Swallowing dysfunction in infants less than 1 year of age

Area of Science:

• Pediatric Radiology
• Gastroenterology
• Pulmonology

Background:

• Gastroesophageal reflux (GER) is a frequent trigger for reactive airways disease in infants.
• Laryngeal penetration and tracheal aspiration are often observed during upper gastrointestinal studies (UGI) for GER in infants.
• Prospective studies are needed to assess swallowing dysfunction in infants presenting with vomiting or respiratory symptoms.

Purpose of the Study:

• To determine the incidence of swallowing dysfunction in infants presenting with vomiting or respiratory symptoms.
• To evaluate the role of UGI in identifying swallowing dysfunction.
• To correlate UGI findings with modified barium swallow studies (MBSS).

Main Methods:

• 1,003 UGI studies were performed in infants under 1 year of age between 1994 and 1997.
• Swallowing fluoroscopy was integral to all UGI examinations.
• 472 full-term infants with respiratory symptoms or suspected GER, but no other abnormalities, were assessed for swallowing dysfunction.

Main Results:

• Swallowing dysfunction was identified in 13.4% (63/472) of full-term infants with respiratory symptoms or vomiting.
• Tracheal aspiration (TA) occurred in 44 infants, and laryngeal penetration (LP) in 19.
• GER was present in 79.5% of infants with TA and 68.4% with LP; MBSS confirmed UGI findings.

Conclusions:

• UGI is effective in identifying swallowing dysfunction in infants with respiratory issues.
• Careful assessment during UGI is vital to detect potentially overlooked episodes of tracheal aspiration.
• MBSS can confirm UGI findings and guide dietary therapy to minimize aspiration risk during feeding.