Laryngomalacia

Sometimes babies have noisy breathing. This can be due to congestion, or it can be a condition of the larynx called laryngomalacia. Laryngomalacia is a congenital softening of the tissues of the larynx, commonly known as the voice box, above the vocal cords.

What is Laryngomalacia?

Laryngomalacia is the most common cause of raspy, noisy breathing in infancy. It happens when the structure of the larynx is floppy and malformed. This causes the tissues to fall over the airway, partially blocking it and creating noise when breathing.

Is Laryngomalacia Serious Condition?

In most cases, laryngomalacia is not a serious or life-threatening condition. The child may have noisy breathing, particularly when on his or her back, but is still able to eat and grow. The condition usually resolves itself before the child’s second birthday.

There is a small percentage of babies with laryngomalacia, however, who struggle with breathing, eating, and gaining weight. These cases need prompt attention.

What are possible Laryngomalacia signs should I look for?

Beyond noisy breathing, you should watch for the following signs:

• Breathing stops for more than 10 seconds.
• Blue color around the lips when noisy breathing occurs.
• Neck or chest pulls in to no avail after being repositioned or awakened.

The Symptoms of Laryngomalacia

Children are usually born with laryngomalacia. The symptoms may not be initially obvious but become more so as the first few weeks progress. Although most children outgrow the condition at 18 to 20 months, it often gets worse, usually at four to eight months.

Here are the symptoms:

• Noisy breathing is an audible wheeze when the baby inhales. It worsens when the baby is feeding, crying, sleeping on his back, or otherwise agitated.
• High-pitched sound when breathing
• Difficulty feeding, sometimes choking while feeding
• Poor weight gain
• Apnea (breathing stops, usually when sleeping)
• Sometimes face turns blue
• Gastroesophageal reflux
• Food aspiration

Diagnosing Laryngomalacia

At Coastal Ear, Nose, and Throat, we often conduct a nasopharyngolaryngoscopy to evaluate problems with a child’s breathing. We use a very tiny camera that resembles a piece of spaghetti for the test. The camera is inserted into the baby’s nostril and down into the lower part of the throat. This allows our doctors to see the larynx area.

If we think your child has laryngomalacia, we then investigate the extent to see whether the lower airway is affected. Other tests such as microlaryngoscopy could be used at that point.

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What are the treatment options for laryngomalacia?

If the more serious symptoms above, along with confirmation by our examination, dictate a severe case of laryngomalacia, surgery can be necessary to correct the problem. The surgery is called supraglottoplasty and, while it doesn’t eliminate the child’s noisy breathing, it lessens the serious breathing and swallowing problems, allowing your child to breathe normally and gain weight.