What are the long term problems?
Narrowing at the Operation Site (Stricture): This occurs in more than a quarter of all babies with this condition. Signs to look out for are if the baby begins to take longer to complete the feed. They may have difficulty in swallowing and breathing at the same time, they may appear to gasp for air. Significantly, your baby may also 'bubble' at the mouth due to the difficulty in swallowing their saliva. They may also be irritable and draw their knees up as if in pain. An x-ray may be needed to prove that a stricture is present. Treatment for this is to admit your baby to hospital, give a general anaesthetic, and dilate the operation site. Your baby may require this done several times over a period of a few months.
Swallowing Difficulties: This is caused by a malfunction of the oesophagus which still works as if it is in two halves. There may or may not be a stricture present. The baby finds that swallowing is difficult. There may be recurrent chest infections and a reluctance to feed.
Problems with Food Lumps: This occur most frequently as the baby is introduced to solids, and, more significantly later on when your baby is about 18 months and is able to self feed. These tend to get stuck at the join (anastamosis). It does not always mean that there is a stricture. Children can usually clear the lumps by taking a drink or by stretching to dislodge it. However, some lumps need removal under general anaesthetic.
Reflux of Stomach Contents: This is quite an uncomfortable condition for your baby. It is as if the baby has 'heartburn'. It may be minor to severe and may predispose to a stricture. Babies may present with vomiting (again either minor or severe), irritability and in some pain. Treatment may be medication, but some 20% require operation for persistent problems such as failure to grow, noisy breathing and blue attacks, and possibly recurrent chest infections.
Tracheomalacia: This is a floppy trachea caused by the cartilage rings around it being abnormally short. The trachea then flops down as the baby tries to breath out. There are 3 problems associated with this.
- 'TOF Cough'. It sounds like a seal barking and if not noticed prior to discharge can cause concern as it sounds very similar to croup. However the cough does improve and is usually gone by 5 years of age.
- Black attacks - These are rare. The baby goes blue and stops breathing - especially noticeable during feeding. Continuous 'black attacks' will require further surgery to prevent this.
- Chest Infections
