Pharyngeal Dysphagia: How to Care for Your Child

Pharyngeal dysphagia can often be managed with changes in how and what you feed your child.

When a child has trouble swallowing, health care providers call it dysphagia. Pharyngeal dysphagia is when a problem with the pharynx causes trouble swallowing.
 
The pharynx is a passageway at the back of the throat that leads to the esophagus (a tube that carries food down to the stomach) and to the beginning of the airway to the lungs. When a person swallows, a flap of tissue called the epiglottis normally covers the opening to the airway. This keeps food and drink from getting into the airway and lungs. Normally, the food and drink are then pushed down to the esophagus.

In pharyngeal dysphagia, food or drink can get into the airway during swallowing. Kids may cough, gag, become irritable or congested, or have watery eyes when they eat. When food or fluids get into the lungs, it can lead to pneumonia or breathing problems.

Dysphagia can be mild or more severe. Many kids who have pharyngeal dysphagia are born with it, but with some conditions, it develops later on. Pharyngeal dysphagia can happen from:

• an epiglottis that doesn't close properly

• weak throat muscles

• neurological issues that lead to swallowing problems

Treatment varies depending on the symptoms and what's causing the problem. It may include changing the texture of food to make it easier to swallow. It also may include feeding therapy with a speech or occupational therapist. The length of treatment varies from child to child.

• Make any changes to your child's diet and feeding as instructed by your health care provider or therapist. This may include thickening liquids, changing the texture of your child's food, or changing your child's sitting position during meals.

• Your child should use any special bottles, cups, or eating utensils recommended by the health care provider or therapist.

• Do not give your child drinks with a straw unless otherwise directed by the therapist.

• Make meals a positive time for your family to enjoy together. Keep a low stress level about feeding.

• Schedule any follow-up appointments as directed.

• Tell your child's school or childcare providers about any changes to your child's diet and any special requirements during feeding. You may need to show caregivers how to feed your child.

Your child:

• Coughs or gags during eating or drinking.

• Makes wet or gurgling sounds when feeding.

• Gets a stuffy nose, cold, or cough.

• Has a fever.

• Resists eating.

Your child:

• Has lips or skin that appear blue or gray.

• Has a choking spell.

• Becomes very short of breath.

• Has skin between the ribs and neck that pulls in tight during breathing.

• Appears dehydrated; signs include dizziness, drowsiness, a dry or sticky mouth, sunken eyes, producing less urine or darker than usual urine, crying with little or no tears.