Do you sometimes hear a low whistling sound or a low moaning sound when your little one breathes? It's normal for parents to be a little worried when they see this in newborns. But most of the time, it's nothing serious . Today, we're going to talk about a condition called Laryngomalacia, which can cause this, and is common among babies.
What is Laryngomalacia?
Simply put, Laryngomalacia is a slight weakness in the larynx of our baby's voice box . This happens because the soft tissue above the voice box is a little weak, and when the baby breathes, that tissue temporarily pulls towards the windpipe. Think of it like a balloon with the mouth slightly open, making a noise as the air escapes. This is the main reason why newborn babies make a noise when they breathe.
We call this sound a high-pitched whistling sound (stridor) . This sound is most often heard when the baby takes a breath. Most of the time, this is not a dangerous condition. However, in some rare, severe cases , it can cause the baby to have difficulty breathing or have problems feeding.
Is this common?
Yes, this condition called Laryngomalacia is very common among newborns. This congenital condition (Congenital Laryngomalacia) can be seen in more than half of newborns within the first week of life. In some babies, it can appear between two and four weeks of age.
Adults can also develop laryngomalacia, but it is very rare. Doctors call it ``acquired laryngomalacia''.
What are the symptoms?
Laryngomalacia symptoms can range from mild to severe . The main symptom is a loud, whistling, or whistling sound that occurs when a baby breathes. This sound usually gets worse in the first few months of life and usually disappears completely by the age of one or two.
Most babies hear this breathing sound, but it's not a problem with breathing or breastfeeding . However, this sound may be more noticeable when the baby is lying down, sleeping, crying, or after breastfeeding.
However, babies with severe laryngomalacia may show symptoms such as:
- Apnea (long pauses in breathing )
- Aspiration of food or liquids into the lungs
- Blue skin (Cyanosis) (especially around the lips)
- Difficulty swallowing (Dysphagia)
- Difficulty gaining weight (not gaining weight even after drinking milk)
- A feeling of "tugging" or "pulling in" of the neck or chest when breathing
If your baby shows any of the severe symptoms mentioned above, see your pediatrician immediately.
Why does this happen? What are the causes of Laryngomalacia?
Experts still don't know exactly why some babies develop laryngomalacia and others don't. But there are a few things they think might be contributing to it:
- Structural abnormalities: While the baby is growing in the womb, the cartilage or muscles around the voice box develop differently or poorly.
- Neuromuscular disorders: This condition can also be caused by certain disorders that affect the nerves and muscles of the voice box.
- Gastroesophageal reflux disease (GERD): Simply put, it is the result of stomach acid coming up into the throat. If this acid reaches the voice box, it can cause swelling in that area. This can worsen the structural weaknesses that cause laryngomalacia.
Are there types of Laryngomalacia?
Doctors divide laryngomalacia into three main types based on the cause of the condition:
- Type 1: Constriction or shortening of the mucous membranes of the voice box.
- Type 2: Excessive soft tissue in the upper part of the voice box.
- Type 3: Laryngomalacia occurs due to another underlying condition (e.g., GERD or a neuromuscular disorder).
How do you recognize this exactly?
The main test used to diagnose laryngomalacia is a nasopharyngolaryngoscopy (NPL) . In this test, an ear, nose, and throat specialist (ENT specialist) inserts a small camera-equipped tube (endoscope) through the baby's nostril and down the throat to examine the voice box. This test usually takes about two to five minutes. It is not very painful for the baby.
What else are you testing?
If your baby is confirmed to have laryngomalacia, your doctor may need to do some more tests to find out how much damage has been done. These tests include:
- Airway fluoroscopy: This uses X-rays and a special liquid (contrast agent) to clearly see the affected areas of the baby's body. It may also be used to watch the process of swallowing (a `swallow study`).
- Impedance probe: A small tube is inserted through the baby's nose and down into the esophagus to measure how much stomach acid is flowing into the voice box. Babies who have this test usually have to stay in the hospital for at least one night.
- Microlaryngoscopy and bronchoscopy (ML&B): This also uses a lighted tube to examine the baby's trachea/windpipe and voice box to determine the cause of the breathing sound. This is done under general anesthesia.
- Neck or chest X-rays: These images can help the doctor see if there are any other structural defects that could be causing the baby's breathing sounds.
How is it treated?
The important thing is that most of the time, Laryngomalacia will resolve on its own within a year or two . The breathing noise will gradually decrease. In mild, mild cases, you can manage the symptoms at home. However, if your baby has severe Laryngomalacia, you may need medication or surgery.
How to manage at home?
If your baby has typical symptoms, you can keep an eye on these things at home. The way to manage laryngomalacia may vary from baby to baby:
- If your baby is having trouble swallowing: You may need to feed more often to make up for the lost calories and nutrients. You can also try thickening the formula a little (you can use infant cereal or over-the-counter thickeners). This will help reduce the amount of food that comes back up into the throat.
- If your baby is having trouble breathing: Your doctor may advise you to put your baby to sleep with the head of the mattress slightly elevated. This may help open the airway and make breathing easier.
Always ask your doctor about specific ways to manage your baby's symptoms of Laryngomalacia.
Is there any cure with medicine?
If your baby also has GERD (gastroesophageal reflux disease) along with laryngomalacia, your doctor may prescribe a medication such as a proton pump inhibitor (PPI) or H2 blocker to treat it. GERD can increase the swelling associated with laryngomalacia, so it is important to control it.
Will surgery be needed?
Laryngomalacia rarely requires surgery (supraglottoplasty). This surgery involves cutting out and removing the weak, sagging tissue above the baby's voice box. An ear, nose, and throat (ENT) surgeon performs this surgery in an operating room, with the baby under general anesthesia. After surgery, the baby is usually kept in the hospital overnight for observation.
How long does it take to recover after treatment?
Medications for GERD usually reduce symptoms within two weeks, but your baby may need to continue taking the medication for several weeks, or even months.
If your baby has had laryngomalacia surgery, they may hear a slight increase in their breathing for the first few days . This is normal. This is due to the swelling around the vocal cords after the surgery. This noise will gradually subside and will take about two weeks to fully recover.
Can this be prevented?
No, there is no way to prevent laryngomalacia. However, treatment can help your baby's symptoms be better controlled.
As a parent, you always want to protect your baby from all harm. But Laryngomalacia is something that sometimes happens spontaneously. It doesn't mean you did anything wrong. Although the sound your baby makes when he or she breathes can be a little scary at first, it doesn't always require treatment.
Should you be afraid of this?
Laryngomalacia, although it can make a noise when breathing, is usually not dangerous . Most babies recover from this condition on their own, but some babies may need surgery, especially if they have difficulty gaining weight or have severe breathing problems. If your doctor tells you that your baby has this condition, he or she will explain to you what to expect.
How long will this situation last?
Laryngomalacia usually gets better on its own by the age of 1 or 2. However, you should be aware of more serious symptoms, such as apnea, which is a temporary cessation of breathing, and blue discoloration around the lips. These can lead to serious complications.
When should I see a doctor? / When should I go to the emergency room?
If your baby is showing symptoms of laryngomalacia, such as a wheezing sound, it's a good idea to make an appointment with your doctor. The doctor can examine your baby, refer you to an ear, nose, and throat (ENT) specialist if necessary, and give you advice on how to care for your baby at home.
If your baby suddenly develops symptoms, or if your baby has a condition called ``GERD'' (gastroesophageal reflux disease), call your doctor immediately.
In such a case, go to the nearest Emergency Treatment Unit (ETU) :
- If the baby is not breathing for more than 10 seconds .
- If your neck or chest seems to be pulling inward when you breathe.
- If the lips are turning blue .
What is the difference between Laryngomalacia and Tracheomalacia?
Laryngomalacia and tracheomalacia are both conditions that affect the airway. Laryngomalacia is a weakening of the tissue above the voice box, while tracheomalacia is a weakening or sagging of the cartilage below it, in the windpipe . Tracheomalacia is a condition that is much less common than laryngomalacia, and is usually a little more serious.
A few more small questions...
Can Laryngomalacia cause weight gain?
Usually not. In fact, babies with severe laryngomalacia may have difficulty gaining weight .
What makes Laryngomalacia worse?
Laryngomalacia symptoms may be slightly worse when your baby is lying on his back . If you notice that your baby is having difficulty breathing while sleeping on his back, please see a doctor.
In addition, symptoms can worsen due to GERD (gastroesophageal reflux disease), a condition that is common among babies with laryngomalacia.
Finally, things to remember...
A condition called Laryngomalacia can be a bit of a worry, especially if you're a new parent. The high-pitched, low-pitched sound your baby makes when breathing can make you anxious and leave you wondering, "Is this something more serious?"
But remember, in most cases, Laryngomalacia is not dangerous. However, if you have any doubts or concerns, it is always best to see your baby's pediatrician and, if necessary, ask for a referral to an ear, nose, and throat (ENT) specialist. Don't worry, doctors are here to help!
` Laryngomalacia, Laryngomalacia, Baby Breathing, Voice Box, Stridor, Breathing Difficulty, Baby Health
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