The Effectiveness of Slightly Thick Liquids for Improving Swallowing in Bottle-Fed Children With Aerodigestive Concerns.
Renata Mancopes, Cheryl J Hersh, Rebecca Baars and 6 others
PMID 38773997WHAT IT FOUND
Slightly thick liquids did not significantly reduce penetration frequency in bottle-fed children with swallowing concerns.
While they lowered the amount of penetration seen, they increased sucking effort and pharyngeal residue, suggesting a trade-off between safety and efficiency.
Key findings
01The reduction in the frequency of penetration events with slightly thick liquids was not statistically significant.
02Slightly thick liquids significantly reduced the frequency of penetration events scored as 'more than trace' compared to thin liquids.
03Slightly thick liquids were associated with significantly longer sequence durations, fewer swallows per sequence, and more sucks per swallow, indicating reduced feeding efficiency.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was retrospective, so the order of liquid presentation was not randomized (thin was first in 55 of 60 exams), which may have influenced results due to fatigue. The effect of thickening cannot be separated from the effect of the nipple flow rate, as the same nipple was used for both consistencies, likely altering the flow dynamics for the thicker liquid. The sample had heterogeneous medical diagnoses, including laryngeal clefts and trisomy 21. Depth of penetration and clearance of residue were not assessed.
Declared interests
One author serves on the board of the International Dysphagia Diet Standardisation Initiative and has received honoraria from Brium Diagnostics, which makes the barium products used in the study. Another author leads a reference group for the same initiative.
The easy way to misread this
Do not conclude that slightly thick liquids prevent penetration. They did not significantly reduce the frequency of penetration events, and 59 of 60 children still experienced penetration on the thickened liquid. The benefit was limited to reducing the amount of liquid entering the airway, not the occurrence of the event.