Video 2 - Grossly abnormal swallowing in an infant. (Severe pharyngeal phase dysphagia.)

A 7-month-old infant was referred for VFSS by her primary pediatrician because of concerns related to risks for aspiration while feeding orally. She was a term infant with intrauterine growth retardation. An upper GI examination a few days prior to this examination had revealed occasional silent aspiration with swallowing, gastroesophageal reflux, and mild gastritis, and vomiting. She had mild developmental delays with hypertonicity.

This infant was very eager to take her bottle. This section of the VFSS shows multiple aspiration events with the first aspiration occurring at the initiation of the fourth swallow. The aspiration appeared most closely correlated with timing and coordination deficits. With increased residue in the pharynx, particularly in the pyriform sinuses, she also aspirated as residue spilled into the open airway following some swallows. She made no response to the aspiration, but she kept sucking eagerly. She fussed when the nipple was taken out of her mouth. Thickening liquid did not eliminate aspiration events. She did not aspirate with spoon feeding (not shown in this section).