Esophageal atresia or tracheoesophageal fistula (EA/TEF) repair: How to help your child with eating

By SickKids staff

Find out how to help your child with swallowing and digesting food after EA/TEF repair.

Key points

Your child might find it difficult to swallow food and liquids after EA/TEF repair. This is called dysphagia.
You can help your child by serving foods with dressings or sauces, letting your child take sips of liquid after every two or three bites, cutting food into small pieces and scheduling five or six small meals during the day.
If food becomes stuck, stay calm, offer some sips of liquid and distract your child while they wait for the food to pass.
Contact your child’s health-care provider if your child finds it hard to swallow even their own saliva, if food does not pass with the help of liquid or if their eating habits have changed a lot for two meals in a row.

Introduction

More information

Treatment

Your child may experience difficulties drinking liquids and may need to be assessed by an occupational therapist (OT) while in the hospital.
If your child is struggling to swallow their feeds, their esophagus may have narrowed. Contact your health-care provider.

Pureed food is usually introduced to a child between four and six months of age. This will likely be the case for your child as well. Check with your health-care provider before starting your child on purees.
Once your child is able to take smooth purees, feel free to try thicker, more solid textures. First make sure that your child is able to hold their head up and sit comfortably (with some support) in a highchair.

As your child’s diet progresses, avoid food that is sticky or gooey or food that becomes sticky or gooey after chewing, such as soft bread. This type of food can be hard to swallow because it becomes a sticky ball when it is chewed.
Be aware that some children gag and refuse solids or lumpy food. If this is your child’s experience, ask your child’s occupational therapist (OT) for tips to help move from one food texture to another.
If you are offering table food, make sure it is cut into small pieces and that your child chews it really well. Very hard food, or food that is not chewed well, can be difficult to swallow and may get stuck.
Serve foods with lots of liquids (such as dressings, dips, sauces and gravies) to help with swallowing.
Some finger and table food can help to keep scar tissue stretched, but children may tolerate some textures more than others.

Mealtimes should be similar to those for any child.

Provide a balanced diet that includes all food groups from Canada’s Food Guide:vegetables and fruit, grain products, milk and alternatives, and meat and alternatives.
Serve your child several small meals during the day. Many children need to eat five or six small meals throughout the day after esophageal atresia or tracheoesophageal fistula (EA/TEF) repair.
Aim for meals every three or four hours.
Do not let mealtimes last more than 30 minutes.
Encourage your child to:

sit upright while eating (highchairs or booster seats can help younger children)
take small bites and chew their food well
eat slowly

If your child finds it difficult to eat within the time limits of school meal or snack times, talk to your health-care provider about offering higher calorie drinks (such as smoothies or yogurt drinks).

Complications

When to seek medical attention

Last updated: January 26th 2015