Before the Procedure:

Most infants with a diaphragmatic hernia are transferred to a NICU (neonatal intensive care unit). It may take days or weeks for your childâ ' s health to be stable enough for surgery.

• In the NICU, your child will probably need help breathing with a breathing machine (mechanical ventilator) before the surgery. This is because their lungs are smaller than normal.
• If your child is very sick, their doctor may use a heart-lung bypass machine to help them get well enough for surgery. This machine does the work of the heart and lungs for your child.
• Before surgery, the hospital staff will be taking many x-rays and doing many blood tests to see how well your childâ ' s lungs are working. Your child will also have a light sensor (called a pulse oximeter) taped to their skin to monitor the oxygen level in their blood.
• Your child may also be on medicines to control their blood pressure and keep them comfortable.

Your child will also have a tube going from their mouth to their stomach to keep air out of the stomach. They will also have a catheter (tube) placed in an artery and a vein to deliver nutrients and medicines, and so that their blood can be monitored.

After the Procedure:

Your child will stay in the hospital for several days to weeks after the surgery. Your child will be on a breathing machine after the surgery. Once they are taken off the breathing machine, they will still need oxygen and some medicine for a while.

Feedings will start after your childâ ' s bowels start working. Feedings are usually done through a feeding tube from the mouth into the stomach or small intestines until your child can take all the food they need by mouth.

Most infants with diaphragmatic hernias have reflux when they eat. This means the food in their stomach moves up into their esophagus (the tube that leads from the throat to the stomach). This can be painful for your child. It also leads to frequent spitting up, which makes feedings more difficult once your child is taking food by mouth.

The nurses and feeding specialists will help you learn the best way to feed your baby. Some children need to be on a feeding tube for a long time to get enough food to grow.

Outlook (Prognosis):

The outcome of this surgery depends on how well your baby's lungs have developed. Usually the outlook is very good for infants who have enough lung tissue.

All children who have had diaphragmatic hernia repairs will need to be watched closely to make sure the hole in their diaphragm does not open up again as they grow.

Children who had a large opening or defect in the diaphragm, or who had more problems with their lungs after birth, may have ongoing lung disease after they leave the hospital. They may need oxygen, medicines, and a feeding tube for months or years.

Some children will have problems crawling, walking, talking, and eating. They will need to see physical or occupational therapists to help them develop muscles and strength.