Information taken from American Speech-Language Hearing Association (ASHA) and Children’s Hospital and Medical Center in Omaha


Aspiration refers to food or liquid falling into the lungs during swallowing.  During a normal swallow, food and liquid should travel from the mouth to the esophagus.  The airway should close off to stop food and liquids from entering.  Penetration occurs when food or liquids enter the airway and aspiration occurs when food or liquids enter the lungs.  Aspiration is a serious condition which can cause respiratory problems, such as pneumonia.


There are observable signs that accompany aspiration; however, it should be noted that aspiration can also be silent with no observable symptoms.  A modified barium swallow (swallow evaluation) will need to be completed to determine if a child is silently aspirating.  Furthermore, these signs may show up inconsistently.  Please contact a medical professional if your child exhibits any of the following signs.  If you have any doubts or concerns it does not matter how infrequent symptoms may present.

Signs of aspiration:

  • Coughing or gagging when eating or drinking
  • Choking
  • Color change or eye reddening during or after feedings
  • Gurgley vocal quality during or after eating or drinking
  • Poor weight gain
  • Increased feeding periods that take more than 30-40 minutes
  • Poor coordination of swallowing or sucking
  • Aversive responses (refusal) to food or liquids
  • Irritability before, during, or after feedings
  • Poor coordination of breathing during feedings
  • Recurring pneumonia or respiratory infections

Risks for aspiration:

  • Children with neuromuscular disorders (i.e., Cerebral Palsy)
  • Children who have excessive drooling
  • Children with a history of gastroesophageal reflux disease (GERD)
  • Infants who were born prematurely
  • Infants / children with chronic heart disease
  • Infants / children with craniofacial abnormalities (i.e., Cleft Palate)
  • Infants / children with congenital syndromes
  • Children with upper airway anomalies
  • Children who have had a brain injury
  • Children (especially under the age of 2) who are receiving tube feedings


Aspiration is a common result of a feeding and swallowing disorder.  Aspiration occurs when the swallowing mechanism malfunctions and allows food to pass into the airway and lungs.  This can be caused from a variety of conditions, many of which were listed above in the risks of aspiration section.


Therapy will vary depending on the cause and symptoms of your child’s swallowing problem.  Treatment may include medical intervention (i.e., medicine for reflux), direct feeding therapy, postural or positional changes, and nutritional changes.  Feeding therapy will often include making the muscles of the mouth stronger, improving chewing skills, improving sucking ability, and increasing tongue movement.


We may recommend a videofluoroscopic Swallow Study (VFSS) if your child is presenting with any signs or symptoms of aspiration.  A VFSS is a procedure that is completed under a moving X-Ray to determine if food or liquid particles are entering the airway or the lungs.  This procedure helps to determine which food textures and circumstances are safest for a child.  At Key Therapies we will work closely with other medical professionals to determine what diet is safest for your child.  Furthermore, we will create a treatment plan for your child and give recommendations to work on at home.

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