Hi Laura

Has this baby had chest infections? Was the baby used to taking bottles before the test was performed. The test constitutes of looking at a moving x-ray with the baby drinking or eating. As the baby is breastfeeding it is not possible to get an accurate indication of aspiration. Aspirating on a non-familiar bottle does not imply aspiration when breastfeeding. Ultrasound is now being investigated as a more accurate way to look at breastfed babies swallowing. Thickening is used to slow down the flow of milk so that the baby has more time to organize the swallow. The mother can ask if this is the case and whether there is an option of her trying strategies to slow the flow of the breast milk e.g. feeding against gravity, application of pressure on the nipple, pumping off the first let down etc. Aspiration is associated with chest infections and pneumonia, but if there has been no chest infections the mother should ask for what reason the breastfeeding is stopped. 

 Chin tuck is a strategy with some evidence base in adults with swallowing issues. I am not aware of any evidence that the same is true for babies. Their anatomy is very different from adults and therefore strategies cannot merely be generalized from adults to paediatrics.

Loraine

Loraine Hamm
SLT/IBCLC
New Zealand

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