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Feeding disorders in children with oesophageal atresia: a cross-sectional study
  1. Aurélie Pham1,
  2. Emmanuelle Ecochard-Dugelay2,
  3. Arnaud Bonnard3,
  4. Enora Le Roux4,
  5. Thomas Gelas5,
  6. Véronique Rousseau6,
  7. Nadège Thomassin7,
  8. Isabelle Cabon-Boudard8,
  9. Audrey Nicolas9,
  10. Audrey Guinot10,
  11. Julie Rebeuh11,
  12. Aurélie Le Mandat12,
  13. Djamal-Dine Djeddi13,
  14. Virginie Fouquet14,
  15. Aurélie Boucharny15,
  16. Sabine Irtan16,
  17. Julie Lemale17,
  18. Aurélie Comte18,
  19. Laure Bridoux-Henno19,
  20. Claire Dupont-Lucas20,
  21. Georges Dimitrov21,
  22. Anne Turquet22,
  23. Corinne Borderon23,
  24. Cécile Pelatan24,
  25. Emilie Chaillou Legault25,
  26. Camille Jung26,
  27. Stéphanie Willot27,
  28. Louise Montalva3,
  29. Delphine Mitanchez28,
  30. Frederic Gottrand9,
  31. Marc Bellaiche2
  1. 1AP-HP, Department of Neonatology, Armand-Trousseau Childrens Hospital, Paris, France
  2. 2AP-HP, Service des Maladies Digestives de l'Enfant, Hôpital Universitaire Mère-enfant Robert-Debré, Paris, France
  3. 3Department of General Pediatric Surgery, Robert Debre Children University Hospital, APHP, Paris, France
  4. 4AP-HP, Paris, France, Nord-Université de Paris, Hôpital Robert Debré, Unité d’épidémiologie clinique, Inserm, CIC 1426, Robert-Debré Hospital, Paris, France
  5. 5Hôpital Femme-Mère-Enfant, Service de Chirurgie Pédiatrique, CHU Lyon, Lyon, France
  6. 6Pediatric Surgery, APHP, Hôpital Universitaire Necker-Enfants Malades, Paris, France
  7. 7Hépato-Gastroentérologie Pédiatrique, University Hospital Centre Grenoble Alpes, Grenoble, France
  8. 8AP-HM, Service de Pédiatrie, Hôpital de la Timone, Marseille, Provence-Alpes-Côte d'Azu, France
  9. 9Centre de Reference des Affections Chroniques et Malformatives de l’œsophage, CHU Lille, Lille, France
  10. 10Service de Chirurgie Infantile, CHU de Nantes, Hôpital Mère-enfant, Nantes, France
  11. 11Department of Pediatrics, University Hospital Centre Strasbourg, Strasbourg, France
  12. 12Service de Chirurgie Viscérale Pédiatrique, CHU de Toulouse, France, Hôpital des Enfants, Toulouse, France
  13. 13Service de Pédiatrie Médicale, CHU Amiens Picardie, France, Pôle Femme Couple Enfant, Amiens, France
  14. 14Paediatric Surgery, Paris South University Hospitals, Assistance Publique Hôpitaux de Paris, Le Kremlin Bicetre, France
  15. 15Service de Pédiatrie, CHU Dijon, France, Hôpital d'Enfants, Dijon, France
  16. 16Department of Pediatric Surgery, Armand-Trousseau Childrens Hospital, Paris, France
  17. 17Department of Pediatric Gastroenterology, Armand-Trousseau Children's Hospital, Paris, France
  18. 18Service de Médecine Pédiatrique, CHU Besançon, Besançon, France
  19. 19Département de Médecine de l'Enfant et de l'Adolescent, CHU Rennes Unité de Nutrition, Rennes, France
  20. 20Pediatrics, Gastroenterology Unit, Centre Hospitalier Universitaire de Caen, Caen, France
  21. 21Service de Chirurgie Pédiatrique, CHR d'Orléans, Orléans, France
  22. 22Service de Pédiatrie, CHU La Réunion, La Reunion, France
  23. 23Service de pédiatrie, CHU Clermont-Ferrand, Clermont-Ferrand, France
  24. 24service de pédiatrie, CH Le Mans, Le Mans, Pays de la Loire, France
  25. 25Pédiatrie, Pôle Femme-Mère-Enfant, CHU Angers, Angers, Pays de la Loire, France
  26. 26Service de Pédiatrie, CH Intercommunal de Créteil, Creteil, France
  27. 27Service de Médecine Pédiatrique, CHRU de Tours, Hôpital Clocheville, Tours, France
  28. 28Service de Néonatologie, CHRU de Tours, France, Hôpital Bretonneau, Tours, France
  1. Correspondence to Dr Aurélie Pham, Service de néonatologie, AP-HP, Hôpital Trousseau, Paris 75012, France; aurelie.pham{at}inserm.fr

Abstract

Introduction With advances in surgical and neonatal care, the survival of patients with oesophageal atresia (OA) has improved over time. Whereas a number of OA-related conditions (delayed primary anastomosis, anastomotic stricture and oesophageal dysmotility) may have an impact on feeding development and although children with OA experience several oral aversive events, paediatric feeding disorders (PFD) remain poorly described in this population. The primary aim of our study was to describe PFD in children born with OA, using a standardised scale. The secondary aim was to determine conditions associated with PFD.

Methods The Feeding Disorders in Children with Oesophageal Atresia Study is a national cohort study based on the OA registry from the French National Network. Parents of children born with OA between 2013 and 2016 in one of the 22 participating centres were asked to complete the French version of the Montreal Children’s Hospital Feeding Scale.

Results Of the 248 eligible children, 145 children, with a median age of 2.3 years (Q1–Q3 1.8–2.9, min–max 1.1–4.0 years), were included. Sixty-one children (42%) developed PFD; 13% were tube-fed (n=19). Almost 40% of children with PFD failed to thrive (n=23). The presence of chronic respiratory symptoms was associated with the development of PFD. Ten children with PFD (16%) had no other condition or OA-related complication.

Conclusion PFD are common in children with OA, and there is no typical profile of patients at risk of PFD. Therefore, all children with OA require a systematic screening for PFD that could improve the care and outcomes of patients, especially in terms of growth.

  • gastroenterology
  • growth
  • neonatology
  • occupational therapy

Data availability statement

Data are available upon reasonable request from corresponding author (aurelie.pham@inserm.fr)

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Data availability statement

Data are available upon reasonable request from corresponding author (aurelie.pham@inserm.fr)

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Footnotes

  • Contributors AP: conception of the work; the acquisition, analysis and interpretation of data; drafting of the work; final approval of the version published;and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. EE-D and ELR: conception of the work; the analysis and interpretation of data; revising the work critically for important intellectual content; final approval of the version published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. AB and FG: conception of the work; the acquisition of data; revising the work critically for important intellectual content; final approval of the version published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. TG, VR, NT, IC-B, AN, AG, JR, ALM, D-DD, VF, AB, SI, JL, AC, LB-H, GD, AT, CB, CP, ECL, CJ, SW and DM: acquisition of data, revising the work critically for important intellectual content, final approval of the version published, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MB: conception of the work, analysis and interpretation of data, revising the work critically for important intellectual content, final approval of the version published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding This work was supported by the family support group Association Française pour l’Atrésie de l’Oesophage.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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