medical causes. Families of children with swallowing and feeding problems were left unattended in the past as there were not many options available.

Swallow assessment and treatment is a new evolving field, world over. With the advent of newer technologies and the concept of a multidisciplinary approach to manage children with swallowing problems, these patients are able to eat, much to the relief of their parents. For these mostly unattended swallowing disorders, we at Rainbow Children’s Hospitals treat children holistically with a multidisciplinary team approach.

 We have a specialized clinic for children with feeding and swallowing issues. Here, we perform instrumental evaluation such as FEES and VFSS with advanced equipment and trained staff. The goal of this clinic is to diagnose the problem, treat it and provide solutions for patients with long term follow up.

Our clinic caters to children  with a range of problems including:

Picky eaters

Growth and weight gain concerns

Poor eating habits

Choking/gagging/vomiting/coughing while eating

Inability to chew or to swallow

Frequent lung infections (aspiration pneumonia) due to food or liquids entering the lung

Children with drooling/ global developmental delay/ neurological problems

Children with airway problems

Post-surgical patients

Post radiation therapy and chemotherapy

The difficulty in swallowing may be due to problems at the oral (mouth), oropharyngeal (throat) or esophageal (food pipe) levels. The exact level of the problem needs to be identified and treated. Issues at the level of the oral cavity are assessed by the swallow pathologist by evaluating oromotor movements and suck-swallow actions.

Oropharyngeal problems can be assessed by studies such as Functional Endoscopic Evaluation of Swallowing (FEES) or Video Fluoroscopic Swallow Study (VFSS). Oesophageal problems are evaluated using Upper-GI-scopy and Barium Swallow studies. The majority of cases with swallowing disorders are due to Oropharyngeal causes which can be diagnosed by instrumental evaluation.

Treatment is unique to each patient tailored to suit their specific problems and needs. Some children require medical management. A few may even require surgical treatment. Some children may improve with changes in feeding positions and different consistencies of food. Positive feedback from follow up endoscopies will help. Exercises and manoeuvres are sometimes given as a part of therapy where needed. Some children with psychological disorders affecting their feeding may benefit from behavioural therapy.

Dr S Thirunavukkarasu
MBBS, Diploma in Otorhinolaryngology (DLO), DNB – Otorhinolaryngology
Consultant Paediatric ENT and Airway surgeon
Rainbow Children’s Hospital, Chennai.
24x7 Paediatric Emergency Contact no: 044 4860 0000
www.rainbowhospitals.in

This article was created by TNM Brand Studio in association with Rainbow Children Hospital.