A 3-hour old male shows cyanosis that worsens when feeding. What is the likely diagnosis?

In this scenario, the 3-hour old male exhibiting cyanosis that worsens when feeding is indicative of choanal atresia. This condition involves a blockage of the nasal passage that can lead to respiratory distress, particularly during feeding when the infant is unable to breathe through the mouth.

During feeding, an infant typically requires an unobstructed airway to allow for coordinated swallowing and breathing. In cases of choanal atresia, the obstruction can worsen when the infant is in a supine position, such as during feeding, thereby exacerbating episodes of cyanosis. The presentation often includes a history of difficulty breathing, especially when trying to eat, and can be observed more noticeably after the newborn begins to feed since nasal breathing becomes crucial during this action.

Other options, while related to neonatal presentations, do not align as closely with the specific symptoms described. Congenital heart defects typically present with varying levels of cyanosis that may not specifically worsen with feeding but are more constant, while esophageal atresia would primarily manifest with difficulties in swallowing and aspiration. Diaphragmatic hernia typically presents with respiratory distress due to lung compression, presenting signs of cyanosis at rest rather than being specifically triggered by feeding.

Overall, the timing and