Pharyngeal and swallowing disorders in infants.

Although true vomiting is an unusual manifestation of pharyngeal or swallowing disorders in infants and children, the forceful regurgitation of feedings seen with respiratory distress in these children may be interpreted by the clinician as vomiting episodes. This scenerio usually is caused by structural abnormalities of the upper airway or swallowing discoordination placing food as an obstruction in the airway during feedings. A good clinical history and physical examination of affected children often will disclose an anatomic cause for regurgitated feedings, but swallowing disorders are more subtle and usually require a complete swallowing evaluation. The essential components in treating these problems in children include the removal of the airway obstruction or rehabilitation of feeding and swallowing. The approach to treatment is often multidisciplinary in nature and highly individualized.