Aspiration

Question 1

Aspiration

Answer 1

Important in setting risk LRTI
History
- Coughing/choking/gagging/cyanosis/wheeze with feed
- Types of feeds ?modified diet
- Drooling/noisy breathing
- Relationship between feeds and symptoms

Examination

• Posture
• Drooling
• Cough/gag
• Tongue
• UA noises
• Anatomical anomalies e.g. cleft lip/palate
• Increased WOB

Investigate

• Observe feed
• CXR
• VFSS
• Barium meal/swallow

Manage

• Upright posture post feeds
• Thicken feeds
• PPI to reduce gastric acidity
• Trial NJT
• Fundoplication
• PEG +/- PEJ

Consider cause

• Above: cleft, micrognathia, bulbar palsy
• Below: GORD