Feeding difficulties in children with esophageal atresia: A parent-reported multicenter study

Feeding difficulties (FDs) are common among children with esophageal atresia (EA) and tracheoesophageal fistula (TEF), but knowledge about their prevalence and risk factors is limited. This multicenter study aimed to assess the prevalence, subtypes, and associated factors of FD in children with EA/TEF.

Parents of children who underwent surgery for EA/TEF in four tertiary centers in Israel (2005-2022) completed a structured questionnaire. Pediatric feeding disorder (PFD) was diagnosed by means of the Montreal Children's Hospital Feeding Scale and classified by consensus criteria into four subtypes: feeding skills, nutritional, medical, and psychosocial dysfunctions.

Seventy-five children were included (median age: 40 months; 48 males), of whom 57 (76%) were reported to have FD, primarily due to impaired feeding skills (42%). Lower gestational age, low birth weight, and delayed oral feeding were significantly associated with PFD (37 vs. 39 weeks, p = 0.001, 2130 g versus 3084 g, p = 0.001 and 14 versus 10 days, p = 0.05, respectively). Only half of the children received timely and appropriate multidisciplinary follow-up care.

FDs are highly prevalent in children with EA/TEF, mostly due to impaired feeding skills. Several clinical and perinatal factors are associated with the development of these problems, calling for early and multidisciplinary intervention to improve outcomes.