modified barium swallow

[Anonymous]

I wanted to do a modified barium swallow for Hailey, but I was told that since Hailey doesn’t take a bottle on command the couldn’t be done properly. I spoke to the therapist who assessed Hailey a while back, and she said that in order to get accurate results, the baby has to feed while awake and willingly (i.e. voluntary sucking, not by syringe or force feeding). She said that if the baby is feeding while asleep, their suck is often weak and uncoordinated and the swallow can also be delayed, and if they are not eating willingly, then they often show the same signs along with pooling of liquid at the back of the throat as they do not want to eat. She said that this will give invalid results, and so this test is not be done for Hailey.

Just wondering if you heard the same thing, and how you got your non-eaters to eat willingly for this test.

[Anonymous]

Lori – are you able to add any sort of flavouring to the bottle for when you do the test? If so then I would add some golden syrup or do you guys have strawberry or vanilla Nesquick? I would put anything that tastes really good in there.

[Anonymous]

I have never done a modified on a baby, I worked in a regular hospital who didn’t do many pedi cases. So I only know how they did elderly patients……..I would say what you were told sounds right to me. Most of the patients I saw were just coming out of comas or being assesed because they couldn’t verbally communicate but they were all alert and ate on command. Occasionally we would get a fiesty patient who wouldn’t eat or open their mouth and the exam would have to stop.

As far as taste, they usually added chocolate syrup and changed consistancies with each try. I know that is a none issue if they aren’t doing the test.

Good luck

[Anonymous]

Thanks for the suggestions, Amber. Unfortunately, nothing tastes good to Hailey- at least not good enough to get her to eat on command. I already tried the nesquick, and she hated it. We also currently add some golden syrup to each bottle, which hasn’t overall made a difference.

Donna, thank you again for the explanation. I really wanted to get this test done to ensure that she doesn’t have a problem swallowing, but she says it can be done under those circumstances. I’ve just heard so much cr** along the way that you don’t know who you can trust or who knows what they’re talking about. I thought that some babies on the site had their test done with syringe feeding, so I just wanted to make sure. Thanks for clearing things up.

[Anonymous]

Lori,

Thats really interesting. Noah, as you know, doesnt take the bottle very willingly, but they did the test for us. He actually sucked on the bottle for about 10 seconds and then started biting on the nipple. So they used a sryinge for the remainder of the test. Interestingly enough, Noah’s results were exactly as you listed above, with the addition of poor extraction of liquid from the nipple, and poor bolus formation. He did the delayed swallow and pooling at the back of the throat. Now it makes me wonder if this is a true issue or if he only had it because he wasnt interested in eating. The OT and SLP who preformed the test didnt mention anything that your therapist did.

I think I honestly would still push for the test because you will atleast know if she is able to clear her airway or if she aspirates.

[Anonymous]

They won’t do it. They said that they’ll listen to her chest first and something else while she’s sucking (if she’ll do it), and then if there are signs indicating a problem, then they would do it but there would be a month wait. She is definitely not aspirating, though I know that she does have problems some times on thin liquids- wondering though if it’s because she’s asleep.

[Anonymous]

Lori, I will ask our OT. We have already done 2 swallow studies and we go to therapy 2 x a week. I’m sure somebody has run into the same situation before. Sarah

[Anonymous]

Thanks Sarah. I spoke to one of my colleagues today who’s an SLP, and she agreed with this…she said that they can do it, but that the results would be hard to interpret because a child who’s being force fed does not swallow in the same way as a child who is being normally fed. She said that it could even CAUSE aspiration. But I always like to hear what others have to say. Thanks again.

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