Infant and Toddler Aspiration and Why it Matters

Did you know that somewhere around 30% of babies and children aspirate when feeding? Aspiration means that instead of liquid or food going into the esophagus and down to the stomach, some goes into the windpipe and to the lungs. This can cause a whole host of issues including chronic respiratory infections sometimes misdiagnosed as asthma, feeding problems (picky eater, extended meatimes), fussiness at mealtimes, long term decreased lung function, and other respiratory issues.

Almost half of babies who aspirate have “silent aspiration”, which means that there are no hallmark signs that aspiration is occurring. It’s happening silently and no one knows. These babies and children may have poor weight gain, respiratory infections, be diagnosed with “colic”, be labeled as “a picky eater”, or have other generalized diagnoses since the pediatrician or clinician hasn’t evaluated them for aspiration.

If you have a baby or toddler who has been labeled with any of the above, frequently coughs at mealtimes, doesn’t like to drink thin liquids, prefers puréed foods (these are easier to swallow for kids who aspirate than thin liquids), or who has been diagnosed with asthma, bronchiolitis, “overactive airways”, or other vague respiratory disgnoses at a young age, please ask your pediatrician for a feeding team and swallowing evaluation. This issue is commonly not even thought of by many pediatricians, and the missed diagnosis means that the problem is not being addressed and could get worse.

There are numerous causes for aspiration, and most children will grow out of it by the age of two unless there is an anatomical issue which is contributing to the trouble swallowing (most difficulty is in swallowing thinner liquids). Don’t let this often misdiagnosed issue go unaddressed if you have a child who is experiencing any on the above mentioned symptoms. There is no problem with bringing up a potential cause of an issue with your pediatrician and asking for a feeding/swallowing evaluation to rule out aspiration as a cause for your child’s symptoms. If it turns out not to be an issue at least you can know and move forward knowing that all potential causes have been investigated.

If you have any questions on this issue please feel free to email me!

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