The study aimed to assess concerns of caregivers of children with EA-TEF related to feeding–swallowing difficulties, compare the concerns according to type of atresia and repair time, and investigate its relationship with time to start oral feeding. Caregivers accompanying 64 children with EA-TEF were included. Age, sex, type of atresia, repair time, and time to start oral feeding were noted. Parents completed the Turkish version of the Feeding/Swallowing Impact Survey (T-FS-IS) to assess the concerns of caregivers related to feeding–swallowing difficulties. The T-FS-IS has three subscales including daily activities, worry, and feeding difficulties. The median age of patients was 3 (min = 1, max = 12) years, of which 57.8% were male. 43.8% of cases were isolated-EA, and 56.3% were EA-distal TEF. 57.8% of cases received early repair, and 42.2% had delayed repair. The median time to start oral feeding was 4 weeks (min = 1, max = 128). The mean scores of daily activities, worry, feeding difficulties, and total score from the T-FS-IS were 2.43 ± 1.18, 2.73 ± 1.28, 2.10 ± 0.97, and 2.44 ± 1.09, respectively. Caregivers of children with isolated-EA reported more problems in total score and all subscales of the T-FS-IS than EA-distal TEF (p < 0.01). Caregivers of children who received delayed repair reported more problems in total score and all subscales of the T-FS-IS than children with early repair (p < 0.05). Moderate to strong correlations were found between the T-FS-IS and time to start oral feeding (p < 0.01, r = 0.55–0.65). This study suggests that 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.
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We would like to thank the children and parents who consented and participated in this study.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Sistonen SJ, Pakarinen MP, Rintala RJ. Long-term results of esophageal atresia: Helsinki experience and review of literature. Pediatr Surg Int. 2011;27:1141–9.CrossRefGoogle Scholar
Koivusalo A, Pakarinen MP, Turunen P, Saarikoski H, Lindahl H, Rintala RJ. Health-related quality of life in adult patients with esophageal atresia-a questionnaire study. J Pediatr Surg. 2005;40:307–12.CrossRefGoogle Scholar
Yalcin S, Demir N, Serel S, Soyer T, Tanyel FC. The evaluation of deglutition with videofluoroscopy after repair of esophageal atresia and/or tracheoesophageal fistula. J Pediatr Surg. 2015;50:1823–7.CrossRefGoogle Scholar
Serel Arslan S, Demir N, Karaduman AA, Tanyel FC, Soyer T. Chewing function in children with repaired esophageal etresia-tracheoesophageal fistula. Eur J Pediatr Surg. 2018;28:534–8.CrossRefGoogle Scholar
Faugli A, Emblem R, Veenstra M, Bhornland K, Diseth TH. Does esophageal atresia influence the mother-infant interaction? J Pediatr Surg. 2008;43:1796–801.CrossRefGoogle Scholar
Kovesi T, Rubin S. Long-term complications of congenital esophageal atresia and/or tracheoesophageal fistula. Chest. 2004;126:915–25.CrossRefGoogle Scholar
Mahoney L, Rosen R. Feeding difficulties in children with esophageal atresia. Paediatr Respir Rev. 2016;19:21–7.Google Scholar
Abidin RR. The determinants of parenting behavior. J Clin Child Adolesc Psychol. 1992;21:407–12.CrossRefGoogle Scholar
Hewetson R, Singh S. The lived experience of mothers of children with chronic feeding and/or swallowing difficulties. Dysphagia. 2009;24:322–32.CrossRefGoogle Scholar
Tawfik R, Dickson A, Clarke M, Thomas AG. Caregivers’ perceptions following gastrostomy in severely disabled children with feeding problems. Dev Med Child Neurol. 1997;39:746–51.Google Scholar
Heckathorn DE, Speyer R, Taylor J, Cordier R. Systematic review: non-instrumental swallowing and feeding assessments in pediatrics. Dysphagia. 2016;31:1–23.CrossRefGoogle Scholar
Lefton-Greif MA, Okelo SO, Wright JM, Collaco JM, McGrath-Morrow SA, Eakin MN. Impact of children’s feeding/swallowing problems: validation of a new caregiver instrument. Dysphagia. 2014;29:671–7.CrossRefGoogle Scholar
Serel Arslan S, Kılınç HE, Yaşaroğlu ÖF, İnal Ö, Demir N, Karaduman AA. Reliability and validity of the Turkish version of the feeding/swallowing impact survey. J Dev Phys Disabil. 2018;30:723–33.CrossRefGoogle Scholar
Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–91.CrossRefGoogle Scholar
Mukaka MM. Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24:69–71.Google Scholar
Goday PS, Huh SY, Silverman A, Lukens CT, Dodrill P, Cohen SS, et al. Pediatric feeding disorder: consensus definition and conceptual framework. J Pediatr Gastroenterol Nutr. 2018;68:124–9.CrossRefGoogle Scholar
Kovar KJ. Nutrition assessment and management in pediatric dysphagia. Semin Speech Lang. 1997;18:39–50.CrossRefGoogle Scholar
Nund RL, Scarinci NA, Cartmill B, Ward EC (2015) Dysphagia and the family, seminars in dysphagia. In: Renee Speyer (ed.), InTech.Google Scholar
Fracchia MS, Diercks G, Yamasaki A, Hersh C, Hardy S, Hartnick M, Hartnick C. Assessment of the feeding Swallowing Impact Survey as a quality of life measure in children with laryngeal cleft before and after repair. Int J Pediatr Otorhinolaryngol. 2017;99:73–7.CrossRefGoogle Scholar
Hiremath G, Rogers E, Kennedy E, Hemler J, Acra S. A comparative analysis of eating behavior of school-aged children with eosinophilic esophagitis and their caregivers’ quality of life: perspectives of caregivers. Dysphagia. 2019. https://doi.org/10.1007/s00455-019-09984-x.Google Scholar
Kumari V, Joshi P, Dhua AK, Sapra S, Srinivas M, Agarwala S, et al. Developmental status of children operated for esophageal atresia with or without tracheoesophageal fistula along with maternal stress, their quality of life, and coping abilities at AIIMS, New Delhi. Eur J Pediatr Surg. 2019;29:125–31.CrossRefGoogle Scholar
Tröbs RB, Finke W, Bahr M, Roll C, Nissen M, Vahdad MR, Cernaianu G. Isolated tracheoesophageal fistula versus esophageal atresia—early morbidity and short-term outcome. A single institution series. Int J Pediatr Otorhinolaryngol. 2017;94:104–11.CrossRefGoogle Scholar
Healey PJ, Sawin RS, Hall DG, Schaller RT, Tapper D. Delayed primary repair of esophageal atresia with tracheoesophageal fistula: is ıt worth the wait? Arch Surg. 1998;133:552–6.CrossRefGoogle Scholar
Hunter CJ, Petrosyan M, Connelly ME, Ford HR, Nguyen NX. Repair of long-gap esophageal atresia: gastric conduits may improve outcome-a 20-year single center experience. Pediatr Surg Int. 2009;25:1087–91.CrossRefGoogle Scholar
Cavallaro S, Pineschi A, Freni G, Cortese MG, Bardini T. Feeding troubles following delayed primary repair of esophageal atresia. Eur J Pediatr Surg. 1992;2:73–7.CrossRefGoogle Scholar
Conforti A, Valfre L, Falbo M, Bagolan P, Cerchiari A. Feeding and swallowing disorders in esophageal atresia patients: a review of a critical issue. Eur J Pediatr Surg. 2015;25:318–25.CrossRefGoogle Scholar
Golonka NR, Hayashi AH. Early “sham” feeding of neonates promotes oral feeding after delayed primary repair of major congenital esophageal anomalies. Am J Surg. 2008;195:659–62.CrossRefGoogle Scholar