Could silent aspiration causing repeat chest infections?

[DizzyBlondeBexx]

My DS2 with DS age 6 months spent most of Decmber in hospital with chest infections. He would get one need oxygen be admitted, have afew days at home getting better then be struggling to breathe again. We had three admissions and two course of anti-biotics.

Drs reckon he is picking up viruses from his big Bro but I'm not convinced as he doesn't have other symptoms of virus e.g. runny nose. But doers have a red throat.

Since his first chest infection at end Aug he has had a rattle wi=hich is upper respiratory.

My mum works in stroke and she says stoke patients who make a similar noise often also aspirate.

The chest infections often follow a few days after an episode of vomitting. So I wonder if under pressure he is aspirating a little. There are no signs of mjr aspiration on xray and in general he doesn't appear to have problems.

Has anyone had experience of silent aspiration. We have consultant appointment tomorrow and any evidence you can help me with to persuade them to consider this would be much appreciated!!

Thanks!!

yes it could be if they are, eye tearing coughing chocking on food all while eating or drinking or even swallowing some of the vomit back into the lungs, there is a test they do under xray with white stuff and watch the food to see where it goes ie in stomach or lungs, as the pead where you go dd had this tests very easy to do better when younger and only on milk . good luck

Yes definatly.

My ds2 was prem & was O2 dependant until they got his reflux medicaiton sorted.

I also know children who are tube fed because aspirations caused pneumonia.

I would discuss it with his paed, its certainly worth trying some reflux medication

DizzyB - silent aspiration is normally diagnosed with a videofluoroscopy - swallow barium while a film of continuous x-rays of the swallow is taken. However if your ds is only 6 months then it is also possible that these are infections he's not yet met up with in his short life. The rattle in the upper airways can just be because he doesn't completely cough out mucus there, and not all viruses come with a runny nose.

As the others say, deffo take your concerns back to the paediatrician.

Anon - my dd2 is one of those aspirators now tube-fed. She's forgotten how to chew now.

ds is sue a fluroscophy as theres concern over aspirations he does cough and choke but other times eats fine .

But they want to see whats happening , if it shows aspiration is a tube a definte ?

No, depends what they see. If ds does cough and can recover and does not have many chest infections due to aspirations then there would probably need to be other very compelling reasons before they did a tube.

In our case I sat there holding her thinking "yeah, no coughing and spluttering, the stuff is going down the right way" and the Docs viewing the monitor were thinking "OMG the stuff is going down the wrong way and the kid isn't even coughing!" - she was losing her cough reflex.

Anyway, in her case the tube was the best thing for her and she wouldn't be with us now if we hadn't, I reckon, 4 years later.

Best of luck on the day.

ty

Ds does recover even if sometimes he gags and wretches till he is sick .Other times he make sno noise just goes red in the face

Though he does suffer repeat chest infections but think there looking at how he move sthe food down to

Hello
My ds with ds has been on reflux medication for about a year now. Even though it wasn't the reflux was never that bad, the sleeping at night and the recurrent coughs / chest infections were.
Since we have been treating the reflux - he has not had one cough (am touching some wood as I type!) - deffo try the reflux meds first.
Also found cetirizine when he is snotty at night really helpful as well.
Hope your appt went well today.
was it an ENT appt?

My daughter had a test for silent aspiration a year ago and it came back negative but are needing to be retested now. However she does have a lot of problems as she was diagnosed with a brain tumour which affects her cranial nerves and one promblem of this is that it has caused a paralysed left vocal cord. Due to this she can't cough very well and talks with a very quiet voice. She has started in the last 4 months to gag on food more so is encouraged to take small mouthfulls and is due to have another videoflouroscopy soon. She has just had a bad couple of months where she was in and out of hospital with suspected aspiration pneumonia so they have now decided to do a vocal cord operation. They are hoping this will give her a louder cough to clear the mucus stuck in her throat and also will close the vocal cords when needed which hopefully will stop her aspirating. I had been taking her to the hospitals/doctors from 16months of age and they didn't find anything until she was 4 when they did all the tests.She always had the rattle at the back of her throat and sounded like Darth Vadar from Star Wars - was always told upper respiratory and we know now that this was beacuase of the paralysed vocal cord.
I would suggest you take some of your own food with you on the videoflouroscopy (not sure how they do it on a 6 month old) but I found that dipping my daughters favourite foods into the barium helped her try them.

Good Luck and I hope the videoflouroscopy goes well.

Hmm be fun trying get ds to drink it then he's 5.5 and intrested what you said about vocal cords we know ds vocal cords do not work in the way they should as he struggles to prodecue speech so for him it's two birds one stone

Sorry don't have much to add but hope you get what you want from your appointment. I can only add that virus infections might not always have all the symptoms, but at the end of the day, also go with your gut instinct.

Meltedmarsbars - have you heard of www.tubefedkids.ning.com and www.notube.at
I don't know what stage you're at with your daughter but the first is a great support website for parents of tube-fed kids, and the second is a clinic specialising in weaning children off the tube. Just thought I'd share it, DS2 was premie and is tube-fed since birth due to swallowing problems.

Thanks, southcoaster, will have a look.

dd2 used to get chest infections from aspiration - some silent, some coughing/choking/spluttering. she was tube fed initially as she was born with no gag/cough/swallow reflex, but gradually learnt to suck. (dd2 has cp from birth hypoxia - difficulties muscle can be similar to that found in ds, i think?)

she had most problems with 'thin' liquids, quite often just thickening milk etc is enough to allow the baby to form a bolus and swallow safely... with dd2 it was a bit more complex, and we had lots of issues weaning. very slow, very late, and tbh we had brilliant support from a feeding trained sly all the way from birth because of her issues. (i've credited our slt with saving my sanity over the first 18 mos or so of dd2's life very frequently on here!) we fannied around hugely with weaning - thicker purees were good, any sort of blw was very bad (although quavers were her first solid food - i thought the slt was off her head lol)

anyway, just wanted to say that dd2's feeding issues were hugely problematic intially, and once she was off the tube she spent quite a lot of time on anti-b's for chest infections (in fact, we were often able to predict with frightening accuracy when she was aspirating and have to wait it out for two or three days when we would make the gp appointment...), but we did get through it. these days she is a robust and healthy 7yo who is now able to mostly eat a normal diet. without aspirating.

she still doesn't have any lateral tongue mobility though - so it's a bit of a mystery how she actually chews anything.

The 3 wheeler we had was one of <a class="break-all" href="http://www.google.co.uk/imgres?imgurl=www.comparestoreprices.co.uk/images/ma/maclaren-mac3-pushchair.jpg&imgrefurl=www.comparestoreprices.co.uk/push-chairs/maclaren-mac3-pushchair-reviews.asp&usg=__0MhTMEWo-pVjei6vI4b0GvJfwYA=&h=298&w=298&sz=17&hl=en&start=0&zoom=1&tbnid=7phgTCGC15F5xM:&tbnh=157&tbnw=157&prev=/images%3Fq%3Dmaclaren%2B3%2Bwheeler%2Bpushchair%26hl%3Den%26sa%3DX%26rlz%3D1C1CHNU_enGB371GB374%26biw%3D1152%26bih%3D773%26tbs%3Disch:1%26prmd%3Divns&itbs=1&iact=rc&dur=514&oei=4ogvTevRCsqwhQeG8_nnCg&page=1&ndsp=21&ved=1t:429,r:13,s:0&tx=72&ty=82" rel="nofollow" target="_blank">these

Sorry, wrong thread! [bluxh]

Hi, my son had undiagnosed silent aspiration, and as a result got repeated chest infections, so bad he was ventilated twice in the space of 3 months. We were told initially that as he didn't have any neurological issues/problems, there couldn't posssibly be any issue with his swallow. The aspiration was eventually diagnosed by doing a wash out of his lungs, ( when he was on the vent for the 2nd time) where they found lots of milk cells, and later, they did a video fluoroscopy, and they were just all sitting there shocked, watching the milk pouring into his airway, and he never even went red,or coughed. He was smiling away and everything. Scary! he also had bad reflux, and vomited a LOT. Just for info, they checked his swallow just by letting the SALT watch him, and listen, and said his swallow was totally OK-which of course it's not. Since he stopped oral liquids ( he's safe with solids), he hasn't had a chest infection since, and has kept generally very well-we think silent aspiration was the casue of most of his problems. Good Luck at your appointment, I would push for the VF to be done. I am the same as melted , I think if the aspiration hadn't been caught, and tube feeding started, DS wouldn't be here.

Hi just chipping in. My DS2 was born with hypotonia which meant he had to be tube fed to start with. We had a speech and language therapist trained in feeding issues visit us at home.She listened to his swallow with a stethoscope, said it was okay. DS2 ended up in hospital with an awful chesty cough that we never got the bottom of. Not a chest infection but we think pooling of liquid at the back of his throat. We think he was a silent aspirator. We didn't go for the tests but put him on Carobel thickener for the milk (when he was bottle feeding) and he has Ranitidine anti-refux meds which have knocked it all on the head. No problems now.