Signs of Aspiration

Sometimes, food, drink, or saliva can go down the wrong way into a child’s airway instead of their stomach. This is called aspiration. It can be hard to notice, so here are some signs to watch for, particularly during or after your child eats or drinks, whether by mouth or through a feeding tube.

These are easier to spot and may happen during or soon after eating or drinking:

• Coughing or choking
• Gagging
• Refusing to feed
• Wet-sounding or gurgly voice
• Hoarse or raspy voice
• Drooling or pooling of saliva
• Apneas (pauses in breathing)
• Desaturations (drops in blood oxygen saturation) with feeds
• Noisy breathing or breathing that seems harder than usual
• Physiological instability (e.g., changes in heart rate, blood pressure, or temperature)

These signs may be less obvious but could still mean your child is having difficulty:

• Watery eyes during or following feeding or when swallowing saliva
• Sudden tone changes, such as becoming floppy or stiff unexpectedly
• Sudden state changes, such as changes in mood, energy, or mental state
• Ongoing need for supplemental oxygen or increased oxygen during or following feeding
• Frequent respiratory infections, such as colds, influenza (flu), and pneumonia
• Poor weight gain
• Feeding takes a long time, or very little is eaten
• Getting tired easily while feeding
• Nasal flaring during feeding
• Color changes (like looking pale or bluish) during or after feeding

Aspiration can happen without any apparent signs. If you notice any of the signs above—or if you’re ever unsure—talk to your child’s healthcare providers. It’s always okay to ask questions or ask for an evaluation. You know your child best.

If you have any questions or concerns, call the Gillette Telehealth Nurse line at 651-229-3890.