Feeding difficulties, food intake, and growth in children with esophageal atresia

Objectives
Challenges regarding feeding difficulties and nutrition in children with esophageal atresia (EA) have been sparsely studied. The aim of this study was to explore parent-reported feeding difficulties in children with EA by applying Montreal Children's Hospital-Feeding Scale (MCH-FS), and to further explore associations between feeding difficulties and clinical factors, growth and nutritional intake.

Methods
Parents of EA children born between 2012 and 2017 were invited. Clinical data were collected from medical records. In a prospective cohort-study parent-reported feeding difficulties (by MCH-FS) were reported at two assessments, and at the second assessment, dietary data were collected by using the 24-h food-recall method.

Results
Out of 55 eligible participants, we evaluated 53 children at median age of 1.6 years (Q1:Q3 1.0:2.9) (first assessment) and 38 at median age of 4.2 years (Q1:Q3 1.0:2.9) (second assessment). Feeding difficulties were reported by 34% and 31% of the parents, respectively, but no particular profile of concerns could be identified. Children's energy intake and weight-for-age were correlated with feeding difficulties (MCH-FS total score) (p < 0.02).

Conclusion
Parent-reported feeding difficulties were identified in one-third of children with EA and related to low energy intake and low weight-for-age, but not to clinical factors. This implies that feeding difficulties must be screened for during follow-up in all EA children and may facilitate early detection of challenges and intervention if needed.