Lena Torres
Laryngomalacia is a birth defect that causes noisy breathing in babies, often described as a harsh, squeaky sound when breathing in. This sound, called stridor, can be concerning for parents, but most babies with laryngomalacia do not have trouble breathing or feeding. The condition is typically not life-threatening and often resolves on its own by the time the baby reaches their first birthday. However, in some cases, laryngomalacia can cause severe symptoms, including breathing difficulties, feeding issues, and poor weight gain, which may require surgical intervention. So, while babies with laryngomalacia may sound congested, it is important to monitor their symptoms and seek medical advice if there are any concerns.
| Characteristics | Values |
|---|---|
| Sound | A harsh, high-pitched, squeaky, wheezing sound when breathing in, known as stridor |
| When it occurs | When the baby is agitated, feeding, crying, sleeping on their back, lying down, or has an upper respiratory infection |
| When it starts | As soon as the baby is born or in the first few weeks or months after birth |
| How long it lasts | Symptoms usually get worse over the first few months, then start to improve after 3-8 months, and clear up before the baby turns 2 |
| Severity | Symptoms can be mild, moderate, or severe |
| Treatment | In most cases, laryngomalacia resolves on its own without treatment or surgery by the time the baby is 18-20 months old. In severe cases, a surgery called supraglottoplasty is required. |
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What You'll Learn
Laryngomalacia is a common cause of noisy breathing in infants
The exact cause of laryngomalacia is not known, but it is believed to be related to the formation of the voice box before birth. The muscles supporting the voice box may be weak or lack proper muscle tone, causing the tissues above the vocal cords to be floppy and easily fall back over the airway opening. This partial blockage of the airway leads to the distinctive stridor sound.
Symptoms of laryngomalacia typically appear at birth or within the first few weeks of life. Stridor may worsen during the baby's first few months, but it usually improves as the infant gets stronger and typically resolves before their second birthday. In rare cases, laryngomalacia can occur in older children or adults, particularly those with other medical issues.
While most babies with laryngomalacia do not experience breathing or feeding difficulties, a small percentage may struggle with these issues, as well as poor weight gain. Severe cases of laryngomalacia may require surgical intervention, known as supraglottoplasty, to open the airway and improve breathing and feeding. However, the majority of cases resolve without treatment by the time the child reaches 18 to 20 months of age.
If your baby exhibits any concerning symptoms, such as respiratory distress, prolonged pauses in breathing, or colour changes in the skin, it is important to seek immediate medical attention. For milder cases, a paediatrician can provide guidance on monitoring and managing the condition, which may include medications to control associated symptoms such as acid reflux.
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The condition is usually not serious and resolves on its own
Laryngomalacia is a condition that affects the voice box, causing noisy breathing in babies. Despite the concerning sound, the condition is usually not serious and will resolve on its own. In most cases, babies with laryngomalacia do not have trouble breathing or feeding, and they are able to grow at a healthy rate.
The primary symptom of laryngomalacia is noisy breathing, known as stridor. This is a harsh, high-pitched, or wheezing sound that babies make when inhaling. It is often worse when the baby is agitated, feeding, crying, or sleeping on their back. This is because the floppy tissues above the voice box can more easily fall over the airway opening when the baby is in these positions.
Stridor may get worse before it improves, usually around 4 to 8 months of age. In most cases, the condition will resolve without surgery by the time the child is 18 to 20 months old. Over 70% of infants will have resolution of stridor by 1 year of age, and 90% by 2 years of age.
While laryngomalacia is typically not serious, a small percentage of babies do struggle with breathing, feeding, and weight gain, and their symptoms require immediate treatment. Severe cases of laryngomalacia may require surgery, known as supraglottoplasty, to improve the baby's breathing and feeding. This surgery involves cutting the folds of tissue above the vocal cords to open up the airway.
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Breathing and feeding issues may indicate severe laryngomalacia
Laryngomalacia is a common cause of noisy breathing in infants, resulting from a partial blockage of the voice box. This blockage is caused by the softening and collapsing of the tissues around the baby's voice box, which produces a characteristic high-pitched squeaking sound known as stridor. While most babies with laryngomalacia do not experience trouble breathing or feeding, severe cases can lead to breathing and feeding issues that may require medical intervention.
Babies with severe laryngomalacia may exhibit symptoms such as apnea (long pauses in breathing), aspiration (pulling food into the lungs), cyanosis (bluish skin colour), difficulty swallowing (dysphagia), and "tugging" or "pulling in" of the neck or chest when breathing. These symptoms can indicate respiratory distress, and parents should seek immediate medical attention. Severe cases of laryngomalacia may also be accompanied by gastroesophageal reflux (GER), which can worsen the condition.
In terms of treatment, most cases of laryngomalacia resolve without intervention by the time the infant reaches 18 months of age. However, for severe cases that impact breathing and feeding, surgery may be required. The surgical procedure, known as supraglottoplasty, involves tightening the floppy tissue above the voice box to improve breathing and feeding. This surgery is typically performed by an ENT surgeon while the baby is under general anaesthesia.
While waiting for the condition to resolve or for surgery, parents can manage their baby's symptoms at home. Feeding techniques such as thickening the baby's formula or feeding them in a sitting position can help with feeding difficulties. Additionally, anti-reflux medication may be prescribed to control associated symptoms like acid reflux (GERD), which can exacerbate laryngomalacia.
It is important for parents to closely monitor their baby's symptoms and seek medical evaluation if they are concerned. While laryngomalacia is typically not life-threatening, severe breathing and feeding issues can indicate a more serious condition that requires prompt medical attention.
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Supraglottoplasty is a surgical treatment for severe cases
Laryngomalacia is a condition that causes noisy breathing in babies. It occurs when the tissues around the baby's voice box soften and temporarily block their airway. This results in a characteristic squeaking or wheezing sound when the baby breathes in, known as stridor. Although most cases of laryngomalacia are mild and do not affect the baby's ability to breathe or feed, in severe cases, the condition can cause breathing and feeding difficulties.
The type of supraglottoplasty performed depends on the type of laryngomalacia. Type 1 laryngomalacia, for example, necessitates removing redundant supra-arytenoid tissue, while type 2 involves an incision of the shortened aryepiglottic folds. These surgical interventions can be combined.
Supraglottoplasty is considered safe and effective, with impressive success rates ranging from 70% to 100%. It is generally well-tolerated, with no cases of surgical complications reported in one study. Babies typically stay overnight in the hospital for observation following the procedure. While supraglottoplasty can lead to significant improvements in symptoms, it is important to note that breathing may sound worse for a few days after surgery due to post-operative inflammation.
Although most cases of laryngomalacia resolve without treatment, up to 20% of patients may require surgery, particularly if they are having trouble gaining weight or experiencing severe breathing difficulties. The decision to proceed with surgery is made by a doctor, who will consider the severity of the baby's symptoms and their impact on breathing and feeding.
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Gastroesophageal reflux may contribute to symptoms
Laryngomalacia is a congenital softening of the tissues of the larynx above the vocal cords. It is the most common cause of noisy breathing in infancy, with a harsh, squeaky sound when breathing in, known as stridor. This sound can start as soon as the baby is born but is more likely to occur in the first few weeks after birth. In most cases, babies with laryngomalacia do not have trouble breathing or feeding, and the condition is usually not life-threatening. However, gastroesophageal reflux (GER) may contribute to the severity of symptoms in babies with laryngomalacia.
Gastroesophageal reflux, or GER, is a condition where stomach acids flow back up into the oesophagus. It is commonly associated with laryngomalacia, with studies finding GER in 64% of patients with laryngomalacia. The presence of GER can negatively impact the clinical course and symptoms of laryngomalacia, making them more severe. This is because the acid reflux associated with GER can cause swelling above the vocal cords, worsening the noisy breathing that is characteristic of laryngomalacia.
The presence of GER in infants with laryngomalacia can be evaluated through various methods, including questionnaires, barium esophagrams, and 24-hour pH monitoring. Treatment options for GER in infants with laryngomalacia may include anti-reflux medications, which can help manage the reflux and improve symptoms. However, it is important to note that, while GER may contribute to the symptoms of laryngomalacia, other factors such as smoking in the infant's household and other concurrent medical problems can also negatively impact the condition.
The association between GER and laryngomalacia has been observed in multiple studies, with some authors reporting GER in up to 80% of patients with laryngomalacia. However, despite these findings, no definitive study has established a causal link between the two conditions. Nonetheless, the concurrent occurrence of GER and laryngomalacia can have significant implications for the management and treatment of infants with these conditions. In some cases, surgical intervention, such as supraglottoplasty, may be necessary to improve the infant's airway and alleviate symptoms.
In summary, gastroesophageal reflux (GER) is a common concurrent condition in infants with laryngomalacia, and it can contribute to the severity of symptoms. The presence of GER can worsen the noisy breathing associated with laryngomalacia due to swelling above the vocal cords. Therefore, managing GER through anti-reflux medications and other treatments can be an important aspect of caring for infants with laryngomalacia and reducing the impact of their symptoms.
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Frequently asked questions
Laryngomalacia is a birth defect that results in a partial blockage of the voice box. It occurs when the tissues around the baby's voice box soften and temporarily block their airway. It is the most common cause of noisy breathing in infants.
The primary symptom of laryngomalacia is noisy breathing, known as stridor. This is a harsh, high-pitched, or wheeze-like sound that babies make when inhaling. Other symptoms include trouble breathing and feeding, gastroesophageal reflux (GER), and, in severe cases, apnea, aspiration, cyanosis, and difficulty swallowing.
Yes, babies with laryngomalacia often sound congested due to the partial blockage of their airway. The characteristic noise produced is called stridor, which is a noisy, wheeze-like sound during breathing. This sound can worsen when the baby is agitated, feeding, crying, or sleeping on their back.
