Benefits of thickened feeds in previously healthy infants with respiratory syncytial viral bronchiolitis

Infants with respiratory syncytial virus (RSV) bronchiolitis have an increased risk of aspiration. The optimal feeding strategy for these patients has not been described. Fifteen previously healthy and clinically stable infants with RSV bronchiolitis underwent video-fluoroscopy studies to assess swallowing using thin barium. Those with abnormal studies underwent a repeat study, using barium that was thickened with rice cereal. Nine of 15 infants had abnormal studies with thin barium. Laryngeal or tracheal penetration with thin barium was seen in 3 and 2 infants, respectively, but not with thickened barium. Aspiration of thin barium was seen in 4 infants, but it corrected in 3 of these 4 infants with thickened barium. Thickened feeds provide a simple, safe, and cost-effective intervention to improve swallowing dysfunction and prevent aspiration in infants with RSV bronchiolitis.