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Respiratory problems and chest infections

Children born with OA/TOF certainly suffer more with respiratory infections than other children, particularly in the early years. This is not due to impaired immunity but a difficulty clearing the airways of the extra mucus during normal infections.

Most childhood chest infections are caused by viruses. The body fights these by making specific antibodies which endow the child with resistance to future attacks by the same virus.

This defence system is called the immune system. TOF children have a normal immune system and make antibodies in the normal way.

  • Viruses are not killed by antibiotics.

  • Some viruses irritate the airways and cause them to become swollen and tight. 


Problems arise with normal chest infections after OA/TOF repair for two reasons:

Impaired clearing of airway secretions can allow mucus to settle in the lungs.

Often antibiotics are given right from the start of respiratory infections in young children born with OA/TOF because they are likely to have difficulty coughing up phlegm. As the child gets older he/she may not need so many antibiotics.

The airways may be more sensitive to viruses.

This causes swelling and tightening, making it hard to move air in and out. The effect is the same as is seen in asthma and responds to the same type of treatment.

Wheeze is the word used to describe the high-pitched whistling noise that air makes when it moves through narrow airway tubes.

Long term outlook

OA/TOF children, on average, have more respiratory symptoms than other children. This is most marked in the first nine years,
however in most cases they can be just as fit and active as their friends of the same age, albeit perhaps needing some medication.

As they grow older any symptoms often improve greatly, although specialised breathing tests may still show differences from normal.

With the exception of activities depending on above average lung function, or those where exposure to airway irritants is common, there should be no restrictions on what an individual born with OA/TOF can do for work or for leisure.

Would you like more information?

Published by TOFS, The TOF Book is the must have guide for anyone affected by, or caring for someone with OA/TOF.

With contributions from medical experts, the TOF Book contains chapters on every aspect of OA/TOF and VACTERL condition, from infancy to adulthood all presented in an easy-to-understand format.