Like breathing, swallowing is a reflex and essential to everyday life. Humans swallow at least 900 times a day: around three times an hour during sleep, once per minute while awake and even more often during meals. We swallow food, liquids, medicine and saliva. People who have trouble swallowing are at risk of poor nutrition and dehydration, while babies and children may not take in enough nutrients to support growth and brain development.
Swallowing skills develop from infancy. Babies drink milk, from their mother’s breast or a bottle, using muscles in their lips, tongue, jaw and cheeks. The infant holds the nipple at the back of their mouth and the milk triggers the swallow reflex. When children start to eat solid food, they learn to move the food from the front of the mouth to the back to trigger the same swallowing reflex. Chewing is also important – food mixes with saliva and is broken into tiny pieces so that it forms a soft slippery ball that is easy to safely swallow.
Swallowing difficulty (dysphagia) is any problem with: sucking, swallowing, drinking, chewing, eating, controlling saliva, taking medication, or protecting the lungs from food and drink ‘going the wrong way’. It can be a problem with keeping the lips closed so that food, liquid or saliva doesn’t dribble out. Sometimes, the first sign of a swallowing problem is coughing, gagging or choking when eating and drinking. Swallowing problems can mean food, drinks or saliva gets into the lungs and this can cause lung infections (pneumonia). Reflux is a problem where the valves in the oesophagus causes the contents of the stomach (like food, drink or stomach acid) to come back up, sometimes reaching as far up as the throat and mouth. Who can have a swallowing problem? A swallowing problem can occur at any stage in life. Babies born prematurely, those with heart defects or damage to the brain (e.g. cerebral palsy) often have swallowing problems. Children with abnormalities in the structures of the head, neck and face such as cleft lip or palate may also have difficulty feeding.
What can be done about swallowing difficulties? Early identification is very important.
• Your baby has difficulty sucking during breast or bottle feeding
• A feeling that food or drink gets stuck in the throat
• A feeling that food or drink is going the wrong way
• Long meal times or eating slowly (it takes more than 30 minutes to finish a meal)
• Coughing, choking or frequent throat clearing during or after eating and drinking
• Becoming short of breath or your breathing changes when eating and drinking
• Avoiding certain foods because they are difficult to swallow
• Unplanned weight loss for adults or for children, or failing to put on weight because of avoiding foods or finding it hard to eat
• Frequent chest infections with no known cause
Speech pathologists may recommend changes to the textures of foods or drinks, and provide rehabilitation techniques and exercises to help people swallow safely. If the swallowing problem is very severe, a speech pathologist may recommend the person take food and drink via a tube that goes directly to the stomach. Speech pathologists work with other health professionals such as doctors, nurses, dietitians, lactation consultants, occupational therapists, physiotherapists and others to help people with swallowing problems.
This information was provided by Speech Pathology Australia. for more information, go to www.speechpathologyaustralia.org.au