One of the common tests that doctors will run for children who aren’t feeding well is a swallow study. A swallow study will show if fluid is going into the lungs (aspirating) while feeding and if the swallow mechanism is working correctly.
A swallow study is a relatively simple procedure, but can be very helpful if you suspect that your child might be aspirating when feeding. Aspiration is very dangerous and can lead to a variety of health issues.
A speech-language pathologist performs the swallow study. For infants that are breast or bottle feeding, barium is added to bottles of formula in a variety of thicknesses. Usually they have one without thickener and one or two thickened bottles. Will sat in a seat similar to a car seat and I fed him the bottles as the technician operated the videofluoroscope which is similar to an x-ray. This machine is able to record video instead of just one image like a standard x-ray. This allows the specialist to view what is going on inside the baby’s mouth and throat as they swallow.
As the baby swallows the different bottles with a variety of thin or thickened liquid, the specialist can watch the path it takes from the mouth down the esophagus and into the upper stomach. They will see if the child is able to successfully block their airway or if they allow any of the fluid to leak through. If the child is allowing thin fluid into their airway and ultimately their lungs, the doctors will test to see if the child is more successful with thickened formula. In severe cases where children aspirate all fluid alternative feeding methods will need to be used.
When Will was a baby he had a small swallow issue, which affected his bottle feeding. He was letting fluid into his windpipe, but luckily his vocal cords were clamping down and pushing the liquid back out. Thickening his formula allowed his swallow mechanism to work correctly and keep the liquid out of his windpipe. Jack also had a swallow study done, but he didn’t show any signs of aspiration.
Thickening formula can be achieved very simply with a few methods.
· Rice cereal – We found that it clogged the bottle nipples and led to more issues.
· Powder thickeners – We found that these didn’t clog the bottle nipples like the cereal. However they would continue to thicken the formula throughout the feeding, which can prove problematic.
· Gel thickeners – We had the most success with gel thickeners. They didn’t continue to thicken over time, so we could maintain the correct consistency.
Once we started thickening Will’s formula he went back to eating normally. The swallow study was one of the easiest procedures required of us with little to be concerned about.