Parents' experiences of feeding children born with oesophageal atresia/tracheo-oesophageal fistula.

Alexandra Stewart, Christina H Smith, Roganie Govender, Simon Eaton, Paolo De Coppi, Jo Wray

Journal: Journal of pediatric surgery 2022;57(12):792-799

PMID: 36150934

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Abstract

BACKGROUND

Feeding difficulties are widely acknowledged following oesophageal atresia/tracheo-oesophageal fistula repair. However, little is understood about the nature and severity of these difficulties. This study explored feeding in children with oesophageal atresia/tracheo-oesophageal fistula from the parent perspective.

METHODS

In collaboration with a patient support group, data were collected using a research-specific online discussion forum. Thematic analysis was used to code the data and identify themes.

RESULTS

One hundred and twenty-seven parents registered for the online forum, of whom 83 (65%) provided demographic data. Seventy-four (89%) of responders were mothers, 75 (90%) were of white ethnicity, 65 (78%) were from the UK. Six key themes were identified: feeding is a traumatic experience, feeding my child is scary, feeding is isolating and filled with uncertainty, feeding outside of the home is difficult, feeding associated emotions, developing coping strategies. Parents described features of medical, nutritional, feeding skill and psychosocial dysfunction across all stages of eating/drinking development. They described how their child's feeding difficulties had an impacted their own well-being. An interactional model of feeding difficulties in OA/TOF is proposed.

CONCLUSIONS

Exploring parent experiences provides rich data from which to expand understanding of the complex nature of feeding difficulties in OA/TOF. Feeding should be viewed as a dyadic process, occurring within a family system. Intervention for feeding difficulties should be family-centred, addressing parental anxiety, trauma and uncertainty, as well as the child's underlying medical/surgical needs to optimise outcome. Further study of clinical correlates with parental experience is required.

LEVEL OF EVIDENCE

IV (non-experimental, qualitative).

Address: Department of Language and Cognition, University College London, Chandler house, 2 Wakefield Street, London, WC1N 1PF, UK; Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK. Electronic address: [email protected].; Department of Language and Cognition, University College London, Chandler house, 2 Wakefield Street, London, WC1N 1PF, UK.; Research Department of Behavioural Science & Health, University College London, Gower Street, London, WC1E 6BT, UK; Head and Neck Academic Centre, University College London Hospital, 250 Euston Road, London, NW1 2PG, UK.; Stem Cells and Regenerative Medicine Section, University College London Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.; Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK; Stem Cells and Regenerative Medicine Section, University College London Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.; Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK.

DOI: 10.1016/j.jpedsurg.2022.08.013

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MeSH Terms: Humans, Child, Esophageal Atresia, Tracheoesophageal Fistula, Parents