barium test questions plus a swallowing question

[MommyUpNorth]

DS (9 months old) is going for a barium test next week. Has anyone been through this? We're still waiting to get a leaflet about it, so was wondering what to expect?

DS seems to be struggling with swallowing and has done for a while now, but it's getting worse in the last month or so. He's been on reflux meds since he was 5 months old, but now he's on lots of things (losec, domperidone, gaviscon) and it's still not helping. Anyway, the question... he's drinking 70mls per feed (Infatrini), and after he's finished there is a large pool of milk sitting at the back of his mouth and he just swallows and swallows and swallows... and it takes about 10/15 minutes to all go down. I'm fairly sure this isn't normal, but just wondering what it might be, or if anyone else's child has anything similar? Is there anything I could try differently to help him out? We have a dietician, and have been assessed by a SALT, but apart from telling us that his swallow is 'safe', there is no advice and they claim not to know what's going on. We've been dropping his feed amounts steadily (started at 150ml, and now on the 70) to help with the vomiting, which it has, but this other problem just isn't shifting...

Any thoughts?

Many thanks.

bump...
anyone?

I don't know - could it be some sort of hernia?

hopefully, it will show up with the barium. I've had it done as an adult but I don't know what they do with children. Basically, I had to drink a big glass of the stuff (like a thick milkshake - I know they can flavour it for children. Don't know what they do for babies) and then they watch it going through your body on a screen (down the throat and into the tummy - because it lights up so you can see any blockages, any problems).

Good luck with it - I hope it goes ok!

Thanks foxinsocks. Someone did mention a hernia (stomach going up through the esophagus I think). Hopefully he won't need to drink too much as that'll just start up the vomiting again.

poor boy

at least they should be able to see why it is happening

Hi Mommyupnorth - my daughter had a swallow study done when she was about one - also called a video fluoroscopy.

She was NG fed and we had it done to see if she could be fed orally. (She has very low tone and our SALT didn't think she was safe).

We had to sit her in her special feeding chair, and give her small amounts of food/drinks of differing thickness containing barium , whilst the radiographer video X-rayed it. You can see her swallow in real time, and follow the path of the food/drink, and afterwards they can freeze it, rewind etc, so they can look more closely. They store the video and images so they can print off pictures and so on.

It sounds like your son has something similar to what my DD had - it's called pooling, where they don't swallow normally. The food or drink pools at the space at the back of the throat and can put them at risk of aspiration (where it is breathed in to the lungs.) It may be that you need to thicken his milk so it is easier for him to clear. However if the SALT has assessed his swallow as safe then it may not be that at all!

Hope it goes well and you get some results.

Thanks so much for your reply Sidge. We couldn't actually get him to reproduce this when we saw the SALT as the problem was a bit more intermittant at that time. Now it happens after every feed, and even after meds (as low as 2.5ml).

As he's still losing weight, FTT, and reflux meds not helping, they've ordered this barium test. DS is also low tone, and the neurologist said that this may cause problems with his digestion (he's also on lactulose & senokot to help with constipation). No one seems to have any answers yet!

Can I ask if your dd had fed 'normally' before going onto the NG tube? Our dietician mentioned tube feeding when he was about 5 months old, but as we were just starting with solids, we wanted to wait and see. He never really got the hang of it, and has had more problems than sucess. Since then we've had lots more appointments with various specialists and perhaps things aren't going to go as planned...

Sorry to hear things have been difficult. We have always had feeding problems - DD was prem and, well, pretty much dead when born - had to be resuscitated so was NG fed from the start. (Well fed into a vein and then by NG)

We didn't give her anything orally at all for months and months (SALT advised against it as so unsafe, her tone was SO low). Then tried a few teats but no joy (partly as she had no suck) and SALT was still unhappy with her hence referral to radiologist.

We even had to thicken her milk (EBM) for tube feeds as she had reflux and it wouldn't stay down!!

I really sympathise with you, it must be hard so I really hope you get some answers. If they suggest NG feeding for a while if he has FTT don't panic, it can be a means to an end. You can still work on oral feedings whilst NG feeding. And we NG fed DD for 18 months so I am a veritable mine of information

Thanks again Sidge for the info. What a worrying time that must of been... I can't even begin to imagine.

DS was born at term, and started off fine. It was around 5/6 weeks old that we started noticing that things weren't quite right. He was breastfed up until 5.5 months old, but dropped too much weight so got put onto Infatrini with the breastfeeding to see if it would pick up. Since then it just seems to be one problem after another... Every time we think we've cracked it, things go downwards again. So maybe after this test they'll be able to give us more help with things. I'll post again if we do get into the tube feeding as I'm sure I will have absolutely loads of questions!