Feeding and swallowing difficulties during radiotherapy

Children receiving radiotherapy can sometimes experience feeding and swallowing difficulties (called ‘dysphagia ’) caused by the side effects of the treatment.

Some children may already have had difficulty with swallowing before radiotherapy because of the size and location of their cancer or tumour.

The impact of the side effects can depend on the location and dose of radiation your child is receiving, the length of treatment and your child’s general health.

Common side effects that can affect a child’s ability to eat and/or swallow safely include:

• Weakness and/or incoordination of the muscles used for chewing and swallowing. This can also mean your child tires quickly during meals.
• Pain when swallowing.
• Frequent coughing when eating or drinking.  This may indicate that food and drink is ‘going down the wrong way’ to the lungs. This is known aspiration and can lead to chest infections.
• Ulceration of the mouth, tongue and throat (mucositis).
• Swelling around site of treatment (head and neck) can impact on your child’s strength and/or range of movement of their jaw, tongue, voice box and throat muscles.
• Altered taste (dysgeusia) – your child may start to refuse their favourite foods because they no longer taste the same. Some children experience an unpleasant or metallic taste when they eat.
• Saliva changes - reduced saliva production or thickening of saliva for the mouth and throat.
• Dry mouth and throat.
• Stiffness of the jaw.
• Oral and jaw pain – due to tooth sensitivity or decay, muscle wasting (atrophy) and mouth ulcers.
• Reduced appetite, leading to weight loss.

If your child experiences any of the above side effects, tell a member of their oncology care team as soon as possible.

How can a speech pathologist help your child?

A speech pathologist can assess your child’s feeding and swallowing and may recommend:

• Changes to the texture and consistency of foods and drinks your child consumes to make it easier for them swallow.
• Providing suggestions to keep your child’s mouth clean and healthy and assist with reducing any sticky / thick saliva in your child’s mouth and throat.
• Providing strategies and /or exercises to help make your child’s eating and drinking as safe and enjoyable as possible.

If you have concerns about your child’s feeding or swallowing, tell your child’s oncology team so they can make a referral. A speech pathologist may see your child before, during or after their treatment.

Dental care

Encourage your child to clean their teeth and use a mouth wash after eating and drinking. This prevents teeth decay developing and keeps the lining of the mouth feeling clean and comfortable.  See your dentist or oncologist for further information.

Contact us

Speech Pathology Department
Queensland Children’s Hospital
t 07 3068 2375   e LCCH-SPEECH@health.qld.gov.au

Developed by Speech Pathology Department and Oncology Services Group, Queensland Children’s Hospital.  

Resource No: FS327  Reviewed: January 2024.

Disclaimer: This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.