Abstract
Aim
Children with esophageal atresia and tracheoesophageal fistula (EA-TEF) may experience feeding and swallowing difficulties, which result in stressful interactions between children and caregivers, and potentially impact the concerns of caregivers. The aim of this study was to assess concerns of caregivers of children with EA-TEF related to feeding–swallowing difficulties and compare the concerns according to type of atresia, repair time and time to start oral feeding.
Methods
Caregivers accompanying 24 children with EA-TEF were included. Age, sex, type of atresia, repair time, and time to start oral feeding of children were noted. Parents completed the Feeding/Swallowing Impact Survey (FS-IS) to assess the concerns of caregivers related to feeding–swallowing difficulties. It has three subscales, including daily activities, worry, and feeding difficulties. Average scores range between 1 and 5, of which increasing scores reflect more caregiver concern.
Results
The mean age was 3.41 ± 2.71 years, of which 66.7% were male. 56.3% of cases were isolated EA, and 43.8% were EA–distal TEF. 60.9% of cases received early repair (<1 month of age), and 39.1% had delayed repair (between 1 and 12 months). The median time to start oral feeding was 4 weeks (min = 2, max = 128). The mean scores of daily activities, worry, feeding difficulties, and the total score were 2.40 ± 1.01, 2.79 ± 1.06, 2.14 ± 0.95, and 2.49 ± 0.88, respectively. Caregivers of children with isolated EA reported more problems with ‘daily activities’, ‘feeding difficulties’, and ‘total score’ than EA–distal TEF (P < 0.05). Caregivers of children who received delayed repair reported more problems with the ‘daily activities’ subscale and ‘total score’ than children with early repair (P < 0.05). Moderate to strong correlations were found between the ‘daily activities’ and ‘feeding difficulties’ subscales of FS-IS and time to start oral feeding (P < 0.05, r = 0.56–0.69).
Conclusions
This study suggests that concerns of caregivers of children with EA-TEF related to feeding–swallowing difficulties are associated with the surgical outcome of EA. Caregivers of children with isolated-EA and/or delayed repair and/or delay in oral intake may have higher concerns related to feeding–swallowing difficulties.
Immediate and delayed repair bond strength of a new ormocer resin restorative material as a function of mechanical and chemical surface conditioning methods
