Author: Newman, LA, Keckley, MA, Peterson, MC, & Hamner, A.
Source: Pediatrics 2001 Dec, Vol 108, no. 6.
Objective : The main purpose of this study was to look at how an with a feeding problem swallows. Babies with suspected swallowing problems were referred for an x-ray test to look at their swallowing function.
Methods: 43 infants were looked at during modified barium swallowing studies (also called MBSS). This is a type of x-ray moving picture that?s taken while the child eats food and liquid mixed with barium, a chalky white substance that shows up on the x-ray. Swallowing was looked at to see how many infants had laryngeal penetration (liquid going part way down the wrong tube or into the airway but not past the vocal cords), aspiration (liquid going down the wrong tube past the vocal cords), or nasopharyngeal backflow (liquid going into the nose) and why this happened. Reaction to aspiration (cough or no reaction called silent aspiration was studied). The infant?s medical diagnoses were looked at to see if diagnoses that are alike might cause the same kinds of swallowing problems.
Results: More than half of the babies had some penetration or aspiration (liquid go down the wrong tube) and nasopharyngeal backflow (liquid going into their nose while eating). However, this didn?t happen until after the infant had already taken several swallows. Most babies did not cough or show a response even when liquid went down the wrong way, callled silent aspiration. However, all the babies were able to clear their airway after laryngeal penetration (liquid going part-way down the wrong tube). Babies born prematurely had more liquid go into their noses than full term babies.
Conclusion: This study showed that most babies who were thought to have a swallowing problem showed some type of difficulty during their x-ray test (MBSS). The problems tended to happen after the child started eating and not in the first few swallows. Therfore, when a child has this kind of test, it should last long enough to see several swallows. Also, because many of the babies had silent aspiration (no reaction to the food going the wrong way), it would be difficult to tell if the baby was having a problem just by watching them feed without an x-ray examination. The dangers of silent aspiration include respiratory problems such as pneumonia, bronchitis, or congestion or the risk of choking or obstructing the airway with food. Therefore, it is important to have a test like this done to make sure the baby is able to swallow food safely.
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