Side-Lying Position Is Associated With Improved Swallow Outcomes When Compared to Semi-Upright Position in Infants With Dysphagia.

purposeThe purpose of this study was to examine the effects of side-lying and semi-upright positions on videofluoroscopic swallow study (VFSS) outcomes in infants with dysphagia.

methodA cross-sectional, within-subject design was employed. Infants diagnosed with dysphagia and undergoing VFSS as part of standard of care were prospectively identified at a tertiary care academic children's hospital. Both semi-upright and side-lying positions were assessed with thin liquids using identical bottles/nipples across positions. Severity and frequency of penetration/aspiration and pharyngeal swallow timeliness were rated by three speech-language pathologists specialized in the evaluation and management of pediatric dysphagia. Severity of airway invasion was assessed using the Penetration-Aspiration Scale (PAS) and swallow timeliness using a 3-point ordinal scale. Mixed-level modeling was used to compare swallow outcomes across positions to determine if side-lying was associated with decreased severity and frequency of airway invasion and timelier pharyngeal swallow initiation.

resultsTwenty-one infants diagnosed with oropharyngeal dysphagia were included (

conclusionsSide-lying position in infants with dysphagia was associated with less severe and less frequent penetration/aspiration when compared with semi-upright position. Future research should identify predictors of which infants benefit most from side-lying position, as well as the physiological mechanisms underlying these findings.