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Aspiration/Chronic Lung Disease

Children with CP and other chronic disorders are at risk for acute and chronic respiratory illness due to neurological and anatomical dysfunction. Recurrent pneumonia can be a frequent and often unrecognized sign of aspiration. Although pneumonia may occur as an isolated illness in any child, it should prompt consideration for further evaluation in a child with CP.

Factors contributing to aspiration in children with chronic illness include oral motor dysfunction, gastroesophageal reflux, sleep apnea, seizures, atelectasis/bronchiectasis, trachealmalacia, restrictive lung disease, airway hyposensitivity, ineffective cough, inadequate seating posture, and scoliosis.

Optimal management of the child includes:
  • Minimizing aspiration risk
  • Optimizing nutrition
  • Immunizing - including influenza and pneumococcal vaccines
  • Ensuring good posture support in seating
  • Monitoring for scoliosis
  • Avoiding active/passive tobacco smoke
Monitor and manage problems associated with:
  • Dysphagia/aspiration
  • Gastroesophageal reflux
  • Sleep apnea/obstruction
  • Comorbid pulmonary conditions (e.g., asthma, allergies, bronchopulmonary dysplasia (BPD).
Refer to a pediatric gastroenterologist, pulmonologist, or sleep specialist for further evaluation and intervention if indicated.

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Authors & Reviewers

Initial publication: September 2008; last update/revision: August 2018
Current Authors and Reviewers:
Author: Lynne M. Kerr, MD, PhD
Reviewers: Lynne M. Kerr, MD, PhD
Meghan Candee, MD
Nicholas Johnson, MD