Achievement of feeding milestones after primary repair of long-gap esophageal atresia

Khan, Khalid; Krosch, Tara C.K.; Eickhoff, Jeffrey; Sabati, Arash; Brudney, James; Rivard, Andrew L.; Foker, John E.

doi:10.1016/j.earlhumdev.2009.01.006

Cited by 37 publications

(32 citation statements)

References 27 publications

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“…They documented no significant differences between the two EA groups although both groups were significantly different from their control group at age one and two. More recently, Khan and his colleagues reported the achievement of feeding milestones in children with long‐gap EA after primary repair . They demonstrated extreme variability in individual results, although overall no difference was appreciated comparing the EA group and controls.…”

Section: Discussionmentioning

confidence: 99%

A pilot investigation of feeding problems in children with esophageal atresia

et al. 2014

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While many long-term complications of esophageal atresia (EA) have been well investigated, little is known about feeding difficulties in children after surgical correction of EA and its impact on caregivers. This study investigates the feeding behaviors of children with EA through a validated feeding questionnaire. The Montreal Children's Hospital Feeding Scale (MCH-FS) was filled out by the primary caregiver during patient follow-up visits in the multidisciplinary EA clinic. Demographic information, EA subtype, associated anomalies and outcomes were recorded. Results were compared between groups and to a normative sample. Thirty caregivers have completed the MCH-FS; 26 patients had type C atresia (86.7%). In comparison to controls, 17.5% of EA cases are one standard deviation above the mean feeding difficulty score, while 6.7% (n = 2) cases are greater than two standard deviations above normative values. Typical EA patients (type C who were not born <30 weeks) had mean MCH-FS scores in the subclinical range, whereas one extremely premature child and the patients with non-type C EA (n = 4) all had scores in the severe range. Feeding difficulties of patients with typical EA appear mild. Likely explanations include the use of early protocolized care and intensive multidisciplinary care in follow up. Nonetheless, patients with complicated EA (non-type C) and their caregivers tend to experience significant feeding difficulties. Early targeted care may be required for this patient subset, and additional cases will be investigated to confirm these preliminary findings and explore further risk factors of feeding problem in this cohort.

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Section: Discussionmentioning

confidence: 99%

A pilot investigation of feeding problems in children with esophageal atresia

et al. 2014

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“…While these feeding difficulties decreased with age, these rates are still extremely high (10, 11). While patients who have undergone primary repair of long-gap EA have delayed onset of feeding and significant variability in individual results, overall the major feeding milestones occurred in a similar pattern to normal infant controls (12). …”

Section: The Prevalence Of Feeding Difficulties In Children With Eamentioning

confidence: 97%

Feeding Problems and Their Underlying Mechanisms in the Esophageal Atresia–Tracheoesophageal Fistula Patient

Mahoney

Rosen

2017

Front. Pediatr.

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Feeding difficulties such as dysphagia, coughing, choking, or vomiting during meals, slow eating, oral aversion, food refusal, and stressful mealtimes are common in children with repaired esophageal atresia (EA) and the reasons for this are often multifactorial. The aim of this review is to describe the possible underlying mechanisms contributing to feeding difficulties in patients with EA and approaches to management. Underlying mechanisms for these feeding difficulties include esophageal dysphagia, oropharyngeal dysphagia and aspiration, and aversions related to prolonged gastrostomy tube feeding. The initial diagnostic evaluation for feeding difficulties in a patient with EA may involve an esophagram, videofluoroscopic imaging or fiberoptic endoscopic evaluation during swallowing, upper endoscopy with biopsies, pH-impedance testing, and/or esophageal motility studies. The main goal of management is to reduce the factors contributing to feeding difficulties and may include reducing esophageal stasis, maximizing reflux therapies, treating underlying lung disease, dilating strictures, and altering feeding methods, routes, or schedules.

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“…They are typically slow or reluctant to feed, many cough and choke while eating, and once they start on solids, food may get lodged in the esophagus . Compared with healthy infants, approximately half as many are breast‐fed, and feeding milestones may be delayed . In view of these difficulties, feeding their EA infant poses unique challenges for parents.…”

Section: Impact Of Ea On Infant and Child Developmentmentioning

confidence: 99%

Psychological impact of esophageal atresia: review of the research and clinical evidence

Caplan

2013

Dis Esophagus

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Esophageal atresia (EA) occurs in one out of 2500 to 4500 live births. As the vast majority of infants are now surviving neonatal corrective surgery, the focus has shifted from mortality to morbidity associated with EA. However, little is known about its psychological morbidity. This paper synthesizes research and clinical evidence to highlight the psychological sequelae of EA, including its impact on parents' psychological functioning and its effects on child development from infancy to adulthood. Whether it is discovered at birth or prenatally, EA is a psychologically traumatic event, and parents are at risk for developing traumatic stress reactions following diagnosis. Neonatal surgery and intensive care, risk of complications, associated anomalies, and genetic etiologies multiply risk for parents' acute and post-traumatic stress disorders (PTSD). Parental PTSD has a negative impact on infant and child development through its effects on parenting skills and parent-child interactions. EA children are also at risk for PTSD because of invasive and stressful procedures they undergo during the neonatal period. Consequences of EA can have an important long-term impact on children's psychological and social development. The scant studies pertaining to cognitive functioning suggest that EA does not affect mental development during infancy, but may be associated with deficits as children reach school age. Long-term sequelae are unclear because psychological functioning in adults has not yet been adequately examined. Research and clinical evidence of psychological morbidity associated with EA has implications for clinical practice. Psychological support for parents must begin during the neonatal period and should continue as an integral component of long-term follow up for both children and parents. Support is best provided within the context of a multidisciplinary treatment team that follows patients from birth through childhood and adolescence. Psychological follow up should continue into adulthood, as patients grow up and transition from pediatric to adult health-care settings.

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Achievement of feeding milestones after primary repair of long-gap esophageal atresia

Cited by 37 publications

References 27 publications

A pilot investigation of feeding problems in children with esophageal atresia

A pilot investigation of feeding problems in children with esophageal atresia

Feeding Problems and Their Underlying Mechanisms in the Esophageal Atresia–Tracheoesophageal Fistula Patient

Psychological impact of esophageal atresia: review of the research and clinical evidence

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