Restriction of oral intake of water for aspiration lung disease in children

Weir, Kelly A.; McMahon, Sandra; Chang, Anne B.

doi:10.1002/14651858.cd005303.pub3

Cited by 8 publications

(8 citation statements)

References 30 publications

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“…Indigenous children who aspirated during swallowing in our series were more likely than other children who aspirated to have had an LRTI. Several authors 23, 24 have demonstrated that aspiration may be a significant risk factor for LRTI only if there are other co‐occurring factors. Boesch et al11 have stated that the “threshold of what constitutes pathological aspiration in a given individual may vary.” In a study of infants undergoing VFSS, Newman et al demonstrated comparable numbers of infants with and without aspiration had had pneumonia 25.…”

Section: Discussionmentioning

confidence: 99%

Is aspiration during swallowing more common in Canadian children with indigenous heritage?

Rempel

Borton²,

Esselmont

et al. 2011

Pediatric Pulmonology

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While many factors that contribute to the occurrence of lower respiratory tract infections (LRTI) in Canadian indigenous children have been described, the role of aspiration during swallowing has not been explored in these children. Because of an increase in referrals of indigenous children from our catchment area (Manitoba, North Western Ontario, and Nunavut) for assessment of aspiration during swallowing, we retrospectively reviewed the clinical records of 325 consecutive children undergoing videofluoroscopic swallowing studies (VFSS) to evaluate which factors, including indigenous heritage and LRTI, were associated with aspiration during swallowing. Our sample had an overrepresentation of indigenous children (35% compared to 23% in the catchment area). These children were more likely to aspirate during swallowing (P = 0.001) and to have experienced an LRTI prior to the VFSS (P = 0.000). When separating the children who aspirated into two groups based on indigenous heritage, the indigenous children were more likely to have had an LRTI (P = 0.028) than the other children in the sample. With logistic regression analysis, significant correlations between indigenous heritage, LRTI (P = 0.000), and aspiration (P = 0.009) were found. When aspiration during swallowing was the factor of interest, it correlated with both LRTI (P = 0.001) and the presence of congested upper airway noises after eating (P = 0.000). These upper airway noises were strongly associated with aspiration in indigenous children (P = 0.004). While prospective data are required to determine if the correlations seen in this retrospective review will remain robust, indigenous children were more likely to aspirate during swallowing and have LRTI in this sample. Whether aspiration during swallowing is related to environmental, ethnic, or biological factors in indigenous children remains to be determined, but the association between aspiration and congested upper airway noises after eating may assist in the early diagnosis of aspiration during swallowing, and thereby enable timely intervention to decrease aspiration risk in children already at risk of repeated LRTI due to a number of other confounding factors.

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Section: Discussionmentioning

confidence: 99%

Is aspiration during swallowing more common in Canadian children with indigenous heritage?

Rempel

Borton²,

Esselmont

et al. 2011

Pediatric Pulmonology

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“…Of interest, Weir et al [58] performed a systematic review questioning the practice of restricting oral intake of water for children with demonstrated aspiration of thin fluids. They concluded that there is currently insufficient evidence to support either a strict approach of full restriction of oral intake of water or a more liberal approach of allowing oral water ingestion.…”

Section: Management Of Pediatric Swallowing Disordersmentioning

confidence: 99%

Pediatric Dysphagia: Physiology, Assessment, and Management

2015

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Infancy and childhood represent a time of unparalleled physical growth and cognitive development. In order for infants and children to reach their linear and neurological growth potential, they must be able to reliably and safely consume sufficient energy and nutrients. Swallowing difficulties (dysphagia) in pediatric populations can have a detrimental effect on dietary intake and, thus, growth and development. As a result, it is imperative to accurately identify and appropriately manage dysphagia in pediatric populations. This article provides an overview of dysphagia in children, as well as common causes of childhood swallowing difficulties, populations at risk for pediatric dysphagia, techniques used to assess swallowing in pediatric patients, and the current treatment options available for infants and children with dysphagia.

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“…There are no studies on the safety of allowing children with dysphagia to have plain unthickened water. 7 In limited studies done on animal models and adults, no significant differences were found in the availability of fluid for hydration between thickened liquid and water. Also, no differences in fluid absorption were found with different viscosities.…”

Section: Issues With Thickened Liquidsmentioning

confidence: 99%

“…[2][3][4][5][6] There is very limited high-quality research in either children or adults to support the use of thickeners to reduce aspiration and aspiration pneumonia. 7,8 Questions have arisen in new, large studies in adults showing increased complications with aspiration of honey-thick liquids (see the appendix for definitions). 9 This research demonstrates that using thicker liquids does not necessarily make swallowing safer for all patients.…”

Section: Introductionmentioning

confidence: 99%

Addressing Nutrient Density in the Context of the Use of Thickened Liquids in Dysphagia Treatment

McCallum

2011

ICAN: Infant, Child, & Adolescent Nutrition

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Thickening liquids has become a standard of practice for managing children with oropharyngeal dysphagia. A variety of commercial products have been developed from guar gum, xanthan gums, and modified corn starch. Practitioners and families are also trying to thicken liquids with available foods, such as infant rice cereal, yogurt, strained baby foods, and instant potato flakes. Throughout this process little consideration is given to the impact of the use of different thickeners on the nutrient density of human milk, formula, or other beverages. Various fluids were thickened by the author using different products to achieve National Dysphagia Diet nectar-like, or honey-like consistencies. Nutrient analysis of the calorie effect of the thickeners was calculated using the USDA Agriculture Research Service Nutrient database, manufacturer information, and displacement factors to evaluate the effects on calories per ounce of the thickened fluids. Considerations of thickener choice on other nutrients are discussed, including potential for toxicity of nutrient loads with specific thickeners. No one thickener is appropriate for all patients, but the characteristics of the various thickeners need to be understood. The assessment of the individual patient by an interdisciplinary team, including a registered dietitian should determine the patient's specific needs before recommending a thickener.

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Restriction of oral intake of water for aspiration lung disease in children

Cited by 8 publications

References 30 publications

Is aspiration during swallowing more common in Canadian children with indigenous heritage?

Is aspiration during swallowing more common in Canadian children with indigenous heritage?

Pediatric Dysphagia: Physiology, Assessment, and Management

Addressing Nutrient Density in the Context of the Use of Thickened Liquids in Dysphagia Treatment

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