Ep. 12: Assessing Feeding and Swallowing Function in Breastfeeding Infants Via Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

In this episode, hosts Ellen Chetwynd and Adina Kopinsky are joined by Tina Tan and Diahann Cuevo to discuss the article, “From the Field: Assessing Feeding and Swallowing Function in Breastfeeding Infants via Fiberoptic Endoscopic Evaluation of Swallowing (FEES).”Published in JHL Volume 41, Issue 3, this clinical practice article explores how FEES is being used in real-world settings to assess swallowing function in breastfeeding infants, expanding the possibilities beyond traditional bottle-based swallow studies.Together we compare FEES with Videofluoroscopic Swallow Study (VFSS) and explore why assessing infants during direct breastfeeding can significantly improve clinical decision-making and lactation support.Key takeaways include:Traditional VFSS has important limitations for breastfeeding infants, including radiation exposure, time constraints, and reliance on bottle feeding, which may not reflect true feeding dynamics at the breast.FEES enables real-time visualization of swallowing during direct breastfeeding, allowing clinicians to observe airway protection, coordination, and fatigue over a full feeding without radiation.The ability to trial and immediately evaluate feeding interventions such as positioning or managing milk flow helps create highly individualized, responsive care plans.FEES and VFSS serve complementary roles, and findings from these studies can guide interdisciplinary collaboration and support breastfeeding goals, rather than functioning as pass/fail assessments.The episode also highlights a clinical case where FEES supported the transition back to breastfeeding after initial aspiration concerns, illustrating how feeding plans can evolve as infants mature.Links to the article:Tan T, Cuevo D. From the Field: Assessing Feeding and Swallowing Function in Breastfeeding Infants via Fiberoptic Endoscopic Evaluation of Swallowing (FEES). Journal of Human Lactation. 2026;41(3).https://journals.sagepub.com/doi/10.1177/08903344251342216Join the Conversation:Connect with us on social media:Facebook⁠ ⁠⁠⁠@JournalofHumanLactationInstagram⁠ ⁠⁠⁠@journalofhumanlactationX⁠ ⁠⁠⁠@JHL_LactationIf you enjoyed this episode, please subscribe, rate, and review us on your favorite podcast platform. Your support helps us continue to bring you the latest in lactation research. Don’t forget to follow us for updates and join our community of lactation professionals and advocates!