Evaluating the Clinical Symptoms of Neonates with Suspected Dysphagia

ABSTRACT

OBJECTIVE: To evaluate the prevalence of dysphagia in neonates who showed abnormal findings on videofluoroscopic swallowing studies (VFSSs), and to compare the accuracy of the clinical evaluation with the VFSS results. METHOD: A clinical investigation of 142 neonates admitted to a neonatal intensive care unit was carried out to evaluate the presence of low O2 saturation (<80%), symptoms of cyanosis, coughing and/or vomiting, nasal regurgitation, drooling saliva, voice change and crying during feeding. VFSSs were performed on the neonates who had at least one of these clinical abnormalities. RESULTS: Of the 142 patients, 37 (26.1%) had at least one of the clinical symptoms of dysphagia. Twenty two of 37 (59.5%) showed abnormal findings on the VFSS. The patients exhibiting cyanosis and coughing during feeding had a higher incidence of aspiration (11 of 11, 100%) on the VFSSs than did the patients with other symptoms cyanosis (3 of 13, 30.8%), cyanosis with vomiting (0 of 2, 0.0%), coughing without cyanosis (2 of 5, 40.0%), voice change (2 of 2, 100%) and nasal regurgitation (1 of 3, 33.3%). CONCLUSION: The prevalence of laryngeal penetration or subglottic aspiration among those neonates who were clinically suspected of dysphagia was 59.5%. Coughing with cyanosis during feeding was the best predictor of both these abnormalities.