Gaining and Growing: Assuring Nutritional Care of Preterm Infants in the Community

Aspiration

 Definition
 Background
 Diagnosis
 Treatment

Definition

Aspiration can be defined as entry of material into the airway below the true vocal cords.

Background

Aspiration can occur when there are problems with swallowing and/or in conjunction with gastroesophageal reflux (GER). Aspiration can result from a primary swallowing dysfunction or from lack of coordination between sucking, swallowing, and breathing. Infants with increased respiratory rate may be at increased risk of aspiration.

Respiratory consequences of aspiration can be severe. When aspiration is suspected, families should be promptly referred for further diagnosis and treatment.

Diagnosis

Feeding Behavior: Coughing or choking during swallowing or noisy or "wet" respirations can indicate that liquid is impinging on the airway. This can be liquid that is actually aspirated into the airway or that merely penetrates the airway and then is expelled. It is important to note that aspiration can also be "silent."

History: Infants with aspiration may have cough, wheeze, and tachypnea during or after feedings. Recurrent aspiration may lead to secondary infection and pnuemonia. Left untreated, infants with aspiration may develop stridor, persistent atelectasis, bronchiectasis with chronic productive cough and failure to thrive. Some infants may have difficulty handling oral secretions.

Videofluoroscopic Swallowing Study (VFSS): VFSS is used to document occurrence of aspiration, reasons for aspiration, and possible therapies for aspiration. The infant is given breastmilk or formula mixed with liquid barium. The infant is placed in a feeding seat and the fluoroscope table is tilted so that the response of the pharyngeal area during feeding can be captured as a permanent video image.

Treatment

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More information contact: growing@uw.edu
Page reviewed: March 24, 2015