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Saug\u2011, Such- und W\u00fcrgreflex des Neugeborenen und des S\u00e4uglings ver\u00e4ndern\/differenzieren sich mit zunehmendem Alter, sodass der Ess\u2011, Kau- und Schluckvorgang beim Kleinkind differenziert und willentlich m\u00f6glich sind. Ess\u2011, F\u00fctter- und Schluckst\u00f6rungen sind im S\u00e4uglings- und Kleinkindalter h\u00e4ufig schwierig zu unterscheiden. Essst\u00f6rungen umfassen Nahrungsverweigerung, inad\u00e4quate Essgewohnheiten, Verhaltensauff\u00e4lligkeiten bei der Nahrungsaufnahme, selektive und\/oder einseitige Nahrungspr\u00e4ferenzen. Schluckst\u00f6rungen beschreiben eine Beeintr\u00e4chtigung der oralen, pharyngealen sowie \u00f6sophagealen Phase; alle oder einzelne Phasen k\u00f6nnen betroffen sein. Ursachen sind Verhaltens- oder Entwicklungsst\u00f6rungen, Syndrome, neurologische Erkrankungen, Erkrankungen der Atemwege und\/oder \u00d6sophagitiden (mit oder ohne gastro\u00f6sophagealen Reflux, eosinophile \u00d6sophagitis) oder anatomische Fehlbildungen der oberen Speisewege. Ess\u2011\/Schluckbeschwerden werden bei bis zu 25\u2009% aller Kinder beschrieben; circa\u00a040\u2009% der fr\u00fchgeborenen Kinder, bis zu 64\u201378\u2009% der entwicklungsauff\u00e4lligen Kinder und bis zu 99\u2009% der Kinder mit schweren Zerebralparesen zeigen Schluckst\u00f6rungen.<\/jats:p><jats:p>Die Diagnostik der Ess\u2011\/Schluckst\u00f6rung beinhaltet einen multifaktoriellen Ansatz. Die Anamnese erfasst das soziale Umfeld, die Eltern-Kind-Interaktion und die elterlichen Sorgen, die k\u00f6rperliche Untersuchung den aktuellen Gesundheitszustand mit Bestimmung von Gewicht, K\u00f6rpergr\u00f6\u00dfe und Kopfumfang sowie eine ausf\u00fchrliche HNO-\u00e4rztliche-Diagnostik. Klinische F\u00fcttersituationen k\u00f6nnen Teil der Kindesbeobachtung sein oder Videoaufnahmen von dem Kind beim F\u00fcttern\/Essen die Diagnostik erg\u00e4nzen. Zur Beurteilung schluckdynamischer Prozesse sind die Videofluoroskopie und die fiberoptische Diagnostik des Schluckens (FEES) m\u00f6glich. Bei sehr jungen Kindern ist die standardisierte FEES selten aussagekr\u00e4ftig, stattdessen sollte eine fiberoptische-endoskopische Schluckuntersuchung (FESU) mit \u201eLeeraufnahme\u201c und Videoaufnahme nach dem Schluckversuch erfolgen.<\/jats:p><jats:p>Die Therapie beginnt mit der Empfehlung einer angenehmen F\u00fctterumgebung, von Hilfsmitteln (spezielle L\u00f6ffel etc.) beim Essen, Kostform\/Konsistenz, K\u00f6rperhaltung beim Essen, alternativen\/additiven Ern\u00e4hrungsmethoden (Gastrostomien, Nasogastralsonden) sowie orofazialen Stimulationsverfahren und Kompensationsverfahren bei kooperativen \u00e4lteren Kindern.<\/jats:p><jats:p>Ein interdisziplin\u00e4res Team ist die Basis f\u00fcr eine umfassende Diagnostik und Therapieplanung.<\/jats:p>","DOI":"10.1007\/s00106-017-0388-y","type":"journal-article","created":{"date-parts":[[2017,7,31]],"date-time":"2017-07-31T05:43:05Z","timestamp":1501479785000},"page":"515-526","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["F\u00fctter\u2011, Ess- und Schluckst\u00f6rungen bei S\u00e4uglingen und Kindern","Feeding, eating, and swallowing disorders in infants and children"],"prefix":"10.1007","volume":"66","author":[{"given":"C.","family":"Schwemmle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Arens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2017,7,31]]},"reference":[{"key":"388_CR1","doi-asserted-by":"publisher","first-page":"S306","DOI":"10.1055\/s-0035-1545298","volume":"94","author":"C Arens","year":"2015","unstructured":"Arens C, Herrmann IF, Rohrbach S, Schwemmle C, Nawka T (2015) Positionspapier der DGHNO und der DGPP \u2013 Stand der klinischen und endoskopischen Diagnostik, Evaluation und Therapie von Schluckst\u00f6rungen bei Kindern und Erwachsenen. 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