In a baby with tracheoesophageal fistula (TEF), there is an abnormal connection in at least one location between the esophagus and the trachea.
The trachea is a tube that travels from the throat to the baby’s windpipe and lungs. A critical part of their airway system, it carries oxygen-rich air to their lungs and carbon dioxide out of them.
Under normal conditions, the esophagus and trachea are two separate tubes that exist and operate independently of one another. They do not connect.
With TEF, a fistula forms that connects the two tubes together. When they swallow formula, milk, or saliva, those liquids can travel across that connection, passing through the esophagus and into the trachea. There, they can be inhaled into the baby’s lungs.
This can cause the baby to cough and choke during feeding. It can also lead to respiratory issues as they get older, as well as frequent lung infections or pneumonia.
There are five main tracheoesophageal fistula types, categorized from Type A to Type E. The most common is Type C. This occurs when the upper portion of the baby’s esophagus ends in a blind pouch and the lower portion connects to the trachea by a fistula. About 85% of babies born with TEF have Type C.