Aspiration pneumonia occurs when food, saliva, liquids, or vomit is breathed into the lungs or airways leading to the lungs, instead of being swallowed into the esophagus and stomach. This causes inflammation of the airways and infection of the lungs (pneumonia).

When your child swallows food, it passes from the mouth down into the throat. This is called the pharynx. From there, the food moves down through a long tube (esophagus) and into the stomach. This journey is made possible by a series of actions from the muscles in these areas. If your child has swallowing difficulty or dysphagia, the muscles don’t work normally. They cause problems with the swallowing process.

Who are at risk of developing aspiration pneumonia?

Children with any of the following problems are at risk of developing aspiration pneumonia:

• Gastroesophageal reflux. When contents of the stomach come back in the throat.
• Abnormal anatomy, such as a cleft palate or a problem in the esophagus
• Delayed growth, from premature birth or a condition such as Down syndrome
• Brain damage or other problems, such as from cerebral palsy or infection
• Problems with the cranial nerves that control the muscles of swallowing
• Neuromuscular disease, such as spinal muscular atrophy
• Medical procedures, such as a nasogastric tube or a tracheostomy

What are the indicators of aspiration?

Children with aspiration usually show the following symptoms and signs:

• Choking or coughing while feeding
• Other signs of feeding trouble, like a red face, watery eyes, or facial grimaces
• Stopping breathing while feeding
• Faster breathing while feeding
• Voice or breathing that sounds wet after feeding
• Slight fever after feedings
• Wheezing and other breathing problems
• Repeated lung or airway infections

These symptoms may occur while feeding or sometime after feeding. Symptoms may differ with age of the patient.

How do we diagnose Aspiration?

There are several tests that can be used to demonstrate aspiration in a baby or child. Clinical assessment is most important in diagnosing aspiration. Thorough history and clinical evaluation of swallowing should be done in the pediatric pulmonologists’ clinic

If aspiration is suspected strongly by clinical assessment the following tests can be done.

• Chest Xray or CT scan chest
• Videofluroscopic swallow study
• Fibreoptic endoscopic evaluation of swallowing (FEES)

These tests can be performed and analysed by a pediatric pulmonologist. TO know more about these tests READ HERE

What is the treatment of aspiration pneumonia?

Treatment for aspiration may vary depending on the cause and severity. Treatments for your child may include:

• Making changes in position and posture during meals
• Changing the thickness of liquids
• Changing the types of foods in your child’s diet
• Doing exercises to help with swallowing (for an older child)
• Medicines for GERD
• Surgery to reduce reflux
• Surgery to correct a problem such as a cleft palate

If the child is at high risk of aspiration pneumonia, he might require a tube which is inserted through the nose into the stomach and can be used to feed the child.