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Fixed the gap, solved the problem? Eating skills in esophageal atresia patients at 3 years
Francesca Bevilacqua1, Benedetta Ragni2, Andrea Conforti3
1Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy.
Insights
Many children with esophageal atresia (EA) experience eating difficulties, including choking and mealtime anxiety, by age three. Early intervention is recommended to improve eating skills and developmental milestones in these children.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Developmental Pediatrics
Background:
- Esophageal atresia (EA) is a congenital condition that can lead to long-term eating problems.
- Few studies have specifically investigated eating outcomes in children with EA as a primary focus.
Purpose of the Study:
- To assess eating skills and problems in children at 3 years of age following surgical repair of EA.
- To identify factors associated with eating difficulties in this population.
Main Methods:
- A telephone-based structured interview was administered to parents of 51 children who underwent EA repair.
- Clinical data, including number of dilatations and mechanical ventilation days, were collected from medical records.
- Eating skills, food texture acceptance, curiosity about food, and parental anxiety were assessed.
Main Results:
- 45% of children experienced choking episodes at 3 years, with 45% of those having weekly episodes.
- 39% of parents reported increased mealtime anxiety.
- Weaning and chewing ages correlated with dilatations and mechanical ventilation.
- Choking episodes were linked to food curiosity and parental anxiety.
Conclusions:
- Significant eating challenges persist in children with EA up to age three.
- Factors like dilatations, ventilation, and gastrostomy tube use are associated with delayed eating milestones.
- A dedicated preventive intervention from birth is advocated to improve eating development in children with EA.
Abstract:
Although eating problems have been described as long-term morbidities of esophageal atresia (EA), there have been few studies exploring eating outcomes in children born with EA as primary aim. Parents of children operated on for EA in our Institution from January 2012 to January 2016, answered a telephone structured interview developed specifically to conduct the present study, assessing eating skills at 3 years of age. Clinical data were collected from children's medical records. Parents (45 mothers and 6 fathers) of 51 children (male = 34; female = 17) with a median age of 3.5 years form the object of the study. Considering eating problems, parents reported that 23 children (45%) still have episodes of choking during meals at 3 years of age, 9 (45%) of these have more than one episode a week, and 19 parents (39%) reported higher levels of anxiety during mealtimes. Forty-four children (86%) were described by their parents as able to eat alone, 32 (65%) accepted all food textures and 45 (90%) was described as curious about food (3 years). Forty-three (86%) parents let their children eat with other people. Correlations showed that weaning age was significantly associated with number of dilatations (rs = 0.35, P = 0.012), days of mechanical ventilation (rs = 0.40, P < 0.001), and presence of gastrostomy tube at discharge (rs = 0.45, P < 0.001). Chewing age resulted associated with number of dilatations (rs = 0.34, P < 0.01) and days of mechanical ventilation (rs = 0.38, P < 0.01). Presence of choking episodes was associated with curiosity about food (rs = 0.29, P < 0.05), while frequent choking episodes were associated with higher parental anxiety during mealtimes (rs = 0.45, P < 0.05). In order to prevent delay in the achievement of eating developmental milestones in children operated on of EA, we advocate a dedicated preventive intervention from birth to follow-up.
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