What You Should Know About VATER Syndrome

newborn in hospital
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VATER Syndrome (sometimes called VATER or VACTERL association) is a set of birth defects which often occur together. The initials in V.A.T.E.R. syndrome refer to five different areas in which a child may have abnormalities:

  • Vertebrae
  • Anus
  • Trachea
  • Esophagus
  • Renal (kidneys)

There may also be cardiac and limb conditions, which changes the acronym to V.A.C.T.E.R.L. A child diagnosed with one of these syndromes will not necessarily have a problem in every area, but a constellation of birth defects involving many of the areas.​​

VATER Syndrome Diagnosis

VATER is not a discrete disorder or disease, so there is no medical test such as a blood test that can diagnose the problem. In order to be diagnosed with VATER Syndrome, a child must have at least three of the problems described above.

While the disorder is unusual (affecting one in 10,000 to 40,000 children), the symptoms can differ greatly from one child to another. An important element of VATER is that it does not seem to impact intellectual development. Thus, if a child has the physical symptoms of VATER along with developmental and/or cognitive challenges, the VATER diagnosis is not appropriate.

Causes of VATER Syndrome

Since VATER is not an actual disease, it is referred to as a "nonrandom association of birth defects." In other words, the specific set of birth defects that may be part of VATER or VACTERL is not known to be causally connected. Instead, they occur together too often to be a random collection of symptoms.

There is no currently known cause, but a gene defect is believed to be involved. Research suggests that some kind of damage may occur early in pregnancy. Also, diabetic women appear to be more likely to have children with VATER.

Treatment of VATER Syndrome

While some children with VATER/VACTERL may have such severe problems that they fail to thrive as infants, many do grow up and live full lives.

The treatment method depends entirely on the specific needs of the individual child. For example, some of the abnormalities in organs and limbs can be successfully treated with surgery. Others may require pharmaceutical interventions, physical therapy, occupational therapy, and so forth.

As children with VATER grow up and begin to attend school, they may have some developmental or physical issues that must be addressed. For instance, they may have difficulty walking, with vigorous exercise, or fine motor coordination.

It is important to note, however, that VATER is not a disorder of the brain. Most children with VATER should be able to manage the intellectual and cognitive demands of school without too much difficulty.

Parents of children with VATER/VACTERL may wish to request genetic counseling as they consider the possibility of having more children. The disorder is genetic and, therefore, your risk of having another child with a similar or related genetic disorder is higher.

VATER Syndrome Resources

In addition to asking your doctor questions, these resources may be useful in further understanding the syndrome.

A number of children's hospitals throughout the country work on treatments of VATER. Some are specialists in a certain aspect of this very complicated syndrome.