Possible Newborn Health Problems
Gastro-intestinal Tract Disorders
Unusual Blood Results
Tracheo-oesophageal Fistula (TOF)
Tracheo-oesophageal fistula (TOF) means
the top of the oesophagus is blocked
and cannot allow the passage of food or saliva (oesophageal
the bottom of the oesophagus is linked
to the trachea so air and stomach contents can pass between
the two tubes
Sometimes a tracheo-oesophageal fistula is
found before birth by an ultrasound scan.
But usually it is found on the first day after
a baby is born.
the baby is unable to swallow saliva
and may froth at the mouth
the baby may have problems breathing
or have blue lips or hands, because fluid is getting into the
trachea or lungs,
the baby may have a swollen tummy because
lots of air is passing from the trachea into the intestines.
A doctor tries gently to pass a tube
into the babies stomach but cant because the oesophagus
These babies need
- a drip
- a heart echo
- to be in a paediatric surgery centre
An x-ray of the chest to show where
the tube is being held up and whether there is fluid in the
An x-ray of the abdomen shows air in
Once a tracheo-oesophageal fistula is found,
surgery is always urgently needed.
During the operation the surgeon
Joins the two ends of the oesophagus
Closes off any connection(s) between
the oesophagus and trachea
May put a tube from outside the body
into the babys stomach (a gastrotomy) this means the baby
can have food directly into the stomach while the operation
site is healing
puts in a chest drain, to drain away
fluid from around the lungs while the operation site heals
Afterwards, the baby will need some time in
the neo-natal intensive care unit. For a day or two the baby
will probably be kept paralysed and on a ventilator so movement
cant interfere with the early healing.
The baby will need a few weeks in hospital
until feeding is going well and there are no other problems.
The child will continue to have check-ups
with the paediatric surgeon to check that the child is getting
enough nutrition and has no intestinal problems.