Growth Charts
Possible Newborn Health Problems
Heart Defects
Gastro-intestinal Tract Disorders
Duodenal Atresia
Hirschsprung's Disease
Imperforate Anus
Tracheo-oesophageal Fistula
Congenital Cataracts
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 atresia)

• 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 can’t because the oesophagus is blocked.

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 lungs.

• An x-ray of the abdomen shows air in the stomach.

Once a tracheo-oesophageal fistula is found, surgery is always urgently needed.

During the operation the surgeon

• Joins the two ends of the oesophagus together

• Closes off any connection(s) between the oesophagus and trachea

• May put a tube from outside the body into the baby’s 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 can’t 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.