Care at the CDH Clinic

The Congenital Diaphragmatic Hernia (CDH) Clinic provides care for the following medical challenges:

  • Chronic lung disease/ oxygen need: damaged lung tissue can cause difficulty breathing, requiring oxygen and other breathing support. Symptoms include rapid or difficulty breathing, use of chest and abdominal muscles, wheezing, easy fatigue during or after feeds, and pale or gray skin around the mouth.
  • Reactive airway disease/asthma like symptoms: wheezing, rapid shallow breathing, with or without dry cough.
  • Developmental delays: delays may include motor, language, thinking or cognitive, social, emotional and vision. The team focuses on early intervention and aggressive therapies to ensure continued progress after the initial hospital stay.
  • Bowel obstruction: caused by scar tissue, twisting or narrowing to cause complete or partial blockage. It prevents food and gas from moving through the bowels. Symptoms include vomiting and abdominal pain.
  • GERD/reflux: an irritation of the esophagus (food pipe) lining caused by acid contents of the stomach moving backward. Abnormal stomach and sphincter position in CDH patients increase the risk of reflux.
  • Growth failure: when weight is less than 3 percentile on a growth chart. Treatment usually requires supplemental feeding through feeding tube or gastrostomy tube. Despite increased calories, some patients may continue to have trouble gaining weight in the first years of life.
  • Oral aversion: reluctance or refusal to eat by mouth. It is usually a result of a prolonged and difficult hospital course with no feeding for several weeks, oral sensitivities, hyperactive gag and reflux.
  • Hearing loss: risk due to use of Extracorporeal Membrane Oxygenation (ECMO) or some medications used during illness.
  • Reherniation of the diaphragm: may occur with respiratory problems or bowel obstruction, usually in the first 3 years of life.
  • Musculoskeletal deformities: the chest wall may develop asymmetrically, or sized differently on each side, due to the changing breathing process in CDH patients. Scoliosis, a curved spine, can also develop as patients grow, especially for those with a very large defect and poor body tone for several months.