Paediatric Videofluoroscopic Swallow Study

This leaflet is for the parents/carers of children referred for a paediatric VFSS at Cambridge University Hospitals. It will provide more information about what the procedure is and what to expect.

What is a VFSS?

A VFSS is a moving x-ray taken when your child is swallowing. We add some barium (a white liquid) to their food and drink and then ask them to eat as normally as possible. The barium has a chalky texture and a fruity flavour which can change the taste of food, but it is not unpleasant.

While your child is swallowing, we turn on the x-ray machine. The barium allows us to see the food as it is being swallowed. We can also see what the muscles and other structures in the throat are doing during swallowing. The barium will be processed out of your child’s system naturally and should not have any side effects.

The VFSS takes about 20 minutes to complete. Your child will be seated on a special chair or in their own wheelchair for the assessment and you will be seated facing them. The Speech Language Therapist (SLT) may try some different strategies during the assessment, such as changing the consistency of the food or drink, using a different teat or cup or changing your child’s position.

After the VFSS the SLT will go through what they have seen with you and make some recommendations. These may change after further, more detailed review of the images. A report will be written and sent to you, your community SLT and all the doctors involved in your child’s care.

Why has my child been referred for a VFSS?

Your child has been referred for a VFSS because an SLT has done an assessment of their eating and drinking and wants some more information about their swallow. The VFSS is able to tell us information that we cannot get from a feeding assessment alone, such as whether or not they are aspirating (food and drink going ‘the wrong way’) or if they are at risk of aspirating. This will allow them to identify strategies that may reduce this risk.

What do I need to bring to the appointment?

Please bring the food and drink to be assessed. Your community or hospital SLT may advise you what food and drink they would like assessed. Please also bring any equipment your child uses to eat and drink (such as bottle, cup, spoon, and bowl). Please also bring a bib or old shirt as the barium can stain clothing.

Please make sure there are no metal fastenings or jewellery around the head and neck as these can be seen in the images.

Before the exam

We ask that you arrive 15 minutes before your appointment so that we have time to get you and your child ready. The procedure will be explained to you and we will get your consent before going into the room. It is important that your child is hungry, so we advise they are not fed for about two to three hours before the procedure.

What are the benefits of having a VFSS?

A VFSS allows us to see what is happening inside your child’s throat and airway as they are swallowing. We can then use this information to make a plan for your child’s feeding that will improve the safety of their swallow.

What are the risks of having a VFSS?

During the procedure there is the risk that some food or drink will go down the wrong way and be aspirated. We take special care to minimise this risk.

VFSS is a procedure that uses x-rays and we take special care to minimise the amount of radiation your child is exposed to. We have a paediatric radiologist and a radiographer present to manage and monitor this. If you have any concerns please speak to the SLT before the appointment.

Alternatives

There are no alternative imaging options to assess how the swallow functions and if aspiration is occurring.

Important

Please inform the SLT and radiologist if you think you might be pregnant when you come for the assessment. In this case, you would be asked to stay behind the screen. You are welcome to bring another person with you who can feed your child; otherwise the SLT will be able to help. Please be aware that siblings cannot be present in the X-ray room, so it is important that you bring someone with you to supervise them during the assessment.

Contacts/further information

For more information about paediatric VFSS please contact the speech language therapy department at Addenbrooke’s Hospital on 01223 216 200.

VFSS takes place in the X-Ray department on Level 3 of outpatients.