Feeding Difficulties in the Esophageal Atresia Patient

Feeding difficulties are prevalent in children with esophageal atresia and can last into adulthood. Feeding problems in children with esophageal atresia include dysphagia, coughing, choking, vomiting during meals, slow eating, oral aversion, food refusal, stressful mealtimes, poor growth, and malnutrition. Feeding difficulties are complex and are linked to children’s health and the well-being of the family. Gastroesophageal reflux, esophageal mucosal abnormalities, postsurgical anatomical changes, dysmotility, associated anatomical abnormalities, and behavioral feeding disorders are all common causes of feeding difficulties in esophageal atresia. Early involvement by a multidisciplinary team consisting of the surgical and medical team, a feeding therapist, a dietitian, and a psychologist is crucial. The diagnostic evaluation for feeding difficulties in a patient with esophageal atresia typically involves a contrast study, upper endoscopy with biopsies, evaluation for reflux and swallowing difficulties, and/or esophageal/pharyngeal motility studies. Management of feeding difficulties in esophageal atresia patients should be tailored to the underlying mechanism, including feeding adaptation, maximizing reflux therapy, endoscopic intervention, or procedures to address obstruction.