Thickened Liquids Improve Infant Swallow Function as Measured by Penetration‐Aspiration Scale Score on Videofluoroscopic Swallow Study

Thickened liquids are commonly used to treat oropharyngeal dysphagia in infants but the extent to which each viscosity improves swallow function is not well understood. Our objective was to determine improvements in swallow function with provision of thickened liquids as measured by penetration-aspi...

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Published in:Pediatric pulmonology Vol. 60; no. 11; p. e71363
Main Authors: Golden, Clare, Kim, Michael, Larson, Kara, Duncan, Daniel R.
Format: Journal Article
Language:English
Published: United States Wiley Subscription Services, Inc 01.11.2025
Subjects:
Deglutition - physiology
Deglutition Disorders - diagnostic imaging
Deglutition Disorders - physiopathology
Deglutition Disorders - therapy
Dysphagia
Female
Fluoroscopy
Humans
Infant
Infant, Newborn
Male
Respiratory Aspiration
Retrospective Studies
Viscosity
videofluoroscopic swallow study
oropharyngeal dysphagia
infants
penetration‐aspiration scale score
thickening
aspiration
ISSN:8755-6863, 1099-0496, 1099-0496
Online Access:Get full text
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Summary:Thickened liquids are commonly used to treat oropharyngeal dysphagia in infants but the extent to which each viscosity improves swallow function is not well understood. Our objective was to determine improvements in swallow function with provision of thickened liquids as measured by penetration-aspiration scale (PAS) score changes on videofluoroscopic swallow study (VFSS). We performed a retrospective cohort study of infants with aspiration or laryngeal penetration on VFSS. Records were reviewed for highest PAS reported, whether thickened liquids were tested, PAS for each viscosity, and PAS for viscosities recommended after VFSS. Safe swallow was defined as PAS ≤ 2. Proportions were compared with Fisher exact tests and means with t-tests. The cohort included 521 infants of whom 60% (310) had laryngeal penetration and 40% (211) aspiration with 93% (197/211) silent aspiration. Thickening was evaluated during VFSS in 71% (371) of patients and was more likely to be tested in infants that were older, had higher starting PAS score, deep and consistent laryngeal penetration, and aspiration (p < 0.001). The proportion of infants with safe swallowing was found to increase with increasing liquid viscosity with 73% (112/153) showing safe swallowing with mildly thick consistency. Of the 300 infants for whom thickening was recommended, 96% (287) were able to achieve PAS 1 or 2. Thickened liquids have a viscosity-dependent therapeutic effect in the treatment of infants with oropharyngeal dysphagia. Our results suggest it may be possible to facilitate safe swallowing in the majority of infants by using liquids at mildly thick consistency.
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ISSN:8755-6863
1099-0496
1099-0496
DOI:10.1002/ppul.71363