Can you tell me what is done and why one was done on your child?

Allie is gagging majorly on solid food again and I'm wondering if I should request one.

What do they do exactly?

Thanks,
Christyn

Christyn - We haven't done one, so I'm sorry I can't help out. I was thinking you might also want to post this in the testing and procedures forum ecause there might be lots of folks in there with your experience.

good luck!

Sebastian is going to be having one if I can every get Dr. J's nurse to call me back and set it up.

She wants to do it becasue of his choking and rattly breathing and becasue he makes a glurpy nose when he eats solids but not the bottle. She had having problems with different consistencies means there could be a swallowing issue.

She said it was the same as the upper GI but they look at how he is swallowing. I will let you know all about it, if we ever get it done.

Daniel had a swallow study when he was about ten months old. They put him in a chair and "gave" him a bottle filled with [um, I don't remember what it was, something that they could see on the screen] and watched it pass along his tongue and down into his system.

I don't know exactly what they were looking for, but apparently everything was normal. Which was shocking since D was only sleep-feeding at the time, so he basically screamed the entire time he was in the chair as they squirted formula at his mouth. (Since his cleft palate hadn't yet been repaired, he could only use squeeze bottles.)

D's swallow study was done back to back with his second upper GI, and I think the main reason the GI requested it was so an ST and doctor would be present. Our first upper GI was a total waste since the radiology tech was a major *** and looked at D's belly after he took perhaps one tiny sip of formula. The second time, the GI assembled a team who'd be more understanding of D's situation.

Connor had a swallow study done at 2 months old due to choking on his formula. It showed he wasn't aspirating. We are actually scheduled for another one the beginning of Oct because he also gags on food. I'm not sure if they just check to make sure they are able to swallow or what exactly they look for. I know that there is an ST present and they mix the formula to different consistancies to see how they do with each one. I think it would be worth it to have one done with Allie. Sorry I'm not of much help but we are in the same boat as you guys:hug:

KC had the swallow study done when he was about 3 months old. They were looking to make sure it was going down the esophagus and not the trachea. And to make sure his esophagus was properly connected.

A swallow study also called a modified barium swallow (MBS) or videofluoroscopic swallow study (VFSS) is very similar to an upper GI series. A radiologist and a speech language pathologist most likely will be present and will videotape the study for further review following the actual study. Barium will be mixed into various foods and drinks. The evaluator may observe the infant or child swallowing various textures of foods and thin liquids and possibly thicker liquids if needed. Most evaluators try to have the feeding be as close as a typical feeding situation so that they can study his typical swallowing pattern, so they may ask you to bring your infant or child’s own bottle, spoon, cup etc. and possibly some of the foods and drinks your infant or child typically has at home. Of course it is nothing like a typical feeding as the child will be in the radiology suite and will have to be positioned upright - possibly in a special seating system that gives them the observers the best view of the swallowing process.

The evaluators will watch the infant or child orally prepare the bolus (the portion of food or drink taken into the mouth) for swallowing - at this stage they are looking to see how well he chews his foods or pools liquid and transfers it to the back of the mouth for swallowing. Then they will look at the pharyngeal phase of swallowing - at this phase they are looking to see how efficiently the bolus passes through the pharynx. They want to make sure the swallow is strong enough to pass the bolus onto the esophagus and to make sure there is no pooling in the several sinus cavities in the pharynx. If this happens the pooled material can later spill out and penetrate the trachea and into the lungs. Some studies follow the bolus through the esophagus and into the stomach but not all do. They will also look at his ability to clear his airway if it is penetrated- if a cough is triggered and clears the airway. They will look to see if his swallow pattern changes over time.

Pamela Tyler MS CCC SLP
What is Feeding Therapy?
Retrieved 9-15-06 from http://www.reflux.org/Reflux/webdoc01.nsf/(vwWebPage)/Feedingtherapy.htm?OpenDocument

Christyn:

Pamela has given you an excellent description of a modified barium swallow study, which looks at the oral, pharyngeal, and esophageal phases of the swallow with fluoroscopic imaging. I perform MBS studies if you have any specific questions.

Red flags that would indicate a need for a MBS study would include coughing and choking while drinking, frequent colds or upper respiratory infections, low grade fevers or "gurgly" sounds during and after eating, and inability to swallow certain foods. We are able to look at anatomical abnormailites with the radiologists as well. MBS studies are performed by OT's, speech therapists, and radiologists. We do look at all food textures and liquid consistencies while trying to simulate how your child eats and drinks at home with the drinking utensils/flow rates you use.

Please write back if you have any other questions.

Robynne

Christyn:

Pamela has given you an excellent description of a modified barium swallow study, which looks at the oral, pharyngeal, and esophageal phases of the swallow with fluoroscopic imaging. I perform MBS studies if you have any specific questions.

Red flags that would indicate a need for a MBS study would include coughing and choking while drinking, frequent colds or upper respiratory infections, low grade fevers or "gurgly" sounds during and after eating, and inability to swallow certain foods. We are able to look at anatomical abnormailites with the radiologists as well. MBS studies are performed by OT's, speech therapists, and radiologists. We do look at all food textures and liquid consistencies while trying to simulate how your child eats and drinks at home with the drinking utensils/flow rates you use.

Please write back if you have any other questions.

Robynne

Robynne,

Thank you so much for your response. Allie does very well with her bottle now - (she used to have major aversions to it) and does not choke, cough, or have rattly breathing during or after eating. She "sucks it down" so to speak. She has had very few colds (yeah!) or URI, and only one ear ache that we know of. She has never ran a fever.

However, she does gag on food in the high chair, but not always (mind you - she doesn't eat much - she has a major solid food aversion that we're working on). When she gags, she does it so bad she usually makes herself vomit. Based on what you said, maybe it's just a texture thing and not an issue with her swallowing? I don't know that putting her through a swallow study would be beneficial b/c I don't think she would voluntarily eat in that type of setting (we usually have to pop in baby einstein to get her to drink her bottle).

Thanks again. It is so nice having you here!

Christyn