Dysphagia in Children
What is dysphagia in children?
Dysphagia means trouble swallowing. This condition happens when food or liquids can’t
pass easily from your child’s mouth into the throat, down the esophagus, and into
the stomach when swallowing.
What causes dysphagia in a child?
Swallowing happens in 4 stages. Swallowing problems happen when something goes wrong
in 1 or more of these stages. Dysphagia can be long-term (chronic). Or it may come
If your child’s swallowing issues start suddenly and your child is normally healthy,
your child may have something stuck in the esophagus. If your child has trouble swallowing
and a fever, it may be because of an infection. Chronic swallowing problems are often
caused by another health problem.
Which children are at risk for dysphagia?
The following health problems make it more likely for a child to have problems swallowing:
Being born prematurely
Cleft lip or cleft palate
Compression of the esophagus by other body parts
Dental problems, such as an overbite
Diseases that affect how the nerves and muscles work
Eosinophilic esophagitis, an allergic condition that affects the esophagus
Gastroesophageal reflux disease (GERD)
Having a foreign object stuck in the esophagus, such as a coin
Having a tracheostomy, which is an artificial opening in the throat for breathing
Oral sensitivity or vocal cord irritation, which can happen if the child has been
on a breathing machine (ventilator) for a long time
Problems with how the bones of the skull and the structures in the mouth and throat
form (craniofacial anomalies)
Problems with how the digestive tract forms
Paralysis of the vocal cords
Tumors or masses in the throat
What are the symptoms of dysphagia in a child?
Symptoms can occur a bit differently in each child. They can include:
Arching or stiffening of the body during feedings
Chest congestion after eating or drinking
Coughing or choking during or after eating or drinking
Feeling like food or liquids are sticking in the throat or esophagus or feeling like
there’s a lump in the throat
Gagging during feeding
Getting respiratory infections often
Having food or liquids come out of the nose during or after a feeding
Trying to swallow 1 mouthful of food several times
Trouble sucking and swallowing
Spitting up or vomiting often
Irritability or not being alert during feedings
Wet or raspy sounding voice during or after eating
The symptoms of this condition may look like symptoms of other health problems. Make
sure your child sees a healthcare provider for a diagnosis.
How is dysphagia diagnosed in a child?
Your child’s healthcare provider will ask about your child’s health history and do
a physical exam. The healthcare provider will also ask about how your child eats and
if you notice any problems during feedings.
Your child may need a blood test if the provider thinks there’s an infection. Your
child may also need an imaging test or other tests. These tests may include the following:
Barium swallow and upper GI series
Your child is given small amounts of barium to drink. This is a metallic, chalky liquid
that coats the inside of organs. It helps them show up on X-rays better. Your child’s
healthcare provider will take a series of X-rays to see what happens as your child
swallows the liquid.
In this test, a small, flexible tube (endoscope) is used to look at the inside of
your child’s digestive tract. This tube has a light and a camera lens at the end of
it. During the test, your child may have tissue samples removed from the throat, esophagus,
and stomach. These tissue samples will be looked at in a lab.
Your child’s healthcare provider will guide a small tube with a pressure gauge through
your child’s mouth and into the esophagus. The pressure gauge checks the pressure
in your child’s esophagus. This can tell how well food moves through the esophagus.
Your child will get medicine (sedation) to help relax and prevent pain for this test.
Your child’s healthcare provider will place a tube into your child’s throat. This
test is done to check if your child’s throat is narrowed or has any other problems.
Your child will be under anesthesia for this test.
How is dysphagia treated in a child?
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is and what’s causing your child’s dysphagia.
Infection or an object in the esophagus
If your child’s swallowing issues start suddenly, your child may have something stuck
in their esophagus. In this case, your child will have an endoscopy to remove the
object. Your child will need to be under anesthesia for this procedure. If your child
has trouble swallowing and a fever, it may be from an infection. It will need to be
treated with medicine. These can both be emergencies. They need to be treated right
If your child has chronic dysphagia or dysphagia caused by a health condition, speech
or occupational therapy may help. Your child will learn exercises and feeding techniques
to swallow better.
Your child may be able to swallow thick fluids and soft foods better than thin liquids.
Your child’s healthcare provider may suggest giving baby foods or pureed foods. Some
babies who had trouble swallowing formula or breastmilk do better when they’re old
enough to eat baby foods.
Dysphagia with GERD
If your child also has GERD (gastroesophageal reflux disease), treatment for this
condition may help your child swallow better. When your child’s esophagus and throat
aren’t as irritated by acid reflux, they may work better. GERD may be treated with
feeding changes or medicine.
If your child is diagnosed with this allergic inflammatory condition, a particular
elimination diet is often advised for treatment. Medicines may also help.
Children who have scarring or narrowing of the esophagus may be helped with esophageal
dilation. . In this procedure, your child’s healthcare provider may widen (dilate)
their esophagus. Your child will need to be under anesthesia for this. Your child
may need to have this procedure repeated.
What are possible complications of dysphagia in a child?
This condition can cause aspiration. This happens when food or liquids go into your
child’s windpipe and lungs. This can lead to pneumonia and other serious lung problems.
Children with dysphagia often have trouble eating enough. This can cause poor nutrition.
They may not gain enough weight to grow correctly.
Some children with dysphagia will have long-term problems. Some children’s ability
to swallow may not improve much. This is more likely in children who also have other
health problems, such as nerve or muscle issues. Other children may learn to eat and
drink better. Ask your child's healthcare provider about your child’s outlook.
Your child may need to see a team of healthcare providers who specialize in feeding
and swallowing. Your child’s team may include a nutritionist, occupational therapist,
speech and language therapist, psychologist, gastroenterologist, allergist, and an
ear, nose, and throat doctor (ENT or otolaryngologist).
When should I call my child's healthcare provider?
Call your child’s healthcare provider if your child has trouble swallowing or feeding.
If your child suddenly has trouble swallowing, get medical help right away. If your
child has dysphagia and develops new symptoms, such as trouble breathing, get help
Key points about dysphagia in children
Dysphagia means trouble swallowing. This condition can be long-term or it can come
If your child suddenly has trouble swallowing, get medical help right away.
Long-term (chronic) dysphagia may be caused by an underlying health problem.
Treatment for dysphagia depends on the cause of the condition.
Your child’s care team may include a nutritionist, occupational therapist, speech
and language therapist, psychologist, gastroenterologist, allergist, and an ear, nose,
and throat doctor.
Tips to help you get the most from a visit to your child’s healthcare provider:
Know the reason for the visit and what you want to happen.
Before your visit, write down questions you want answered.
At the visit, write down the name of a new diagnosis and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
Ask if your child’s condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if your child does not take the medicine or have the test or procedure.
If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.