Feeding difficulties in the first days of life: findings on upper gastrointestinal series and the role of the videofluoroscopic swallowing study

Abstract

Background. Feeding difficulties in the newborn period are a common indication for an upper gastrointestinal (UGI) series.

Objective. To review the radiological findings in infants with feeding-related difficulties, with no other medical problems, and to evaluate the role, if any, of the videofluoroscopic swallowing study (modified barium swallow, MBSW).

Materials and methods. We retrospectively reviewed all the UGI and MBSW studies performed at our institution over a 5-year period in infants under 1 month of age. We found a total of 77 patients referred for feeding-related problems.

Results. All patients had at least one UGI study performed at our institution, and 17 patients had at least one additional MBSW. The most frequently found abnormality that could directly account for the patients' symptoms was swallowing dysfunction. This was detected in 19 patients; in 10 of these patients the swallowing dysfunction was seen only on the MBSW.

Conclusion. Swallowing dysfunction with aspiration is a common cause of feeding-related difficulties in childhood. In infants with feeding difficulties, a MBSW may demonstrate aspiration when the UGI is negative.