Infants and children with feeding and swallowing disorders have difficulty eating and/or drinking normally or/and safely. These problems may affect a child’s health, growth, development, and even relationships with caregivers that develop during mealtimes. Duke's feeding and swallowing disorders experts include speech pathologists, dietitians, pediatric gastroenterologists, pediatric pulmonologists, and pediatric ear, nose, and throat doctors. Together, we provide the care and support to help your child thrive.
Understanding Feeding and Swallowing Disorders
Children with feeding and swallowing disorders may experience:
- Difficulty with breast or bottle-feeding
- Slow or inadequate weight gain
- Coughing, choking or gagging when eating or drinking
- Difficulty chewing food
- Difficulty eating certain textures
- Refusing food
- Stressful reaction to mealtimes
- pain or irritability with eating
- Need for supplemental nutrition (tube feedings)
Risks for Swallowing and Feeding Disorders
Feeding difficulties are often associated with medical conditions that affect how the brain, mouth, throat, lungs, heart, and/or stomach/intestines work. These conditions include:
- Congenital heart defects
- Cleft lip or palate
- Developmental disorders, such as Autism
- Genetic disorders, such as Down Syndrome
- Short bowel syndrome
- Gastrointestinal reflux or other digestive problems
- Food allergies
- Cerebral Palsy
- Breathing or airway problems
- Weakness in face and neck muscles
- Complex medical conditions
Duke Health offers locations throughout the Triangle. Find one near you.
Our pediatric feeding specialists use various tests to diagnose feeding and swallowing disorders. We observe how your child eats and drinks, and we check the strength and movement of the muscles used for swallowing. Two different swallow evaluations help to visualize and detail your child's swallowing process. Your doctor uses data from these studies and your child’s medical history to develop a treatment plan.
Videofluoroscopy Swallow Study (VFSS)
X-rays are taken as your child eats or drinks food or liquid that contains barium so we can assess swallowing function.
Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
A thin, lighted tube equipped with a camera is inserted through the nose to look in the throat while your child eats.
Your child may also be referred for a clinic visit with our ear, nose, and throat surgeons who perform laryngoscopy. The doctor inserts a thin, lighted tube equipped with a camera through the nose and into the throat. This lets us see what happens inside your child's throat when he or she swallows.
If a problem with the upper GI tract is believed to contribute to swallowing difficulty, your child may have an upper endoscopy. A small tube with a camera at its tip is inserted through the mouth. This allows your gastroenterologist to view the esophagus, stomach, and duodenum, which make up the upper GI tract, and to look for any possible contributing problems.
Duke Children's Hospital & Health Center is proud to be nationally ranked in nine pediatric specialties.
Why Choose Duke
A Team of Specialists
Duke’s pediatric gastroenterologists; speech pathologists; nutritionists, pulmonologists, and ear, nose, and throat surgeons are experienced in caring for all types of feeding and swallowing disorders. Together, we work to create a treatment plan specific to your child’s diagnosis, including follow-up care as your child grows.
If your child has an underlying medical condition causing the problem, we consult with your child’s other providers -- such as cardiologists, neonatologists, oncologists, pulmonologists, allergist, geneticist, pediatric surgeons, plastic surgeons, psychologists, occupational and physical therapists, and social workers. We review the needs of children who require coordinated care and procedures during our regular team meetings. Whenever possible, we work with therapists close to your hometown so your child can continue care without long trips or hospital stays.
Child Life Team
Our child life specialists provide support, education, and guidance to help you and your child during treatment and hospitalization. Child life specialists explain procedures, offer encouragement, and use fun activities to take your child’s mind off treatment.
Care Coordination and Support
Our social workers can help you navigate the medical system and coordinate the variety of health services your child needs. We help you work with insurance providers, connect with resources, and manage details related to your child’s care.