nutritional manifestations in OA (oesophageal atresia) / TOF (tracheo -oesophageal fistula)

Last edited 08/2022 and last reviewed 08/2022

Nutritional manifestations in OA (oesophageal atresia) /TOF (tracheo -oesophageal fistula)

• infants and children may fail to thrive due to eating and absorption difficulties
  
  
• growth and puberty may be delayed, especially in those born with long gap OA
  
  
• calorie intake may be less than needed even in adulthood
  
  
• vitamin D, iron and micronutrients may be deficient
  
  
• malnutrition can occur, especially in long-gap OA (1,2)

Weaning and feeding in infants and children

Many feeding difficulties can occur in infants born with OA/TOF due to a combination of dysphagia, GORD and sometimes oral aversion.

• weaning may be later
  
  
• certain foods- meat, apples, bread, raw vegetables- may not be managed, causing bolus obstruction and choking
  
  
• a small minority may need intensive treatment for oral aversion (refusal to eat any solid food) (3)
  
  

Contributor:

• Dr Caroline Love (August 2022)
• Associate Specialist in Dermatology at York Hospitals Trust; Adult born with OA/TOF and representative of TOFS charity

Reference:

• Presse N, Taillefer J, Maynard S, Bouin M. Insufficient Body Weight of Adults Born With Esophageal Atresia. Journal of Pediatric Gastroenterology and Nutrition. 2016 Mar;62(3):469-73.
• Pelizzo G, Destro F, Selvaggio GGO, Maestri L, Roveri M, Bosetti A, et al. Esophageal Atresia: Nutritional Status and Energy Metabolism to Maximize Growth Outcome. Children (Basel). 2020 Nov 14;7(11):E228
• Puntis, John. Feeding difficulties. In The TOF Book by David Crabbe and Vicki Martin