What is the treatment for dysphagia?
Specific treatment for dysphagia will be determined by your child's health care provider based on the following:
Your child's age, overall health, and medical history
The extent of the disease
The type of disease
Your child's tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
Speech or occupational therapy can be helpful for some children. These therapists can give your child exercises to help make swallowing more effective, or suggest techniques for feeding that may help improve swallowing problems.
Infants and children with dysphagia are often able to swallow thick fluids and soft foods, such as baby foods or pureed foods, better than thin liquids. Some infants who had trouble swallowing formula will do better when they are old enough to eat baby foods. The following suggestions should also be considered when caring for a child with dysphagia:
Adding a small amount of rice cereal to infant formula or pumped breast milk may help dysphagia. Blending the formula or cereal mixture before adding it to a baby bottle can remove the lumps and make the mixture easier to suck through a nipple, as well as easier to swallow.
Do not cut holes in nipples, since this can increase the risk for choking and aspiration, as well as interfere with the baby's oral development. Future feeding and speech skills may be affected.
Baby foods should not be offered to infants from a spoon until they are at least 4 months old, since they do not have the proper coordination to swallow foods from a spoon until this age.
Your child's speech or occupational therapist may be able to recommend other commercial products that help thicken liquids and make them easier to swallow.
Babies who have "oral aversion," which can occur after oral surgery or being on a ventilator for a prolonged period of time, may benefit from exercises and activities to desensitize them to having objects in their mouths. Exercises or activities may include:
Provide safe toys and other objects for babies to chew on and mouth. Try things that have varying textures and temperatures.
Vary the taste, texture, and temperature of soft foods for children older than 4 months.
Allow your child to play with foods and get messy at mealtime.
When symptoms of GERD are also present with dysphagia, treating this condition may produce improvements in your child's ability to swallow. As the esophagus and throat are less irritated by acid reflux, their function may improve. Treatment of GERD may include:
Remaining upright for at least an hour after eating
Medications to decrease stomach acid production
Medications to help food move through the digestive tract faster
An operation to help keep food and acid in the stomach (fundoplication)
Children who have scarring or narrowing of the esophagus (esophageal stricture) may be able to be dilated, or widened, under anesthesia. This procedure may have to be repeated periodically.
What is the long-term outlook for a child with dysphagia?
Some children with dysphagia will have long-term problems. Children who have other health problems, especially those that affect the nerves and muscles, such as muscular dystrophy and brain injury, may not be able to experience much improvement with their swallowing difficulties. Other children may learn to eat and drink successfully. Many pediatric medical centers will have specialized feeding and/or swallowing teams.
Consult your child's health care provider regarding the prognosis for your child.