Tracheoesophageal fistula is suggested in a newborn by copious salivation associated with choking, coughing, vomiting, and cyanosis coincident with the onset of feeding.

[1] Surgical repair can sometimes result in complications, including:[citation needed] Neonates with TEF or esophageal atresia are unable to feed properly.

Children with TEF can also be born with other abnormalities, most commonly those described in VACTERL association - a group of anomalies which often occur together, including heart, kidney and limb deformities.

[3] Congenital TEF can arise due to failed fusion of the tracheoesophageal ridges after the fourth week of embryological development.

Gastrograffin contrast swallow should not be used if TEF is suspected, due to its high risk of allergy and severe intractable chest infection.