Eating, drinking and swallowing problems

At Manchester SLT we treat babies and children with eating, feeding and swallowing difficulties. We aim to improve, support and develop a baby / child's eating, feeding and swallowing difficulties with the overall aim of maximising the baby / child's ability to eat and drink as safely and independently as possible.

What are eating, feeding and swallowing difficulties?

Eating, feeding and swallowing difficulties, also known as dysphagia, occur when babies / children have difficulties managing liquids, solids or food and are unable to swallow them safely.

The baby / child may have difficulties with gathering, sucking, biting or chewing their food and /drink.

Stages of the normal swallow

Swallowing is an extremely complex activity and requires the involvement of numerous muscles and nerves. There are three stages which occur when swallowing, stages of the normal swallow include:

Oral stage

The oral stage involves the baby / child chewing, sucking and moving food or liquid in the mouth in preparation for it entering into the throat.

Pharyngeal stage

The pharyngeal stage is responsible for triggering the swallow. During the pharyngeal stage food / liquid is squeezed through the throat. The airway is closed off during this stage in order to prevent food from entering the airway. If any food or liquid enters the airway this is known as aspiration. Aspirating food / liquid can be very dangerous and in the long run can cause chest infections and / pneumonia.

Oesophageal stage

The oesophageal phase involves the muscles of the feeding tube relaxing and tightening which allows the food / liquid to enter through the oesophagus and into the stomach.

Eating, feeding and swallowing problems can occur at any of the above stages and will cause numerous health problems if left untreated.

Eating, feeding and swallowing difficulties can be caused by a variety of conditions or disabilities, these commonly include neurological disorders, learning difficulties and physical difficulties.

What are the common symptoms of eating, feeding and swallowing difficulties in babies and children?

Eating, feeding and swallowing difficulties in babies and children will differ to that of adults and they will present with different symptoms. This is due to the different underlying causes and also the fact that the anatomical structure of babies and children will be smaller and still developing.

The following, may be indicators of swallowing difficulties in babies and children:

• Stiffening of the body whilst feeding.
• Coughing or choking during or after feeding. This may indicate that the baby has poor coordination of their suck, swallow and breathing sequence.
• Choking or coughing during or after eating / drinking.
• Lacking alertness or irritability during feeding.
• Recurring chest infections or pneumonia.
• Regurgitating food / liquid frequently during feeding.
• Taking longer than thirty minutes for a feed.
• Taking a long time to complete a meal.
• Difficulty accepting new textures.
• Excessive leakage of liquid or food from the mouth.
• Being sick, gagging or coughing during or after eating and drinking.
• Gargly voice quality during or shortly after feeding.

Having an eating, feeding and swallowing difficulty will have a major impact on a baby / child and their family's lives. If left untreated feeding, eating and swallowing difficulties can lead to serious medical complications including:

• Weight loss
• Chest infections
• Pneumonia
• Under nutrition

Speech and language therapy is highly beneficial in helping to manage eating, feeding and swallowing difficulties and also in helping to prevent any further health complications.

How does speech and language therapy help eating, feeding and swallowing problems?

Treatment at Manchester SLT will be highly beneficial for babies and children with eating, feeding and swallowing difficulties.

Speech and language therapy will aim to improve, develop and support any eating, feeding and swallowing difficulties in children. Speech and language therapy will aim to maximise the baby or child's ability to eat and drink as safely and independently as possible and also to minimise the risk of any associated health complications.

Our highly specialised therapists are experienced in treating babies and children with eating, feeding and swallowing problems. One of our therapists will carry out a thorough assessment of the baby / child's eating, feeding and swallowing ability. The therapist will use a variety of specialised assessment tools in order to determine the type and severity of eating, feeding and swallowing difficulties the baby / child has. Specialised assessments may require a referral to a hospital for a barium swallow (x ray of how the baby / child eats and drinks) in order to gain more information about the baby / child's difficulties.

Following an initial assessment the speech and language therapist will devise an individualised treatment plan which will be tailored to the child's specific needs and abilities.

Treatments available for babies and children with eating, feeding and swallowing difficulties include:

• Diet modification ' which includes altering the textures of food and liquids.
• Advice, support and training on positioning during feeding, eating and drinking.
• Advice and training on the amount, frequency and types of food given.
• Education on the signs of aspiration and also any other difficulties.
• Oral- motor exercises ' to strengthen the muscles involved in eating, feeding and swallowing.
• Advice, support and training for parents / carers and other professionals involved in the baby / child's care.
• Any specialist equipment needed to assist with eating and drinking including specialist bottles, modified knives and forks and plates and bowls.
• In more severe cases where a baby / child cannot eat or drink at all the speech and language therapist will discuss alternative ways of feeding e.g. a feeding tube with the parents / carers and other professionals.

At Manchester SLT our specialist speech and language therapy service helps to improve the baby / child's ability to swallow more effectively and safely. We aim to reduce the risk of aspiration and increase the child's nutritional status.

How do I book an appointment for speech and language therapy?

If you feel that our speech and language therapy service at Manchester SLT would be beneficial and would like to book an appointment with one of our highly experienced speech and language therapists, please email info@manchesterslt.co.uk or call 0161 883 0111.