Dysphagia pp 133-154 | Cite as

Pediatric Aspect of Dysphagia

  • Pascale Fichaux Bourin
  • Michèle Puech
  • Virginie Woisard
Part of the Medical Radiology book series (MEDRAD)


Pediatric dysphagia is specific because of the different developmental stages from the neonatal period to the infancy. Diagnosis and treatment will be different if it concerns a newborn or a young child having already experienced oral feeding. Furthermore swallowing and feeding disorders, having a direct impact on the nourishment function of the parents, will have repercussions on the child-parents relationship. Swallowing disorders are frequently multifaceted and impairments can be morphological, functional or induced. The assessment of these disorders includes anamnesis (reviewing family, medical, developmental and feeding history), physical examination (searching for nutritional impact, cardiopulmonary state and looking for developmental anomalies or genetic dysmorphism), swallowing evaluation (analyzing oropharyngolaryngeal structure and function by observation, fiber-optic endoscopy, videofluoroscopy, ultrasonography) and feeding evaluation (implicating parents and caregivers). Management of these disorders is a complex task, thus an interdisciplinary team and recurrent assessments are required so as to match the child’s development and capacities. Its main aims are to prevent repercussions on developmental milestones and to assure the safety of the child and the psychological balance of child-parents relationship.


Autism Spectrum Disorder Feeding Disorder Preterm Infant Oral Feeding Esophageal Atresia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Abadie V (2004) Diagnostic approach in oral disorder in young children. Arch Pediatr 11(6):603–605PubMedCrossRefGoogle Scholar
  2. Abadie V (2008) Apparently isolated feeding behavior troubles in infant. Arch Pediatr 15(5):837–839PubMedCrossRefGoogle Scholar
  3. Abadie V, Cheron G, Lyonnet S et al (1996) Isolated neonatal dysfunction of brainstem. Arch Pediatr 3(2):130–136PubMedCrossRefGoogle Scholar
  4. Abu-Sultaneh SM, Durst P, Maynard V, Elitsur Y (2010) Fluticasone and food allergen elimination reverse sub-epithelial fibrosis in children with eosinophilic esophagitis. Dig Dis Sci 56(1):97–102PubMedCrossRefGoogle Scholar
  5. Albert GW, Menezes AH et al (2010) Chiari malformation Type I in children younger than age 6 years: presentation and surgical outcome. J Neurosurg Pediatr 5(6):554–561PubMedCrossRefGoogle Scholar
  6. Amaizu N, Shulman R et al (2008) Maturation of oral feeding skills in preterm infants. Acta Paediatr 97(1):61–67PubMedCrossRefGoogle Scholar
  7. Amiel-Tison C (2005) Neurologie périnatale, 3rd edn. Masson, Paris, pp 35–73Google Scholar
  8. Amiel-Tison C et al (2005). Why is the neurological examination so badly neglected in early childhood? Pediatrics 116(4):1047; author reply 1047–1048Google Scholar
  9. Armstrong-Wells J, Johnston SC et al (2009) Prevalence and predictors of perinatal hemorrhagic stroke: results from the Kaiser Pediatric Stroke Study. Pediatrics 123(3):823–828PubMedCrossRefGoogle Scholar
  10. Arvedson JC, Brodsky L (2001) Pediatric swallowing and feeding: assessment and management, 2nd edn. Singular Publishing Group, Albany, pp 283-388Google Scholar
  11. Arvedson JC, Clark H et al (2010) Evidence-based systematic review: effects of oral motor interventions on feeding and swallowing in preterm infants. Am J Speech Lang Pathol 19(4):321–340PubMedCrossRefGoogle Scholar
  12. Arvedson JC, Lefton-Greif MA (1998) Pediatric video fluoroscopic swallow studies: a professional manual with caregiver guidelines. The Psychological Corporation, San AntonioGoogle Scholar
  13. Arvedson JC (2008) Assessment of pediatric dysphagia and feeding disorders: clinical and instrumental approaches. Dev Disabil Res Rev 14:118–127Google Scholar
  14. Badawi N, Felix JF et al (2005) Cerebral palsy following term newborn encephalopathy: a population-based study. Dev Med Child Neurol 47(5):293–298PubMedCrossRefGoogle Scholar
  15. Barnard K (1978) The family and you. MCN Am J Matern Child Nurs 3(2):82–83PubMedGoogle Scholar
  16. Borrero C, Vollmer T et al (2010) Concurrent reinforcement schedules for problem behavior and appropriate behavior: experimental applications of the matching law. J Exp Anal Behav 3(93):455–469CrossRefGoogle Scholar
  17. Bosma JF (1985) Post natal ontogeny of performances of the pharynx, larynx and mouth. Am Rev Respir Dis 13(5):S10–5Google Scholar
  18. Bosma JF, Hepburn LG et al (1990) Ultrasound demonstration of tongue motions during suckle feeding. Dev Med Child Neurol 32(3):223–229PubMedCrossRefGoogle Scholar
  19. Buswell CA, Leslie P et al (2009) Oral-motor dysfunction at 10 months corrected gestational age in infants born less than 37 weeks preterm. Dysphagia 24(1):20–25PubMedCrossRefGoogle Scholar
  20. Castilloux J, Noble AJ et al (2010) Risk factors for short- and long-term morbidity in children with esophageal atresia. J Pediatr 156(5):755–760PubMedCrossRefGoogle Scholar
  21. Chatoor I, Surles J et al (2004) Failure to thrive and cognitive development in toddlers with infantile anorexia. Pediatrics 113(5):e440–e447PubMedCrossRefGoogle Scholar
  22. Couly G, Aubry MC et al (2009) Fetal oral immobility syndrome. Arch Pediatr 17(1):1–2PubMedCrossRefGoogle Scholar
  23. de Jong EM, Felix JF et al (2010) Etiology of esophageal atresia and tracheoesophageal fistula: mind the gap. Curr Gastroenterol Rep 12(3):215–222PubMedCrossRefGoogle Scholar
  24. de Lonlay-Debeney P, Cormier-Daire V et al (1997) Features of DiGeorge syndrome and CHARGE association in five patients. J Med Genet 34(12):986–989PubMedCrossRefGoogle Scholar
  25. Delaney AL, Arvedson JC (2008) Development of swallowing and feeding: prenatal through first year of life. Dev Disabil Res Rev 14(2):105–117PubMedCrossRefGoogle Scholar
  26. Dobbelsteyn C, Peacocke SD et al (2008) Feeding difficulties in children with CHARGE syndrome: prevalence, risk factors, and prognosis. Dysphagia 23(2):127–135PubMedCrossRefGoogle Scholar
  27. Dumont RC, Rudolph CD (1994) Development of gastrointestinal motility in the infant and child. Gastroenterol Clin North Am 23(4):655–671PubMedGoogle Scholar
  28. Fanucci A, Cerro P et al (1994) Physiology of oral swallowing studied by ultrasonography. Dentomaxillofac Radiol 23(4):221–225PubMedGoogle Scholar
  29. Ferlito A, Rinaldo A et al (1999) Laryngeal malignant neoplasms in children and adolescents. Int J Pediatr Otorhinolaryngol 49(1):1–14PubMedCrossRefGoogle Scholar
  30. Gewolb IH, Vice FL (2006) Abnormalities in the coordination of respiration and swallow in preterm infants with bronchopulmonary dysplasia. Dev Med Child Neurol 48(7):595–599PubMedCrossRefGoogle Scholar
  31. Gluckman PD, Wyatt JS et al (2005) Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet 365(9460):663–670PubMedGoogle Scholar
  32. Gomes CF, Thomson Z et al (2009) Utilization of surface electromyography during the feeding of term and preterm infants: a literature review. Dev Med Child Neurol 51(12):936–942PubMedCrossRefGoogle Scholar
  33. Gupta A, Gulati P et al (2009) Effect of postnatal maturation on the mechanisms of esophageal propulsion in preterm human neonates: primary and secondary peristalsis. Am J Gastroenterol 104(2):411–419PubMedCrossRefGoogle Scholar
  34. Hanson MG, Landmesser LT (2004) Normal patterns of spontaneous activity are required for correct motor axon guidance and the expression of specific guidance molecules. Neuron 43(5):687–701Google Scholar
  35. Hartnick CJ, Hartley BE et al (2000) Pediatric fiberoptic endoscopic evaluation of swallowing. Ann Otol Rhinol Laryngol 109(11):996–999PubMedGoogle Scholar
  36. Hedberg A, Carlberg EB et al (2005) Development of postural adjustments in sitting position during the first half year of life. Dev Med Child Neurol 47(5):312–320PubMedCrossRefGoogle Scholar
  37. Lagercrantz H, Ringstedt T (2001) Organization of the neuronal circuits in the central nervous system during development. Acta Paediatr 90(7):707–715PubMedCrossRefGoogle Scholar
  38. Lapillonne A (2010) Early nutrition and the development of the preterm infant. Arch Pediatr 17(6):711–712PubMedCrossRefGoogle Scholar
  39. Lapillonne A, Razafimahefa H et al (2011) Nutrition of the preterm infant. Arch Pediatr 18(1):313–323PubMedCrossRefGoogle Scholar
  40. Lau C (2007) Development of oral feeding skills in the preterm infant. Arch Pediatr 14(Suppl 1):S35–S41PubMedCrossRefGoogle Scholar
  41. Lau C, Alagugurusamy R et al (2000) Characterization of the developmental stages of sucking in preterm infants during bottle feeding. Acta Paediatr 89(7):846–852PubMedCrossRefGoogle Scholar
  42. Lau C, Schanler RJ (2000) Oral feeding in premature infants: advantage of a self-paced milk flow. Acta Paediatr 89(4):453–459PubMedCrossRefGoogle Scholar
  43. Lau C, Smith EO et al (2003) Coordination of suck-swallow and swallow respiration in preterm infants. Acta Paediatr 92(6):721–727PubMedCrossRefGoogle Scholar
  44. Limme M (2011) The need of efficient chewing function in young children as prevention of dental malposition and malocclusion. Arch Pediatr 17(Suppl 5):S213–S219Google Scholar
  45. May JG, Shah P et al (2011) Systematic review of endoscopic airway findings in children with gastroesophageal reflux disease. Ann Otol Rhinol Laryngol 120(2):116–122PubMedGoogle Scholar
  46. McAnulty GB, Duffy FH et al (2009) Effects of the newborn individualized developmental care and assessment program (NIDCAP) at age 8 years: preliminary data. Clin Pediatr (Phila) 49(3):258–270CrossRefGoogle Scholar
  47. Miller JL, Sonies BC et al (2003) Emergence of oropharyngeal, laryngeal and swallowing activity in the developing fetal upper aerodigestive tract: an ultrasound evaluation. Early Hum Dev 71(1):61–87PubMedCrossRefGoogle Scholar
  48. Mizuno K, Ueda A (2003) The maturation and coordination of sucking, swallowing, and respiration in preterm infants. J Pediatr 142(1):36–40PubMedCrossRefGoogle Scholar
  49. Nelson KB (2005) Neonatal encephalopathy: etiology and outcome. Dev Med Child Neurol 47(5):292PubMedCrossRefGoogle Scholar
  50. Nicholls D, Bryant-Waugh R (2009) Eating disorders of infancy and childhood: definition, symptomatology, epidemiology, and comorbidity. Child Adolesc Psychiatr Clin N Am 18(1):17–30PubMedCrossRefGoogle Scholar
  51. Nyqvist KH (2008) Early attainment of breastfeeding competence in very preterm infants. Acta Paediatr 97(6):776–781PubMedCrossRefGoogle Scholar
  52. Nyqvist KH, Farnstrand C et al (2001) Early oral behaviour in preterm infants during breastfeeding: an electromyographic study. Acta Paediatr 90(6):658–663PubMedCrossRefGoogle Scholar
  53. Nyqvist KH, Rubertsson C et al (1996) Development of the preterm infant breastfeeding behaviour scale (PIBBS): a study of nurse–mother agreement. J Hum Lact 12:207–219PubMedCrossRefGoogle Scholar
  54. Pickler RH, Best AM et al (2006) Predictors of nutritive sucking in preterm infants. J Perinatol 26(11):693–699PubMedCrossRefGoogle Scholar
  55. Pieltain C, Habibi F et al (2007) Early nutrition, postnatal growth retardation and outcome of VLBW infants. Arch Pediatr 14(Suppl 1):S11–S15PubMedCrossRefGoogle Scholar
  56. Pinelli J, Symington A (2001) Non-nutritive sucking for promoting physiologic stability and nutrition in preterm infants. Cochrane Database Syst Rev (3):CD001071Google Scholar
  57. Prasse JE, Kikano GE (2009) An overview of pediatric dysphagia. Clin Pediatr (Phila) 48(3):247–251CrossRefGoogle Scholar
  58. Qureshi MA, Vice FL et al (2002) Changes in rhythmic suckle feeding patterns in term infants in the first month of life. Dev Med Child Neurol 44(1):34–39PubMedCrossRefGoogle Scholar
  59. Radzyminski S (2005) Neurobehavioral functioning and breastfeeding behavior in the newborn. J Obstet Gynecol Neonatal Nurs 34(3):335–341PubMedCrossRefGoogle Scholar
  60. Reilly SM et al (1999) Oral-motor dysfunction in children who fail to thrive: organic or non-organic? Dev Med Child Neurol 41:115–122Google Scholar
  61. Rosbe KW, Kenna MA et al (2003) Extraesophageal reflux in pediatric patients with upper respiratory symptoms. Arch Otolaryngol Head Neck Surg 129(11):1213–1220PubMedCrossRefGoogle Scholar
  62. Salinas-Valdebenito L, Nunez-Farias AC et al (2010) Clinical characterisation and course following therapeutic intervention for swallowing disorders in hospitalised paediatric patients. Rev Neurol 50(3):139–144PubMedGoogle Scholar
  63. Schaller F, Watrin F et al (2010) A single postnatal injection of oxytocin rescues the lethal feeding behaviour in mouse newborns deficient for the imprinted Magel2 gene. Hum Mol Genet 19(24):4895–4905PubMedCrossRefGoogle Scholar
  64. Schindler O, Ruoppolo G, Schindler A (2011) Deglutilogia, 2nd edn. Omega, Turin, pp 27–50Google Scholar
  65. Sitton M, Arvedson JC et al (2011) Fiberoptic endoscopic evaluation of swallowing in children: feeding outcomes related to diagnostic groups and endoscopic findings. Int J Pediatr Otorhinolaryngol 75(8):1024–1031PubMedCrossRefGoogle Scholar
  66. Smith PM, Ferguson AV (2008) Neurophysiology of hunger and satiety. Dev Disabil Res Rev 14(2):96–104PubMedCrossRefGoogle Scholar
  67. Staiano A, Boccia G et al (2007) Development of esophageal peristalsis in preterm and term neonates. Gastroenterology 132(5):1718–1725PubMedCrossRefGoogle Scholar
  68. Stevenson RD, Allaire JH (1991) The development of normal feeding and swallowing. Pediatr Clin North Am 38(6):1439–1453PubMedGoogle Scholar
  69. Symington A, Pinelli J (2001) Developmental care for promoting development and preventing morbidity in preterm infants. Cochrane Database Syst Rev (4):CD001814Google Scholar
  70. Thach BT (2008) Some aspects of clinical relevance in the maturation of respiratory control in infants. J Appl Physiol 104(6):1828–1834PubMedCrossRefGoogle Scholar
  71. Thibault H, Castetbon K et al (2010) Why and how to use the new body mass index curves for children. Arch Pediatr 17(12):1709–1715PubMedCrossRefGoogle Scholar
  72. Thompson DM (2007) Abnormal sensorimotor integrative function of the larynx in congenital laryngomalacia: a new theory of etiology. Laryngoscope 117(6 Pt 2 Suppl 114):1–33Google Scholar
  73. Thouvenin B, d’Arc BF et al (2005) Infantile rumination. Arch Pediatr 12(9):1368–1371PubMedCrossRefGoogle Scholar
  74. Thoyre SM, Shaker CS et al (2005) The early feeding skills assessment for preterm infants. Neonatal Netw 24(3):7–16PubMedCrossRefGoogle Scholar
  75. Till H, Muensterer OJ et al (2008) Staged esophageal lengthening with internal and subsequent external traction sutures leads to primary repair of an ultralong gap esophageal atresia with upper pouch tracheoesophagel fistula. J Pediatr Surg 43(6):E33–E35PubMedCrossRefGoogle Scholar
  76. Ullenhag A, Persson K et al (2009) Motor performance in very preterm infants before and after implementation of the newborn individualized developmental care and assessment programme in a neonatal intensive care unit. Acta Paediatr 98(6):947–952PubMedCrossRefGoogle Scholar
  77. Vandenplas Y et al (2009) Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr 49(4):498–547Google Scholar
  78. WHO (2001) International classification of functioning, disability and health: world health assembly resolution WHA54.21, 54th session, 22 May 2001Google Scholar
  79. Wu YW, March WM et al (2004) Perinatal stroke in children with motor impairment: a population-based study. Pediatrics 114(3):612–619PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg  2012

Authors and Affiliations

  • Pascale Fichaux Bourin
    • 1
  • Michèle Puech
    • 1
  • Virginie Woisard
    • 1
  1. 1.Unité de la Voix et de la Déglutition, Department of Ear‚ Nose and ThroatCHU de ToulouseToulouse Cedex 9France

Personalised recommendations