Benefits of thickened feeds in previously healthy infants with respiratory syncytial viral bronchiolitis

Abstract

Infants with respiratory syncytial virus (RSV) bronchiolitis have an increased risk of aspiration. The optimal feeding strategy for these patients has not been described. Fifteen previously healthy and clinically stable infants with RSV bronchiolitis underwent video-fluoroscopy studies to assess swallowing using thin barium. Those with abnormal studies underwent a repeat study, using barium that was thickened with rice cereal. Nine of 15 infants had abnormal studies with thin barium. Laryngeal or tracheal penetration with thin barium was seen in 3 and 2 infants, respectively, but not with thickened barium. Aspiration of thin barium was seen in 4 infants, but it corrected in 3 of these 4 infants with thickened barium. Thickened feeds provide a simple, safe, and cost-effective intervention to improve swallowing dysfunction and prevent aspiration in infants with RSV bronchiolitis.

Feeding Problems and Their Underlying Mechanisms in the Esophageal Atresia–Tracheoesophageal Fistula Patient

“…In a study of 15 infants with respiratory syncytial virus bronchiolitis, 9 were found to have abnormal VFSS studies (laryngeal or tracheal penetration or aspiration) with thin barium. However, repeat studies with thickened barium improved these abnormalities in all but one patient (66). In adult patients with neurogenic dysphagia, increasing bolus viscosity significantly improves the safety and efficacy of deglutition (67).…”

Aspiration: A factor in rapidly deteriorating bronchiolitis in previously healthy infants?

“…Further, prevention could be as simple as providing thickened feeds to infants with RSV bronchiolitis. 11…”

Long‐term follow‐up of oropharyngeal dysphagia in children without apparent risk factors

“…Several studies suggest that oropharyngeal dysfunction occurs in children who are without known risk factors 8,9 and also demonstrate that early identification of the problem and prompt initiation of appropriate treatment may reduce the morbidities associated with swallowing dysfunction. 9,10 This study was undertaken because the presence and nature of swallowing dysfunction in children with unexplained respiratory symptoms at the time of pre-sentation continues to be under appreciated and we have found more variability in the clinical presentation than was previously reported. This is the first investigation to demonstrate this variability in respiratory presentations and detail the specific radiologic abnormalities associated with the swallowing dysfunction in this population.…”