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Noisy breathing in infants

Close Up Of Baby Girl Sleeping In Nursery Cot

An infant’s airways are smaller and softer than adults, so even small amounts of blockage, or narrowing of the airway, may cause stridor – an abnormal breathing sound caused by disrupted airflow – and difficulty breathing.

With stridor, an infant’s airflow is normally disrupted by a blockage in the larynx (voice box) or trachea (windpipe). Laryngomalacia is one of the most common causes of stridor in infants and happens because of floppiness and abnormal positioning of soft tissues and structures of the larynx that obstruct the airway. However, this often improves and goes away as the child ages and their voice box further develops and matures. If your child’s stridor worsens with feeding, agitation or lying on their back, it may be laryngomalacia. Having trouble nursing and poor weight gain are also symptoms of laryngomalacia.

There are a number of potential causes of stridor including, among many other causes:

  • infections, like croup
  • vocal cord paralysis
  • subglottic stenosis, which occurs when the part of the trachea just below the vocal cords is too narrow. Many children outgrow this condition, but surgery may be required in severe cases.
  • subglottic hemangioma, which happens when an abnormal mass of blood vessels occurs in the airway. When a hemangioma is on the skin, it looks like a pink or purple birthmark; this condition is rare but may require surgery.
  • vascular rings, which is when the windpipe is compressed by an abnormally located artery or vein. Surgery may be required to eliminate the pressure.

When diagnosing the cause of the stridor, doctors may ask about the sound of your child’s abnormal breathing, if they have difficulty breathing and when the condition first appeared, as well as other symptoms you may have noticed. Your child’s doctor may order an X-ray or CT scan of your child’s chest and neck to check for signs of blockage. An endoscopy may be performed in the doctor’s office with no sedation required. In some cases, doctors will recommend performing direct laryngoscopy and bronchoscopy in the operating room to examine the larynx, windpipe and lungs which will require anesthesia.

Treatment for stridor varies depending on the cause and severity, as well as the age and health of your child. Your child’s doctor may refer you to an ENT specialist or provide medication to decrease swelling in the airway. In severe cases, your doctor may recommend hospitalization or surgery. Do not wait to see if stridor goes away without medical attention.

To learn more visit our website.

Dr. Joshua Bedwell, otolaryngologist