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December 8, 2021 | Wendy Healy Neonatology, Pediatrics.

Parents like to watch their babies sleep. They were very happy to see their lovely children resting so peacefully. But sometimes the baby's breathing is very noisy, and the sound made will make parents wonder if there is a problem.

One of the main reasons leading to noisy breathing or wheezing is called laryngomalacia - long name of one of their own is usually harmless and resolve the condition. Laryngomalacia is caused by loose tissue falling on the larynx (voice box) and partially obstructing the airway when the child inhales.

The sound of laryngomalacia is usually a high-pitched squeaking sound, which usually worsens when the baby is agitated, feeding, crying, or lying on his back. Symptoms usually start within a few weeks or months after birth.

Jocelyn Kohn, MD, an ear, nose and throat (ENT) expert at Stanford Child Health Professional Services, said that although laryngomalacia is the most common cause of noisy breathing in infants and young children, it only requires intervention for a small number of children in Walnut Creek. John Muir Health as part of our partnership with Dr. Kohn is still the East Bay to see a doctor. 

"This condition is called a birth defect by some people, but I prefer to think of it as an immature voice box from 90% of children," said Dr. Cohen.

She added that, in most cases, when children under 2 years of development and throat will get rid of laryngomalacia. "As children get older, their throats get stronger," she said. However, a small number of cases require surgical treatment, which is safe and effective.

Parents may notice these symptoms in their children:

The severity may vary. "Some babies I have seen are mild and just squeak, while other babies may be more serious. Pediatricians always advise parents to ask their doctor about anything related to them," she said. "This is good advice. But as far as laryngomalacia is concerned, treatment is usually not needed."

In the worst case, when the baby is sleeping, difficulty eating and body weight did not increase, it is best to talk with your doctor. "These may indicate the need for intervention by an otolaryngologist," Dr. Cohen said.

She said that when children with laryngomalacia do not gain weight, it is usually because they consume so much energy to breathe that they are exhausted. Breathing difficulties depressed children often regarded as the chest and neck, indicating that he or she can not get enough air.

In these cases, the experts by the camera into the throat to carefully observe the situation of the throat occur. "Saw it helps to let the parents at ease or guide further treatment," said Dr. Cohen.

If the softening of the throat worsens due to reflux, Dr. Kohn will treat it with medication. Babies can also be placed to relieve breathing problems. Most noisy breathing occurs when the baby is lying flat, which is the correct sleeping position. A baby who is awake and being monitored can be placed on the belly to help alleviate the problem.

"We tell parents to put gravity on their side. Keeping babies upright when feeding, lying on their stomachs often, and putting them on their stomachs when awake can help," Dr. Cohen suggested. 

Dr. Kohn said, very severe cases of cases for two years and may require surgery, which is effective for most children. She performed supraglotoplasty, adjusting the tissue above the vocal cords on the glottis. Although the surgery requires general anesthesia, but it is minimally invasive, using a microscope and endoscope inserted into the throat. Remove excess tissue and release tight areas.

“Infants usually stay in the hospital for one night and recover well. Most will experience mild discomfort, but it will subside quickly. Most babies can restart eating immediately after surgery,” Dr. Cohen said.

The cause of many respiratory murmur, in addition to laryngomalacia, as well as cysts, hemangioma, inhaled foreign body. In case of sudden onset, or the child can not put something into his mouth and breathing, seek emergency care immediately.

Learn more about laryngomalacia at Stanford children's health HealthTalks podcast.

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