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Growth and feeding problems after repair of oesophageal atresia
J W Puntis1, D G Ritson, C E Holden
1Institute of Child Health, University of Birmingham.
Insights
Children with oesophageal atresia experience frequent feeding difficulties and growth issues. While problems often resolve slowly, ongoing support is crucial for affected families.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Child Nutrition
Background:
- Oesophageal atresia (OA) presents significant challenges for affected children and their families.
- Feeding difficulties and growth disturbances are common concerns in the long-term management of OA.
Purpose of the Study:
- To investigate the feeding history and growth patterns in children with oesophageal atresia.
- To compare outcomes between different surgical approaches for OA.
- To understand the long-term impact of feeding problems and parental concerns.
Main Methods:
- A detailed questionnaire on feeding history and growth was administered to 124 families of children with OA.
- Anthropometric analysis was used to assess growth status (stunting and wasting).
- Comparison was made with 50 healthy control children and between different surgical techniques (primary anastomosis vs. oesophageal substitution with oesophagostomy).
Main Results:
- Children with OA exhibited significantly more feeding problems (slow feeding, refusal, coughing, choking, vomiting) than controls.
- Nearly one-third of OA patients showed growth retardation.
- Primary oesophageal anastomosis was associated with better growth outcomes compared to oesophageal substitution with prior oesophagostomy.
- Feeding difficulties persisted in half of the children up to 7 years of age.
Conclusions:
- Feeding problems and growth retardation are prevalent in children with oesophageal atresia, necessitating long-term monitoring.
- Surgical approach impacts growth outcomes, with primary anastomosis being more favorable.
- Families require sustained support from healthcare professionals, including those in nutrition, feeding disorders, and primary care, to manage these challenges effectively.
Abstract:
Of 230 families belonging to a support group for parents of children born with oesophageal atresia, 124 returned a detailed questionnaire on feeding history and growth. Being slow to feed, refusing meals, coughing or choking during eating, and vomiting at meal times were significantly more common than in 50 healthy control children. Anthropometric analysis indicated that almost one third of patients were growth retarded, although those with a primary oesophageal anastomosis were less likely to be stunted or wasted compared with children who had an oesophageal substitution preceded by an oesophagostomy. Feeding problems tended to resolve spontaneously but slowly, with half of all children still reporting some difficulties at 7 years of age. Parents were considerably worried by feed related symptoms and families benefited from mutual support. There is a need for additional help and advice to be provided both by hospital staff interested in nutrition and feeding disorders and those professionals involved with primary care.