A birth defect called esophageal atresia affects the esophagus, the tube connecting the mouth and the stomach. In babies with esophageal atresia, the esophagus is either incompletely formed or attached to the wrong place, such as the windpipe. As a result, food and saliva cannot reach the stomach and breathing, feeding, and digestion can become difficult.
In addition to genetic mutations or environmental factors affecting fetal esophageal development, esophageal atresia may also be caused by genetic mutations. It is common for esophageal atresia to occur with other birth defects, including heart, kidney, spine, or rib abnormalities. The following risk factors may increase your chances of having a baby with esophageal atresia:
Older age of the father
Fertility treatments, such as in vitro fertilization or intrauterine insemination
Smoking, drinking, or using drugs during pregnancy
Having diabetes, obesity, or thyroid problems during pregnancy
The symptoms of esophageal atresia usually appear soon after birth and can include:
Choking, coughing, or gagging when trying to feed
Drooling or spitting up saliva or mucus
Bluish skin color or difficulty breathing
Abdominal swelling or vomiting
Poor weight gain or growth
Prenatal tests can detect signs of esophageal atresia, such as excess fluid in the amniotic sac or abnormal development of the esophagus, such as ultrasound and amniocentesis. After birth, a physical exam and an X-ray can confirm the diagnosis. A doctor may also try to pass a feeding tube through the baby's nose or mouth to see if it reaches the stomach or gets stuck in the esophagus.
Esophageal atresia requires surgery to repair the esophagus and allow food and saliva to pass normally. The type and timing of surgery vary based on the severity and type of the condition. The most common type of surgery is called an esophageal anastomosis, which involves connecting the two ends of the esophagus and closing any abnormal connections to the windpipe. In some cases, more than one surgery is required to correct the defect and prevent complications, such as narrowing or leaking of the esophagus.
Before and after surgery, the baby may need special care and feeding methods, such as:
Intravenous fluids and nutrition
Suctioning of saliva and mucus from the mouth and throat
Breathing support with oxygen or a ventilator
Antibiotics to prevent infection
Feeding through a tube that goes directly to the stomach or intestine
Medications to reduce acid reflux or improve digestion
There is no known way to prevent esophageal atresia, but some steps that may reduce the risk of having a baby with this birth defect include:
Taking folic acid supplements before and during pregnancy
Avoiding smoking, drinking, or using drugs during pregnancy
Getting regular prenatal care and screening tests
Managing chronic health conditions, such as diabetes, obesity, or thyroid problems, during pregnancy
The outlook for babies with esophageal atresia depends on the type and severity of the defect, the presence of other birth defects, and the quality of care and treatment provided. Esophageal atresia surgery typically leads to normal growth and development for most babies. However, some may develop long-term problems, including:
Difficulty swallowing or eating
Acid reflux or heartburn
Recurrent pneumonia or lung infections
Asthma or breathing problems
Dental or speech problems
Growth or developmental delays
The doctors and specialists who treat babies with esophageal atresia, including pediatric surgeons, gastroenterologists, pulmonologists, nutritionists, and speech therapists, need to follow them up regularly. With the right care and support, babies with esophageal atresia can overcome their challenges and live a healthy and happy life. They may also need additional tests, treatments, or surgeries to monitor and improve their condition.
