Which conditions are associated with dysphagia in pediatric patients?

Updated: Mar 20, 2020
  • Author: Nam-Jong Paik, MD, PhD; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Certain factors make dysphagia in children unique. Successful oral feeding and growth in infants and children depend not only on functional deglutition but also on a broad range of neurodevelopmental skills involving sensory systems, cognition, communication, and gross and fine motor behaviors. [4, 5]

Prematurity by itself and neurologic impairment (eg, cerebral palsy) are common causes of dysphagia in young patients. Children with cerebral palsy typically manage solid boluses more easily than they do liquid boluses and manage small liquid boluses more easily than large liquid boluses.

Congenital structural lesions (eg, choanal atresia, cleft lip and palate, craniofacial syndromes) can interfere with normal anatomic transport of a bolus. [6] Prosthetic devices or adaptive feeding equipment may be necessary.

Gastroesophageal reflux disease (GERD) is a common problem in children. Choking, food refusal, and food "getting stuck" are nonspecific symptoms that may arise because of reflux and esophagitis.

Childhood achalasia appears to be more common in boys than in girls. Regurgitation of food and dysphagia are the most common symptoms. In about 18% of patients, symptoms begin during infancy.

Management of pediatric dysphagia requires a special approach. Cognitive, developmental, and behavioral issues can affect the treatment options. Treatment does not necessarily imply feeding therapy. Tone abnormalities, postural control, adverse behavior, and primitive reflexes should be managed. Hypoxemia can occur while a child with dysphagia eats, so pulse oximetry during mealtime can be useful. [7]

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