Oesophageal atresia is a rare birth defect that affects a baby’s oesophagus (the tube through which food passes from the mouth to the stomach).
The upper part of the oesophagus doesn’t connect with the lower oesophagus and stomach. It usually ends in a pouch, which means food can’t reach the stomach.
It often happens along with another birth defect called a tracheo-oesophageal fistula, which is a connection between the lower part of the oesophagus and the windpipe (trachea).
This causes air to pass from the windpipe to the oesophagus and stomach, and stomach acid to pass into the lungs.
These defects mean the baby won’t be able to swallow safely, if at all.
They could also develop life-threatening problems such as choking and pneumonia if not treated quickly, so surgery will usually be carried out within a few days of birth.
Oesophageal atresia is thought to be caused by a problem with the development of the oesophagus while the baby is in the womb, although it’s not clear exactly why this happens.
The condition is more common in babies of mothers who had too much amniotic fluid in pregnancy (polyhydramnios).
It’s also more common in babies who have problems with the development of their kidneys, heart and spine.
The risk of having another baby with oesophageal atresia is thought to be very small.
Doctors may suspect your baby has oesophageal atresia before they’re born if routine ultrasound scans show a lot of amniotic fluid in the womb, although this can have a number of causes.
Tests to check for the condition will be carried out after your baby is born, if they seem to be having problems swallowing or breathing.
A thin feeding tube may be passed down your baby’s throat through their nose, to see if it reaches their stomach, and an X-ray may be carried out to check the oesophagus.
An operation to repair an oesophageal atresia and tracheo-oesophageal fistula is usually done soon after birth.
Your baby will be taken to the neonatal intensive care unit, where they’re given a general anaesthetic.
They’ll receive nutrition into a vein (intravenously) and a suction tube is used to remove fluid from the pouch in their oesophagus.
The surgeon makes a cut on the right side of the chest, between the ribs, and closes off the abnormal connection (fistula) between the oesophagus and windpipe. They’ll then sew together the upper and lower parts of the oesophagus.
If the gap in the oesophagus is large, your child may need to wait a few months for the operation, to allow their oesophagus to grow a bit more. During this time, they’ll need to have a feeding tube temporarily placed into their stomach through their tummy.
Occasionally, a procedure to lengthen the oesophagus before repairing it may be carried out.
After surgery, your child will be kept in the intensive care unit and placed in an incubator.
They may also need:
Your baby will be given nutrition intravenously at first, but you should be able to feed them after a few days using a feeding tube passed into their stomach through their nose.
You’ll be able to take your baby home once they’re taking food by mouth. This will usually take a week or two. You’ll be advised about how to feed your child when they get home and as they get older.
Breast or bottle feeding will usually be recommended for at least the first few months.
It may then be possible to very gradually wean your child on to thicker foods. The hospital may be able to refer you to a dietitian for specific advice.
Contact the hospital or your GP if your child is choking or coughing on their feeds, has any difficulty swallowing or is failing to gain weight.
With any surgery, there’s a small risk of bleeding and infection.
For this particular operation, the additional risks are:
A further procedure or operation may be needed to treat these problems if they develop.
Most children who have surgery will go on to have normal lives.
But there’s a chance your child may experience some further problems, including:
Your child will be continuously monitored by specialists after their operation to pick up problems such as these and treat them early on. Some of these problems will improve as your child gets older.
Tracheo-Oesophageal Fistula Support (TOFS) is a charity that supports people born with oesophageal atresia and tracheo-oesophageal fistula and their families.
As well as visiting the TOFS website, you can call their helpline on 0115 961 3092.
If your child had oesophageal atresia as a baby, your clinical team will pass information about them on to the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS).
The NCARDRS helps scientists to better understand oesophageal atresia. You can opt out of the register at any time.
1.1 What these terms cover. These are the terms and conditions on which we supply products to you, whether these are goods or services on the www.kivetonpharmacy.com website.
1.2 Why you should read them. Please read these terms carefully before you submit your order to us. These terms tell you who we are, how we will provide products and to you, how you and we may change or end the contract, what to do if there is a problem and other important information. If you think that there is a mistake in these terms, please contact us to discuss.
2.1 Who we are. We are OTC direct services ltd a company registered in England and Wales under the trading name of Kiveon deliver pharmacy. Our company registration number is 12239643 and our registered office address is: 43 Forthill road Sheffield S9 1BA, United Kingdom. Our registered VAT number is GB373807574.
2.3 How we may contact you. If we have to contact you we will do so by telephone or by writing to you at the email address or postal address you provided to us in your order.
3.1 How we will accept your order. Our acceptance of your order will take place when we email you to accept it, at which point a contract will come into existence between you and us.
3.2 If we cannot accept your order. If we are unable to accept your order, we will inform you of this and will not charge you for the product. This might be because the product is out of stock, because of unexpected limits on our resources which we could not reasonably plan for, because it may not be clinically appropriate to supply the product you have ordered, because we have identified an error in the price or description of the product or because we are unable to meet a delivery deadline.
3.3 Your order number. We will assign an order number to your order and tell you what it is when we accept your order. It will help us if you can tell us the order number whenever you contact us about your order.
3.4 We only sell to the UK and EU. Our website is solely for the sale or supply of our products in the UK and EU. Unfortunately, we do not deliver to addresses outside the UK or EU.
3.5 English Language. We only provide treatment and advice in English and it will be your responsibility to ensure that you fully understand our advice.
3.6 Emergencies. You must not use our website or services for emergencies. In emergencies, you should consult your local doctor or the emergency department of your nearest hospital.
4.1 Product packaging may vary. The packaging of the product may vary from that shown in images on our website.
If you wish to make a change to the product you have ordered please contact us. We will let you know if the change is possible. If it is possible we will let you know about any changes to the price of the product, the timing of supply or anything else which would be necessary as a result of your requested change and ask you to confirm whether you wish to go ahead with the change. If we cannot make the change or the consequences of making the change are unacceptable to you, you may want to end the contract (please refer to clause 8).
Changes to the products and/or services . We may change the product or our services offered on the website at any time which may include amendments required to reflect changes in relevant laws and regulatory requirements.
7.1 Delivery costs. The costs of delivery will be as displayed to you on our website.
7.2 When we will provide the products. We will deliver the products that are the subject of your order as soon as reasonably possible and in any event within 30 days after the day on which we accept your order.
7.3 We are not responsible for delays outside our control. If our supply of the products is delayed by an event outside our control then we will contact you as soon as possible to let you know and we will take steps to minimise the effect of the delay. Provided we do this we will not be liable for delays caused by the event, but if there is a risk of substantial delay you may contact us to end the contract and receive a refund for any products you have paid for but not received.
7.4 If you are not at home when the product is delivered. If no one is available at your address to take delivery, our delivery company will leave you a note informing you of how to rearrange delivery or collect the products from a local depot. We will only post the products through the letterbox without the need for a signature where you have specifically selected this option during the ordering process.
7.5 If you do not re-arrange delivery. After a failed delivery to you and you do not re-arrange delivery or collect them from a delivery depot we will contact you for further instructions. If, despite our reasonable efforts, we are unable to contact you or re-arrange delivery or collection we may end the contract.
7.6 Automatic delivery upgrades. In some instances, we may have to automatically upgrade your delivery method; if the shipment does not comply with the size constraints of your chosen delivery method or your chosen delivery method does not have adequate insurances. In these instances, we will not charge you any more for the upgrade.
7.7 Combination of orders. In the event that two or more orders are placed to the same address by the same account on the same day, we may combine the orders into one single delivery. This decision is ultimately at the discretion of the pharmacist on duty. You will not be charged any extra fees, nor will you be re-reimbursed for the cost of the delivery.
7.8 When you become responsible for the goods. The products which we deliver to you will be your responsibility from the time we deliver the product to the address you gave us.
7.9 When you own goods. You own a product which is goods once we have received payment in full.
7.10 What will happen if you do not give required information to us . We may need certain information from you so that we can supply the products to you, for example, the information you are asked to give us for the medical assessment prior to placing your order with us. If we require additional information, we will contact you to ask for this information. We will not be responsible for liability arising out of supplying the products late or not supplying any part of them if this is caused by you not giving us the information we need within a reasonable time of us asking for it. We will also not be responsible for liability arising as a result of any incorrect or misleading information you have given us.
7.11 Reasons we may suspend the supply of products to you. We may have to suspend the supply of a product after an order has been accepted by us due to a change in relevant laws and regulatory requirements or where the supply of the product would not be clinically appropriate.
7.12 Your rights if we suspend the supply of products. We will contact you in advance to tell you we will be suspending supply of the product if we have already accepted your order. You may contact us to end the contract for a product if we suspend it and we will refund any sums you have paid in advance for the products that have not been supplied to you.
7.13 No right of re-supply. You agree that you will not sell, supply or make available the products we have supplied to you to any other person.
7.14 Mental Capacity Act 2005. You confirm that consent to care and treatment from our website has not been sought in line with the Mental Capacity Act 2005.
7.15 Testing Kits. In relation to any testing kit purchased through our website, you acknowledge that neither we nor the manufacturer of the test kits or the supplier of the testing services are able to guarantee the absolute effectiveness or accuracy of the test kit. Therefore, you acknowledge and accept that there may be instances where results obtained from a test kit may be inaccurate including the occurrence of a false positive or false negative result. Subject to the provisions in clause 12, we will not be liable for any inaccurate or other information arising from the results of a test kit and that you should seek medical advice from an appropriate healthcare professional if you think you may be suffering from a medical condition or have any specific queries on medical matters.
8.1 Ending the contract because of something we have done . You may be able to end a contract for a reason set out at (a) to (c) below. Where you decide to end the contract, the contract will end immediately and we will refund you in full for any products which have not been provided. The reasons are:
(a) we have told you about an upcoming change to the product (please refer to clause 6);
(b) we have told you about an error in the price or description of the product you have ordered and you do not wish to proceed;
(c) there is a risk that supply of the products may be significantly delayed because of events outside our control.
8.2 When you don’t have the right to change your mind. You will not be able to return any medicines which you have ordered if the return is not for any of the reasons set out in clause 8.1 above. Please note that the Consumer contracts (Information, Cancellation and Additional Charges) Regulations 2013 do not apply to the sale of medicinal products under a prescription.
8.3 How we will refund you. If you are exercising your right to end a contract based on the reasons set out in clause 8.1, we will refund you the price you paid for any products which have not been despatched to you, by the method you used for payment.
9.1 We may end the contract if you break it . We may end the contract for a product at any time by writing to you if:
(a) you do not, within a reasonable time of us asking for it, provide us with information that is necessary for us to provide the products;
(b) you do not, within a reasonable time, allow us to deliver the products to you.
10.1 How to tell us about problems. If you have any questions or complaints about the product, please contact us.
10.2 Summary of your legal rights . We are under a legal duty to supply products that are in conformity with this contract. Nothing in these terms will affect your legal rights.
11.1 Where to find the price for the product. The price of the product (which includes VAT) will be the price indicated on the order pages when you placed your order. We take all reasonable care to ensure that the price of the product advised to you is correct. However please see clause 11.3 for what happens if we discover an error in the price of the product you order.
11.2 We will pass on changes in the rate of VAT. If the rate of VAT changes between your order date and the date we supply the product, we will adjust the rate of VAT that you pay, unless you have already paid for the product in full before the change in the rate of VAT takes effect.
11.3 What happens if we got the price wrong . It is always possible that, despite our best efforts, some of the products we sell may be incorrectly priced. We will normally check prices before accepting your order so that, where the product’s correct price at your order date is less than our stated price at your order date, we will charge the lower amount. If the product’s correct price at your order date is higher than the price stated to you, we will contact you for your instructions before we accept your order.
11.4 When you must pay and how you must pay . We accept payment with Visa, Mastercard and American Express credit and debit cards. You must pay for the products before we dispatch them. We will not charge your credit or debit card until we dispatch the products to you.
12.1 We are responsible to you for foreseeable loss and damage caused by us . If we fail to comply with these terms, we are responsible for loss or damage you suffer that is a foreseeable result of our breaking this contract or our failing to use reasonable care and skill, but we are not responsible for any loss or damage that is not foreseeable. Loss or damage is foreseeable if either it is obvious that it will happen or if, at the time the contract was made, both we and you knew it might happen, for example, if you discussed it with us during the sales process.
12.2 We do not exclude or limit in any way our liability to you where it would be unlawful to do so . This includes liability for death or personal injury caused by our negligence or the negligence of our employees, agents or subcontractors; for fraud or fraudulent misrepresentation; for breach of your legal rights in relation to the products.
12.3 We are not liable for business losses. We only supply the products for domestic and private use. If you use the products for any commercial, business or re-sale purpose we will have no liability to you for any loss of profit, loss of business, loss of sales, loss of revenue, business interruption, business interruption, loss of business opportunity or for any indirect or consequential loss or damage.
13.1 How we will use your personal information. We will use the personal information you provide to us:
(a) to supply the products to you;
(b) to process your payment for the products; and
14.1 We may transfer this agreement to someone else. We may transfer our rights and obligations under these terms to another organisation.
14.2 Nobody else has any rights under this contract. This contract is between you and us. No other person shall have any rights to enforce any of its terms.
14.3 If a court finds part of this contract illegal, the rest will continue in force . Each of the paragraphs of these terms operates separately. If any court or relevant authority decides that any of them are unlawful, the remaining paragraphs will remain in full force and effect.
14.4 Even if we delay in enforcing this contract, we can still enforce it later . If we do not insist immediately that you do anything you are required to do under these terms, or if we delay in taking steps against you in respect of your breaking this contract, that will not mean that you do not have to do those things and it will not prevent us taking steps against you at a later date.
14.5 Which laws apply to this contract and where you may bring legal proceedings . These terms are governed by English law and you can bring legal proceedings in respect of the products in the English courts. If you are a consumer and not resident in the UK, you may in some circumstances be permitted to bring proceedings in the EU member state in which you reside. If you are a business customer, then you agree to the exclusive jurisdiction of the English courts.