Partial esophageal obstruction was an unusual complication of tracheos
tomy in an infant. Emesis and failure to thrive prompted a modified ba
rium-swallow study, which revealed that the tracheostomy tube was caus
ing an obstruction in the proximal esophagus. Use of a shorter, custom
ized tube eliminated the esophageal obstruction, allowing normal feedi
ng and weight gain.