Feeding and swallowing

Dysphagia describes eating, drinking and swallowing difficulties in babies, children, and young people.

It often occurs with other health conditions such as being born prematurely, having cardiac, respiratory, ENT, neurological, gastro-enterology problems or renal difficulties

It can significantly impact on the child and their family’s quality of life and If not treated appropriately it can lead to other health complications and in worst cases can lead to serious respiratory illness, lung damage and death.

Improved nutrition and hydration have an impact on physical and mental wellbeing.

Some of the signs and symptoms of dysphagia you may see:

• change in alertness around feed time, becoming sleepy, anxious, distressed,
• coughing or choking before, during or after food or drink
• changes in colour e.g. going red or pale, blue tinges on the upper lip
• changes in breathing –faster or slower than usual
• sounds of breathing difficulty e.g. wheezing, gurgling or “wet” breathing
• eye watering or widening, passive tears or crying, excessive blinking or grimacing
• recurrent chest infections and/or pneumonia
• difficulty with eating or swallowing age-appropriate food/liquid consistencies

Additional signs:

• becoming tired during a meal/lengthy mealtimes
• difficulty in maintaining/achieving a safe position for eating and drinking
• deteriorating physical health
• deteriorating condition of teeth and mouth
• weight loss.

Useful websites

• Advice on weaning
• International Dysphagia Diet Standardisation Initiative
• IDDSI testing video (on YouTube)

Referral

Your GP or health visitor can refer your child to the service if you have concerns you can also contact the service. A referral will be accepted from any medical professional. Your child’s problems will need to meet the feeding service criteria described on the referral page  to ensure you access the right service at the right time.

To refer your child to receive support for Feeding and swallowing please use the Children’s Therapies Service referral form.

Assessment

If your child meets the criteria for an assessment they will be individually assessed by a qualified dysphagia trained Speech and Language Therapist. Please bring some food and drink that your child enjoys and some s/he finds harder.  This will enable us to observe any problem and advise you accordingly. If your child’s problems are intermittent please bring along a video of their feeding behaviours at home.

Management

Having assessed your child’s difficulties and needs your therapist will agree with you on strategies or techniques to improve your child’s swallow safety or oral skills development. This may involve changing the consistency of foods or liquids, advice on positioning, advice on pacing, advice on utensils, practising skills safely and/or signposted to a workshop or training. If your child has an unsafe swallow it may be necessary to consider other ways of feeding such as tube feeding into the nose or tummy. We will always work as part of a multi-disciplinary team to ensure the best outcome for your child.

Workshops

If you have been advised to access our online training resource for restricted eaters or would like to know more about restricted eating please watch the following workshop.

Creating Positive mealtimes for a restricted eater