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Feeding Disorders and Swallowing Problems

Feeding disorders and swallowing problems can occur at any age in the life cycle. Feeding disorders include problems obtaining food and placing it in the mouth to chew or swallow. Swallowing problems (dysphagia) occur at different stages in the swallowing process. With oral phase dysphagia, there is difficulty sucking, chewing and moving food/fluid into the throat. In pharyngeal phase dysphagia, the difficulty lies in initiating the swallow, squeezing food into the throat, and closing off the airway to prevent aspiration or choking. Finally, in esophageal dysphagia, there is difficulty with squeezing food into the stomach from the esophagus.

Signs/Symptoms of Feeding/Swallowing Problems

Children Adults
Arching/Stiffening of the body during feeding Coughing during or right after eating or drinking
Irritability or lack of alertness during feeding Wet or gurgly sounding voice during or after meals
Refusing food or liquid Extra effort or time needed to chew or swallow
Failure to accept different food textures Food or liquid leaking from the mouth
Long feeding times (>30 minutes) Food getting stuck in the mouth
Difficulty chewing Recurring pneumonia
Difficulty breast feeding Recurring chest congestion after eating
Coughing or gagging during meals Weight loss or dehydration from not being able to eat
Excessive drooling  
Food/Liquid coming out of the nose or mouth  
Difficulty coordinating breathing with eating and drinking  
Gurgly, hoarse or breathy voice quality  
Frequent spitting up or vomiting  
Recurring pneumonia or respiratory infections  
Less than normal weight gain or growth  

Feeding disorders and swallowing problems can increase risk of:

  • Poor nutrition and dehydration
  • Aspiration (food or liquid entering the airway leading to chronic lung disease and pneumonia)
  • Embarrassment or isolation in social situations involving eating
  • Less enjoyment of eating or drinking

It is important to monitor patients for feeding disorders and swallowing problems in order to avoid negative consequences and to improve quality of life. If any of the signs/symptoms listed above are noted, it may be necessary to have a swallowing evaluation by a Speech Language Pathologist (SLP). Based on the assessment, a long-term feeding/treatment plan can be established to best meet the needs of the patient. Once the SLP has made diet-related recommendations, the dietitian can be helpful in discussing nutritional changes that will ensure nutritional needs are met.

Source: American Speech-Language-Hearing Association www.asha.org

Questions? Please call your Hospice of Huntington Dietitians:
Kellie Glass RD, LD (606) 615-2585 & Amy McFann RD, LD (304) 690-5063