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Feeding your baby breastmilk


This information has been produced for TOFS by Kate Yardley, Registered Midwife and parent of a child born with OA/TOF. The content has been reviewed by Miss Clare Skerritt Consultant Paediatric Surgeon. It has been endorsed by the National Neonatal Surgical Interest Group (NNSIG) and the Neonatal Nurses Association (NNA). Special thanks to the chair of the NNSIG, Fiona Metcalfe and Education lead, Rhiannon Jones for their scrutiny and input to the document.

Providing breastmilk to your OA/TOF baby has many important benefits, for both them and you. While their initial diagnosis of being born unable to swallow does pose a unique challenge for you both, with the correct support and knowledge, they will still be able to have your expressed breastmilk and progress onto breastfeeding.

How you choose to feed your baby and what works best for you both is a unique choice for all mothers and can take many forms including:

  • Exclusive breastfeeding
  • Expressing breastmilk (EBM) to bottle/tube/enterally feed
  • Combination feeding of breastfeeding and giving EBM via a bottle
  • Combination feeding breastmilk and formula
  • Formula feeding
  • Feeding donated breastmilk

The length of time that you choose to give your baby breastmilk depends upon what works best for you both. The World Health Organisation and UNICEF (WHO, 2023) recommends that feeding breastmilk continues until your child is 2 years old and beyond, but it is important to know that any period of providing breastmilk or breastfeeding that you achieve with your baby is a wonderful gift. No matter how long or via what means you choose to feed your baby, TOFS are here to support you.

Feeding breastmilk provides many benefits for both you and your baby. These include:

Benefits for your baby:

  • Increased brain development
  • Increased immunity
  • Increased bonding between mother and baby
  • Reduced risk of developing allergies
  • Reduced risk of sudden infant death syndrome (SIDS)
  • Reduced risk of obesity
  • Reduced risk of developing asthma
  • Reduced risk of several cancers

Benefits for you:

  • Reduced risk of breast and cervical cancers
  • Reduced risk of obesity
  • Reduced risk of osteoporosis
  • Reduced rates of postnatal depression

(NHS, 2023)

Research has found that many of these benefits are particularly important for babies born with congenital disorders such as OA/TOF:

  • Increased immunity – babies born with OA/TOF are at an increased risk of infections. This is due to the requirement for them to have surgery, the presence of a tracheo-oesophageal fistula and associated tracheomalacia, and the need for them to remain in hospital for a period of time after they are born. Breastmilk contains antibodies which increases a baby’s ability to fight infections, protect from inflammation and to build a mature immune system (Camacho-Morales et al., 2021).
  • Improved wound healing – breastmilk contains healing properties and optimal nutrients and has been shown to decrease wound healing times and complications in infants requiring surgery (Mohamed, 2019).
  • Reduction in pain – as well as surgery, your baby may be required to have further minor procedures, such as blood tests, vaccinations and heel prick tests, during their time in hospital, all of which may be painful. Research has found that, outside of giving medicines, breastfeeding is the most effective method of pain relief for babies (Koukou et al., 2022).
  • Bonding – bonding for you and your baby may feel impacted due to their requirement to be transferred to a neonatal intensive care unit (NICU) and undergo surgery. Expressing breastmilk, having skin-to-skin contact once your baby can be held and breastfeeding once your baby can feed, will help you to feel close to your baby and to begin to build a loving, nurturing, intimate attachment. This will also enable you to begin to learn your baby’s cues as well as lower stress and promote feelings of calm for both of you; benefits that will also be important for your baby’s recovery (Brennan, 2023).