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Stomach

When a newborn baby is unable to hold down milk. Examination reveals a developmental disorder in which the esophagus fail to connect to the stomach. What survival needs are most immediately threatened?

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May 26, 2008 7:49PM

Dehydration is the immediate worry that needs to be addressed. With a malformed connection between oesophagus and stomach, the child will have difficulties in absorbing water. This will therefore need to be supplied, with haste, most probably in intravenous form.

The next issue will be malnutrition. Again, because the deformity will be preventing uptake of fluids, the enriched fluid of breast milk with its vital nutrients will have been missing. Various options exist for providing this nutrition.

Surgical intervention is indicated, although timescales depend upon how bad the deformity is and how strong the child is. This is an issue of oesophageal atresia. I would believe the major concern would be of aspiration of milk into the lungs, leading to the neonate choking and dying. The next issue would be dehydration and malnutrition, solved by parenteral nutrition and IV fluids.