Diagnosis and Management of Pediatric Dysphagia

Importance: Awareness of swallowing dysfunction in the pediatric population is growing. As many as 50% of parents report that their otherwise healthy children have a feeding problem. Dysphagia is increasingly common in the pediatric population, especially as advances in health care improve the survival of extremely premature infants and children with complex congenital anomalies. Symptoms of dysphagia and aspiration prompt referral to otolaryngologists. Observations: Dysfunction can exist at any of the 4 phases of the physiologic swallow. Dysphagia manifests differently in children at each age in their development. Dysphagia can present in otherwise healthy children but is more common in patients with a history of prematurity, neuromuscular disorders, cardiopulmonary disorders, anatomic anomalies of the upper aerodigestive tract, and gastrointestinal tract disorders. Workup involves clinical feeding evaluations, imaging studies, and endoscopic evaluations. Appropriate management depends on the cause of dysphagia. Conclusions and Relevance: The causes of dysphagia in children are varied and often multifactorial. Evaluation by a multidisciplinary team can facilitate accurate diagnosis and guide management.