The Aerodigestive Team

Summary

An aerodigestive team is a group of specialists from different medical fields who work together to care for children with complex airway and digestive conditions. Each team member has a unique role, and together they cover all aspects of breathing, feeding, and related health concerns. They form the foundation of the multidisciplinary care model. Here’s an overview of the main members of an aerodigestive team:

Otolaryngologist (ENT – Ear, Nose, and Throat Specialist)

The ENT specialist evaluates the upper airway (nose, throat, and ear issues). They evaluate structural issues like a floppy airway (laryngomalacia), vocal cord paralysis, airway narrowing (stenosis), or chronic ear/sinus problems. The ENT specialist often leads or co-leads the aerodigestive team and performs procedures like flexible laryngoscopy to look at the voice box and rigid bronchoscopy to evaluate airway structure. They coordinate with other team members to address issues affecting the upper airway and plan procedures.

Pulmonologist (Lung Specialist)

The pulmonologist manages the lower airway and lungs. They address issues like chronic lung disease, tracheomalacia (or a floppy trachea), asthma, chronic cough, or trouble breathing due to anatomy or infection. They may perform tests like pulmonary function tests or examination through a scope. They coordinate care with the team members to see how the child’s respiratory health is impacted overall. If a patient uses a ventilator or has special needs with respiratory issues, they coordinate these as well.

Gastroenterologist (GI Specialist or Digestive Expert)

The gastroenterologist focuses on the digestive system. They evaluate problems like gastroesophageal reflux (GERD), feeding difficulties, vomiting, poor weight gain, or issues related to the esophagus, stomach, and bowel. They often conduct or interpret tests like upper GI endoscopy (looking at the esophagus and stomach with a scope, or camera) or reflux probes to measure acidity and tests of GI motility. The GI specialist works with the feeding team to ensure your child is tolerating food/fluids well. They also address if reflux or digestion problems are contributing to your child’s symptoms in other systems.

Dietitian/Nutritionist (Food Nutrition or Diet Expert)

Dietitians or nutritionists assess how food and feeding impact your child’s growth, especially if they have feeding difficulties, low calorie intake, or malnutrition. They coordinate nutrition things like specialty oral formulas and feeding schedules, or whether your child needs supplemental nutrition (for example, tube feeding) until they can eat safely and adequately. They work closely with the speech-language pathologist or feeding team to ensure the child’s nutritional needs are met without compromising safety (like aspirating or choking).

Speech-Language Pathologist (SLP or Feeding Therapist)

The specialist evaluates and treats problems with feeding issues. They often examine the child’s swallowing and eating during feeding therapy sessions and during feeding video swallow studies (also called modified barium swallow). They may also help with coordination of treatment for children with language concerns. The SLP is vital to figure out safe ways for your child to feed if there is aspiration or if there are feeding difficulties. They offer feeding therapy to help kids develop or improve swallowing skills. They often offer therapeutic techniques (like texture modification or safe feeding techniques) to minimize aspiration risk and help feeding become easier or successful.

Nurse Coordinator

The nurse coordinator is the quarterback of the team. The person ensures child families are informed with schedules/appointments and appointments. They may act as the main point of contact to answer questions and schedule evaluations, to some programs, and specialized nurse practitioners also help facilitate meetings or have significant knowledge of families to share with team members. They coordinate with the team members to share information and help families navigate or understand instructions about how interventions are working, for example, improving or not improving, or if adjustments to the medication or care are needed if their child’s symptoms aren’t improving.

Social Worker/Psychologist

Caring for a child with complex medical needs can be challenging for the whole family. Social workers help find healthcare services, care like financial assistance programs, community support, or special at home care or equipment. They can also help find emotional support and counseling for parents and families. Psychologists or behavioral specialists offer support if parents or kids have emotional or behavioral concerns about feeding for example, stress and anxiety or fear of eating or food refusal problems and psychological aspects of feeding habits. The goal is to ensure that the digestive team is a well-coordinated team that not only treats your child’s symptoms but also supports the whole family through the care journey.

Other Specialists as Needed

Depending on each child’s situation, the aerodigestive team can involve additional experts. This might include surgeons, cardiac (heart) doctors to monitor if circulatory or heart problems are involved, genetics specialists if there’s a suspicion of a genetic condition, a developmental pediatrician if there are concerns about developmental issues or neurologic concerns (head or brain) to look for issues in the stomach or swallowing reflex, a GI surgeon (if there’s a surgical procedure to address issues like feeding tubes, airway abnormalities, and other procedures) to address issues in the airway or breathing system. Other options could include a dietitian (to manage complex needs), a developmental pediatrician (for complex cardiac or developmental concerns), allergy experts (to rule out food or environmental allergies that may contribute to airway problems), or a Sleep Medicine doctor (for complex sleep-related breathing problems). Many times, if the aerodigestive team notices signs of issues in other specialties, or complex dependence, etc., they may consult with these additional experts.

All Team Members Work Together Closely

They may discuss your child’s case at a team meeting, share notes, and constantly monitor your child’s progress. They work as one team, not as isolated specialists. This approach allows teams at all levels of the child’s health. All team members work together as one unified team to address both the symptoms and underlying causes. They share notes and meet regularly to discuss your child’s progress, ensuring all aspects of your child’s aerodigestive condition are addressed in a coordinated way.

Remember: taking care of yourself is also important. Seeking support is not weakness; the aerodigestive team wants you to feel empowered and supported. Many programs specifically offer parents a “got it” and can be a huge relief. Don’t hesitate to reach out through the phone/groups or via your care team to help you find local support resources or support networks. With the right resources and support, you will feel more empowered to handle the challenges and celebrate the milestones through your child’s aerodigestive care journey.