FAQs
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Dysphagia is the medical term for difficulties with eating, drinking and swallowing. This can be difficulties in biting, chewing and/or swallowing or problems when food or drink moves down the oesophagus (food tube into the stomach).
Dysphagia can look different depending on the age of your child.
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There are lots of possible reasons a child may struggle to swallow safely or comfortably. These might include:
Prematurity or a difficult start after birth
Developmental delays
Neurological conditions (like cerebral palsy)
Structural differences such as cleft palate, tongue tie, Trachea Oesophageal Fistula/Oesophageal Atresia (TOF/OA)
Breathing or cardiac (heart) difficulties
Sensory processing differences
Anxiety or stress around eating
Sometimes there’s no clear cause - but support can still make a big difference.
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In babies, swallowing difficulties might show up as:
Coughing and spluttering during feeds.
Milk coming out of their nose or mouth
Difficulty latching or staying latched,
Clicking sounds when sucking
Not gaining weight well
Seeming distressed or tired during feeds
Arching their back or refusing the breast or bottle
Noisy ‘squeaky’ breathing when feeding
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In older children, signs may include:
Gagging, coughing or choking when eating.
Avoiding certain textures (for example lumpy or crunchy foods).
Holding food in their mouth for a long time in cheeks or the roof of their mouth.
Refusing to eat or drink
Taking a very long time to finish meals
Frequent chest infections or wet-sounding breathing during or after eating
Every child is different - some signs are easy to miss and others may be mistaken for fussiness or behavioural issues. That’s why it is important to have a specialist take a look if you’re concerned.
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This is something many people worry about. The link below gives some very sound advice on what to introduce and when. The signs to look out for which would suggest your child has an intolerance to or is allergic to a certain food or group of foods.
Your Health Visitor is a good person to speak to, so is your GP. If your child is showing signs of an allergy or intolerance you may be referred to a Dietitian for further specialist support. If you have concerns about allergies it is important to seek medical assessment and advice from your healthcare team.
https://www.nhs.uk/start-for-life/baby/weaning/safe-weaning/food-allergies/
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Speech and Language Therapists are specially trained to understand how the muscles in the mouth and throat work - not just for talking, but for eating, drinking and swallowing too.
Swallowing is a complex process that involves many parts of the body, including the tongue, lips throat and voice box. These are the same muscles we use to speak, so speech and language therapists are experts in this area.
We work to:
Make mealtimes safer - by reducing the risk of food or drink going down the wrong way (also known as aspiration - see FAQ What is aspiration?).
Support nutrition and growth - by helping your child achieve their potential to eat and drink as safely and effectively as possible.
Improve comfort and confidence - so mealtimes are less stressful for your child and your family.
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Gagging and choking are different responses to food.
Gagging is a normal reflex that happens when a baby learns to chew and swallow food. It is loud and can involve coughing or retching and a baby may go red.
Choking, is silent and may be accompanied by distress. Someone who is choking cannot breathe or speak (make sounds) because their airway is blocked by the piece of food or other object. Someone who is choking may turn blue, or pale. This is a life threatening situation and needs attention in the UK you should dial 999 for support.
If you are worried about your preschool child choking, ask your Health Visitor or GP for advice on dealing with choking episodes. If your child is older, speak to the School Nurse or your GP for advice. If you find you are dealing with choking episodes requiring back slaps on a regular basis your child may need a Speech and Language Therapist’s assessment. Ask your GP or Health Visitor for a referral.
The link below will take you to NHS ‘Start for Life’ webpage where you can find advice on dealing with a choking incident. Again, if you are concerned - speak with your GP.
https://www.nhs.uk/start-for-life/baby/weaning/safe-weaning/choking-and-gagging-on-food/
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Aspiration is the medical term for food or drink, saliva or something else, sometimes vomit, being inhaled into the lungs, instead of passing into the oesophagus (the food tube into the stomach).
Aspiration can be obvious where you will see coughing, eye tearing, gurgly voice, frequent unexplained chest infections, or it can be silent, where there are no outward signs.
If you aspirate you can still breathe and talk, but may have a gurgly voice and it may cause serious chest infections or other chest health issues over time, including pneumonia.
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This can be a source of worry. Your Health Visitor can give you lots of advice on this, but there is a link on the ‘Useful Websites’ page to Infant and Toddler Forum with useful printable leaflets - you might be surprised how little is enough. Knowing how much is enough will help reduce concerns and clarify when to seek advice.
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Weaning should be fun, but when its not, if your child simply doesn’t enjoy it, gags on new textures, or you are feeling anxious about the whole journey, I am here to help you and can offer support either in person if you are in the Midlands, or online.
The links below will give you some guidance to follow to get you started, but if you would like more support than this, or would like help adjusting this advice for your child’s specific needs, please do get in touch.
https://www.nhs.uk/start-for-life/baby/weaning/
https://infantandtoddlerforum.org/#
https://www.nhs.uk/baby/weaning-and-feeding/babys-first-solid-foods/
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Yes absolutely there are some essentials that must be in place before your child can chew effectively.
They need to be developmentally ready to chew - so able to hold their head and able to sit stably and this means in supportive seating with their feet resting on a footrest.
If they are simply not ready, then sometimes it’s best just to wait a little bit longer - all babies are different. In the meantime make sure they are having experiences of mouthing a variety of teething toys or other textured toys.
You can try to grade the foods being offered - easiest to start with may be melting crisps, then soft cooked vegetables moving on to firmer textures as they master each stage. There is plenty of advice out there for weaning foods (see links below). Check the contents on any packets to make sure they are developmentally appropriate and do not contain anything your child might be intolerant of or allergic to.
https://www.nhs.uk/baby/weaning-and-feeding/babys-first-solid-foods/
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Keep a diary of the times of day this happens, any particular foods or drinks and speak to your GP, particularly if your child is experiencing frequent unexplained chest infections, has colour changes when eating and drinking such as blue, pale or red, has eye tearing when coughing and spluttering.
They may refer you to your local Speech and language Therapy Dysphagia Team for advice and support. If not you can contact me for support and advice, or support while you are waiting to see your local team, depending on the wait times in your area.
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When babies move from breast or bottle to cup feeding they have to learn a whole new way of moving fluid in their mouth and swallowing - sometimes this is an easy transition, sometimes they might struggle to coordinate sipping and swallowing resulting in coughing and spluttering.
Things that can help might be to offer naturally thicker fluids in an open cup with your support to hold the cup with them. The thicker fluid moves more slowly giving them time to learn to sip and swallow. Offering a straw cup can also help with this transition and help to reduce the amount of drink they take in each time they suck.
Make sure you are using free flow beakers and straw. cups though as this will ensure you give their teeth and drinking skills best chance of development along typical lines.
If you are concerned about coughing and spluttering and the above does not help then speak to your GP or Health Visitor about a referral to your local Speech and Language Therapy Service. Or you can contact me for an assessment and advice.
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Mind and Emotion Reset. Hypnotherapy offers a calm, focused space to support your wellbeing, manage stress and reconnect with your inner resources.
It offers support to manage anxiety, reduce overwhelm, lifting low mood, improving sleep and rest. Offering gentle post natal emotional support, also working through common feelings of “not being enough” or “getting it wrong”.
Rebuilding confidence and calm, preparing for challenges like hospital appointments, transition to school and creating calm reset moments.
This technique can also help to reduce or eliminate phobias.
Hypnotherapy sessions with me cost £120 for the initial session and £95 after this - packages are available contact me to find out more
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Reset your mind and emotions
IEMT is a gentle, non-invasive technique that uses guided eye movements to help process negative emotional responses and chronic patterns of distress. Unlike talk therapy, it doesn’t require you to share your whole story or re-expose you to painful memories - in fact you don’t need to explain the details at all.
IEMT can help reduce feelings of guilt, overwhelm or anger that keep resurfacing, build emotional resilience, alter identify based issues such as self worth and confidence as well as address behavioural patterns and emotional triggers.
This technique can also work well to reduce or eliminate phobias.
Sessions cost £120 for the initial session and £95 for sessions after this. Packages are available contact me to find out more.
Disclaimer:
External links are provided for informational purposes only. I am not affiliated with these organisations and cannot guarantee the accuracy of their content. Please seek direct advice from your healthcare provider or local services if you have concerns about your child’s health or safety.