we have 20 days old neonates whom alwys has choking with every feeds and sometimes goes all the way to cyanosis and respiratory arrest .... what is the differnial and could it be H-type TOF and if so how to diagnose

What does the plain x-ray look like?

Do you feed the infant formula or breastmilk?

x ray looks normal and wegive him formula feeds

Are there any other symtoms or signs, from the respiratory tract, or any other organ system!?

we have 20 days old neonates whom alwys has choking with every feeds and sometimes goes all the way to cyanosis and respiratory arrest .... what is the differnial and could it be H-type TOF and if so how to diagnose

yes, it can be a H-type TOF, which can be diagnosed by endoscopy.

D/D : Pierre-Robin syndrome, neuromuscular disorders e.g. spinal muscular atrophy, trisomy 18, other disorders involving inco-ordination of sucking& swallowing

Has a modified barium swallow or upper GI been performed on this infant yet?