Pediatric
Swallowing
Disorders
Explore signs,
causes, and
treatments
Learn about pediatric swallowing disorders. Explore signs, causes, and treatments for feeding and aspiration issues in children at UCLA’s Pediatric ENT Clinic
What Is Dysphagia?
Swallowing disorders, also called dysphagia, occur when a child has difficulty chewing, moving, or safely swallowing food, liquids, or saliva. This can affect a child’s nutrition, growth, and breathing—and in some cases, may lead to serious complications like aspiration pneumonia.
Swallowing involves a complex series of actions between the mouth, throat, and esophagus, coordinated by nerves and muscles. When any part of this system isn’t working correctly, a swallowing disorder can occur.
Who Is at Risk?
Swallowing disorders can affect infants, toddlers, and older children, especially those with:
- Prematurity or low birth weight
- Neurologic disorders (e.g., cerebral palsy, brain injury)
- Cleft palate or other craniofacial anomalies
- Developmental delay
- Congenital syndromes (e.g., Down syndrome)
- History of prolonged intubation or airway surgery
- Gastroesophageal reflux (GERD)
- Cardiac or respiratory conditions
Common Signs and Symptoms
- Coughing, choking, or gagging while eating or drinking
- Wet or “gurgly” voice after swallowing
- Recurrent pneumonia or upper respiratory infections
- Difficulty breastfeeding or bottle-feeding
- Poor weight gain or growth
- Food or liquid leaking from the nose
- Arching or irritability during feeds
- Refusal to eat certain textures or consistencies
- Taking a long time to finish meals
How Is a Swallowing Disorder Diagnosed?
Our evaluation starts with a detailed medical and feeding history and a physical exam. Additional testing may include:
Clinical Feeding Evaluation
- Observation by a speech-language pathologist (SLP) during feeding.
Modified Barium Swallow Study (MBSS)
- An X-ray video taken while your child eats and drinks contrast material to assess how well they swallow.
Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
- A small flexible camera is passed through the nose to view the throat while your child swallows colored food or liquid.
pH Probe or Impedance Study
- If reflux is suspected, these studies help detect acid or non-acid reflux events that may contribute to swallowing difficulty.
Treatment Options
Treatment is individualized and may include:
Feeding Therapy
- Guided by pediatric speech-language pathologists or occupational therapists.
- Focuses on oral motor skills, safe swallowing strategies, and sensory feeding issues.
Medical Management
- Acid reflux treatment (e.g., PPIs)
- Allergy or inflammation control
- Treatment of underlying respiratory or neurologic conditions
Surgical Interventions
- For anatomical abnormalities (e.g., laryngeal clefts, tracheoesophageal fistula, vocal cord paralysis)
- May include supraglottoplasty, airway dilation, or other reconstructive procedures
Our Multidisciplinary Approach
At UCLA, we offer comprehensive care for children with swallowing difficulties. Our team includes:
- Pediatric Otolaryngologists
- Speech-language pathologists
- Pediatric gastroenterologists
- Pulmonologists
- Nutritionists
- Feeding specialists
We collaborate to evaluate the airway, swallowing mechanism, and gastrointestinal system to create a treatment plan that supports growth, development, and safety.
When to Call a Specialist
Contact us if your child has:
- Recurrent coughing or choking during meals
- Frequent pneumonia or unexplained respiratory symptoms
- Feeding refusal or signs of distress while eating
- Poor weight gain or growth concerns
Expert Care You Can Trust
Dr. Sohit Kanotra leads a team of experts in pediatric swallowing and airway disorders at UCLA. As Director of the Complex Pediatric Airway Program, he specializes in caring for children with feeding challenges and aspiration, including those who’ve undergone airway surgery or have congenital anomalies.