Back to fact sheets
Print Friendly, PDF & Email
Children’s Health Queensland Hospital and Health Service Children’s Health Queensland Hospital and Health Service

Dysphagia (swallowing difficulties) in children fact sheet

Dysphagia (swallowing difficulties) in children

Swallowing difficulties (also known as dysphagia) can affect children of all ages. Children with swallowing difficulties may find it hard to eat and drink safely. They are also at an increased risk of medical complications such as aspiration pneumonia (chest infections).

Common causes of swallowing difficulties

Swallowing difficulties can occur for a variety of reasons including:

  • neurological conditions e.g. epilepsy, cerebral palsy, brain injury
  • prematurity / very low birth weight
  • breathing and/or respiratory difficulties e.g. need for oxygen, chronic neonatal lung disease (CNLD), laryngomalacia
  • ear, nose and throat (ENT) issues e.g. choanal atresia, tracheostomy, laryngeal cleft, vocal fold palsy
  • complex medical conditions e.g. cardiac conditions, VACTERL association, oesophageal atresia
  • side effect of medication.

Signs and symptoms

Signs and symptoms of swallowing difficulties in children that may occur during or after feeding may include:

  • coughing / throat clearing
  • choking / gagging
  • multiple swallows
  • refusal to eat certain food textures
  • watery or teary eyes
  • nasal congestion
  • colour change (e.g. turning blue around lips)
  • wet/gurgly breathing or wet/gurgly voice
  • rapid or increased breathing rate
  • stridor (a high-pitched wheezing sound)
  • wheezing
  • apnoea (longer than normal pauses in breathing)
  • recurrent chest infections/illness.

Consequences of swallowing difficulties

Swallowing difficulties can lead to:

  • aspiration
  • chronic lung disease
  • dehydration
  • aspiration pneumonia (chest infections)
  • poor weight gain/malnutrition
  • oral aversion (reluctance/avoidance/refusal to eat/drink).

What is aspiration?

Aspiration is when food, drink or other material enters the trachea (airway) and passes below the level of the vocal cords (towards the lungs). There are two different types of aspiration:

  • primary aspiration: aspiration of saliva, food or drink
  • secondary aspiration: aspiration of reflux or vomit.

Aspiration can be ‘silent’. This means that a child does not show any overt signs of swallowing difficulty e.g. coughing, choking, throat clearing.

Contact us

Speech Pathology Department
Level 7, Queensland Children’s Hospital
501 Stanley Street
South Brisbane 4101
t: 07 3068 2375

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

Resource No: FS320. Developed by the Speech Pathology Department, Queensland Children’s Hospital. Updated: July 2018. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.


  1. Pediatric Dysphagia: Overview. (2017). Retrieved 20 September 2017, from
  2. LaMantia, A., Moody, S., Maynard, T., Karpinski, B., Zohn, I., & Mendelowitz, D. et al. (2016). Hard to swallow: Developmental biological insights into pediatric dysphagia. Developmental Biology, 409(2), 329-342.
  3. Kakodkar, & Schroeder. (2013). Pediatric Dysphagia. The Pediatric Clinics of North America, 60(4), 969-977.
  4. Speech Pathology Australia. (2012). Dysphagia Clinical Guidelines [Position statement]. Retrieved from