Aspiration in Babies and Children
Aspiration is when something enters
the airway or lungs by accident. It may be food, liquid, or some other material. This
can cause serious health problems, such as pneumonia. Aspiration can happen when a
person has trouble swallowing normally. This is known as dysphagia. It can also happen
if a child has gastroesophageal reflux disease (GERD). This is when the contents of
stomach come back up into the throat.
When your child swallows food, it
passes from the mouth down into the throat. This is called the pharynx. From there,
food moves down through a long tube (esophagus) and into the stomach. This journey
made possible by a series of actions from the muscles in these areas. If your child
dysphagia, the muscles don’t work normally. They cause problems with the swallowing
The pharynx is also part of the
system that brings air into the lungs. When a person breathes, air enters the mouth
moves into the pharynx. The air then goes down into the main airway (trachea) and
the lungs. A flap of tissue called the epiglottis sits over the top of the trachea.
flap blocks food and drink from going down into the trachea when your child swallows.
But in some cases, food or drink can enter the trachea. It may go down as your child
swallows. Or it may come back up from the stomach. A child with dysphagia is much
likely to aspirate. A child with a developmental or health problem is more likely
Aspiration can happen during a
feeding or meal. And it can happen after a feeding or meal. This is common in babies
children with certain health conditions. Aspiration can also happen at any time when
your child swallows saliva.
If your child aspirates a small
amount of material, it may not cause much harm. This can happen in children who don’t
have a health problem. It can happen when eating, sleeping, or talking. But aspiration
that happens often or in a large amount can be serious.
Aspiration is often caused by dysphagia. This is when the muscles don’t work normally
in the throat and lead to swallowing problems. Different medical conditions can lead
to this, such as:
- Abnormal anatomy, such as a cleft palate or a problem in the esophagus
- Delayed growth, from premature birth or a condition such as Down syndrome
- Brain damage or other problems, such as from cerebral palsy or infection
- Problems with the cranial nerves that control the muscles of swallowing
- Neuromuscular disease, such as spinal muscular atrophy
- Medical procedures, such as a nasogastric tube or a tracheostomy
Gastroesophageal reflux disease (GERD) can also cause aspiration. This is when the
contents of the stomach come back up into the throat.
Aspiration can cause signs and symptoms in a baby such as:
- Weak sucking
- Choking or coughing while feeding
- Other signs of feeding trouble, like a red face, watery eyes, or facial grimaces
- Stopping breathing while feeding
- Faster breathing while feeding
- Voice or breathing that sounds wet after feeding
- Slight fever after feedings
- Wheezing and other breathing problems
- Repeated lung or airway infections
And aspiration can cause signs and symptoms in an older child such as:
- Choking or coughing while eating
- Voice that sounds wet after eating
- Slight fever after meals
- Complaints of food feeling stuck or coming back up
- Wheezing and other breathing problems
- Repeated lung or airway infections
Signs and symptoms can happen right after eating. Or they may happen over time. Your
child may not have all of these signs and symptoms. The signs and symptoms may depend
on the age of your child, and how often and how much your child aspirates.
Some children who aspirate do not have any signs or symptoms. This is called silent
Your child will need to be checked
for aspiration if they have:
- Any signs or symptoms of aspiration
- Health problem that can cause trouble swallowing
The healthcare provider will ask
about your child’s medical history and symptoms. This may be done by a speech-language
pathologist (SLP). The SLP may ask about what foods or drink cause problems and when
your child’s symptoms happen. They may want to watch your child during a feeding.
Your child may also need tests. These can check for problems and show if food and
fluid is going into your child’s lungs. The tests may include:
- Chest X-ray or CT scan
- Modified barium swallow test (MBS)
- Fiberoptic endoscopic evaluation of
Treatment for aspiration may vary depending on the cause and severity. Treatments
for your child may include:
- Making changes in position and posture during meals
- Changing the thickness of liquids
- Changing the types of foods in your child’s diet
- Doing exercises to help with swallowing (for an older child)
- Medicines for GERD
- Medicines or Botox injection for children who make excess saliva
- Surgery to reduce reflux
- Surgery to correct a problem such as a cleft palate
If your child still has a high risk
of aspiration despite these methods, they may need a special tube to help with eating
for a while. The feeding tube will help your child get good nutrition until their
of aspiration improves. Your child will not eat or drink normally until the tube is
removed. A thin tube may be put through the nose down into the stomach. This is called
nasogastric tube. This may be used for a short time while other treatment is considered.
Or a tube may be put directly into your child’s stomach during a surgery. This is
a gastrostomy tube.
In some children, aspiration
lessens over time. In other cases, a child may need more treatment to address the
Your child’s healthcare providers will carefully watch your child so that they can
return to normal eating as soon as possible.
Talk with your child’s healthcare provider if your child has a tracheostomy tube.
You may need to suction food or liquid from the tube.
A major complication of aspiration
is harm to the lungs. When food, drink, or stomach contents make their way into your
child’s lungs, it can damage the tissues there. The damage can sometimes be severe.
Aspiration also increases the risk of pneumonia. This is an infection of the lungs
causes fluid to build up in the lungs. Pneumonia needs to be treated with antibiotics.
In some cases, it may cause death.
Other possible complications from aspiration include:
- Weight loss
- Increased risk of other illness
When to Call a Healthcare Provider
Let your child’s healthcare provider know right away if your child has any signs or
symptoms of aspiration. It needs to be treated as soon as possible.
Aspiration is when something enters the airway or lungs by accident. It may be food,
liquid, or some other material. This can cause serious health problems, such as pneumonia.
Aspiration can happen when a child has trouble swallowing normally. This is known
- Your child might have aspiration caused by problems with growth, development, or certain
- Your child may have signs such as
breathing problems and a wet-sounding voice after meals.
- Some children with aspiration don’t have any signs or symptoms. This is known as silent
- If your child has any symptoms of
aspiration, they need to be checked and treated right away.
- Aspiration may be treated by addressing the cause of dysphagia. It can also be managed
with methods to help your child feed better.
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.