Aspiring To End Aspiration

Barium Swallow Study revealed that Andi aspirates on thin liquids. 

Aspiration is: 
Aspiration can occur when there are problems with swallowing and/or in conjunction with gastroesophageal reflux (GER). Aspiration can result from a primary swallowing dysfunction or from lack of coordination between sucking, swallowing, and breathing. Infants with increased respiratory rate may be at increased risk of aspiration.
Respiratory consequences of aspiration can be severe. When aspiration is suspected, families should be promptly referred for further diagnosis and treatment.

So ... what do we do about it?!

Treatment of GER. Please see section on gastroesophageal reflux.

Modification of the food or feeding positioning: Sometimes VFSS shows that an infant can swallow thickened feeds, foods with temperature alterations, or foods with other changes in characteristics. In this case modified feedings may be given. Adequate fluid, energy, and nutrient intake should be assured when modifications are made. This treatment should always be frequently and carefully monitored. Infants with nippling problems or GER may have difficulties with thickened feedings. Adequacy of fluid intake should be assured when feedings are thickened. For more information, see Feeding and Swallowing Disorders in Infancy by Wolf and Glass.

Pacing of feedings: Caregivers may promote more appropriate coordination of suck-swallow-breathe by helping the infant to "pace" the feeds. Referral to a feeding therapist is appropriate for further assessment and for caregivers teaching.

Elimination of oral feedings: Aspiration that can not be successfully treated in other ways may require at least temporary elimination of oral feedings. In this case, referral for ongoing therapies to maintain appropriate development of oral motor skills is essential if oral feedings are to be successfully reinstated.

Infants at risk for aspiration associated with BPD and increased respiratory rate should be referred to a specialist for management of BPD.

We're to work on the pacing of feeds, 3 times a day and no thin liquids - such as water or pedialyte by mouth, and no disolvable solids -- only purees. I'm hoping this won't set us back too long on a g-tube removal party I hope to throw with glee.  And to quote the lady who might've seen my disappointment at the news, said, 'hey, it's information and that's a place to start.'