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Symptoms of TEF and EA

The most common signs of TEF/EA are:

  • Breathing problems
  • Coughing or choking when babies try to swallow

Babies who have TEF only usually have mild coughing or respiratory symptoms when they are feeding. Since many conditions can cause these symptoms, it may take doctors some time to diagnose TEF. Children who have TEF without EA usually have no noticeable symptoms at birth. Doctors usually find TEF several weeks or months after the baby is born. Signs include:

  • Coughing frequently while feeding
  • Frequent lung infections

Babies with TEF/EA may have problems that are not directly caused by the conditions, but are linked to them. Doctors call this the VACTERL association. Each letter stands for a possible problem that is associated with TEF/EA:

  • V = vertebral, problems with the bones in the spine
  • A = imperforate anus, a problem with the way a baby's anus or rectum has formed
  • C = cardiac, problems with the heart
  • TE = tracheoesophageal fistula and esophageal atresia
  • R = renal, or kidney problems
  • L = limb, problems with arms and legs

All babies with TEF/EA will need a series of evaluations to see whether they have any of these other problems.

Tracheoesophageal Fistula and Esophageal Atresia Diagnosis

Sometimes doctors are able to diagnose TEF/EA before your baby is born based on the results of a prenatal ultrasound.

After your baby is born, doctors diagnose TEF/EA by trying to insert a nasogastric tube (NG tube). The tube passes through the baby’s nose, down the esophagus and into the stomach.

In children who have EA, the NG tube hits a blocked end, usually in the mid- chest. Doctors can see this on an X-ray. Usually they need no other diagnostic test.

In children who have both EA and TEF, the X-ray will also show gas in the baby's stomach. Because the esophagus has not formed properly, the only way gas can get into the stomach is through an abnormal channel. So, finding gas in the baby's stomach means the baby has a fistula. Children who have only EA do not show gas in the stomach.

To find TEF without EA, doctors sometimes use special tests:

  • Barium swallow test. The doctor asks your child to swallow a chalky liquid called barium and takes X-rays. The barium helps the digestive tract show up on X-rays.

Babies who have TEF/EA need tests and treatment to check for other problems that are linked to the conditions. They may need:

  • X-rays to check for spinal problems
  • Ultrasound of the heart (echocardiogram, or ECHO) to check for heart problems
  • Kidney ultrasound and possibly other tests of their kidneys
  • X-rays to check for problems with arms and legs
  • Treatment for problems with the way the anus is formed (imperforate anus).

If your baby has any of these problems, your baby's doctor will explain any tests or treatment they need.

Who Treats This at Seattle Children's?

Should your child see a doctor?

Find out by selecting your child’s symptom or health condition in the list below:

Summer 2014: Good Growing Newsletter

In This Issue

  • Understanding the Power and Influence of Role Models
  • Legal Marijuana Means Greater Poisoning Risks for Children
  • Why Choose Pediatric Emergency Care?

Download Summer 2014 (PDF)