Swallow Study after a Tracheostomy
Why does my child need a swallow study?
Swallowing is very complex. Swallowing
needs perfect timing and coordination to
make sure food and fluid safely go into the
esophagus (feeding tube). When your child
has a tracheostomy, the anatomy, airflow
and sensation of airway and throat structures
change. This may affect the timing and
coordination of swallowing. This may result
in food or fluids going into the airway.
What happens if food or fluids go into my
If food or fluids go into the airway, this is
called aspiration. When we sense
something in the airway, we cough or try to
clear our throats to get rid of it. A
tracheostomy makes it harder to sense that
something is in the airway. Sometimes, food
or fluids sneak down the airway without
knowing it or without causing a cough to
clear it. This is called silent aspiration.
Why is silent aspiration concerning?
ξ When aspiration happens, there is a
greater risk of choking and/or
ξ Your child may seem to do well
eating and drinking, but may still be
at high risk for silent aspiration.
ξ Silent aspiration can lead to illnesses
that may increase your child’s
How can a Speech-Language Pathologist
(SLP) help my child?
The SLP is an important member of your
child’s team during the hospital stay and
when you go home. The SLP is trained to
evaluate and treat swallowing disorders, also
called dysphagia. Careful evaluation and
treatment focuses on identifying risk factors
for aspiration. The SLP works with you,
your child and the medical team to identify
ways to decrease the risk for aspiration.
How is a swallow study done?
ξ The study begins at the bedside with
a clinical swallowing assessment by
ξ This study looks at feeding readiness
skills such as alertness,
communication, and small trials of
different consistencies of foods or
fluids (this depends on your child’s
ξ The SLP closely watches and feels
for signs of trouble swallowing, and
decides if your child is ready for
This study cannot rule out silent aspiration.
The SLP cannot see inside the body during
the swallow. The risk of silent aspiration
with a tracheostomy is very high. Your child
will not be able to eat by mouth until the
next level of evaluation (the
videofluoroscopic swallow study or VFSS)
What is a videofluoroscopic swallow
ξ This study uses moving x-rays to
clearly see where food or liquid is
going during a swallow.
ξ Your child goes to the Radiology
department. Once there, your child is
fed different consistencies of barium.
ξ Barium is a substance that shows up
well on x-rays.
ξ The SLP may feed your child, or we
may ask for a parent or caregiver to
help if this will make it easier for
your child to do the study.
ξ The SLP and Radiologist watches
closely to see how and where the
ξ We may try different thicknesses of
foods, different positions, or
different cups, utensils or bottles to
figure out the safest way to feed by
ξ After the study, the SLP reviews the
video, and talks with you and your
child’s doctors about the safest way
to feed your child based on the
results of the VFSS.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor.
This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because
each person’s health needs are different, you should talk with your doctor or others on your health care team
when using this information. If you have an emergency, please call 911. Copyright © 7/2016 University of
Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7911