Baby making gasping noises while feeding

Laryngomalacia (for Parents) - Nemours KidsHealth

What Is Laryngomalacia?

Laryngomalacia is a common cause of noisy breathing in infants. It happens when a baby's larynx (or voice box) is soft and floppy. When the baby takes a breath, the part of the larynx above the vocal cords falls in and temporarily blocks the baby's airway.

Laryngomalacia (luh-ring-oh-muh-LAY-shuh) usually gets better on its own by the time a baby is 1 year old.

What Are the Signs & Symptoms of Laryngomalacia?

Babies with laryngomalacia make a harsh, squeaky sound when breathing in. This sound, called stridor, can start as soon as the baby is born or, more often, in the first few weeks after birth. Symptoms usually get worse over several months.

Most babies with laryngomalacia do not have trouble breathing or feeding, even though their breathing is noisy. Breathing usually gets noisier when the baby is crying, feeding, sleeping, lying down, or has an upper respiratory infection.

Most babies with the condition have mild symptoms. A baby whose symptoms are more serious might have:

  • trouble breathing (look for tugging in at neck or stomach)
  • feeding problems
  • poor weight gain
  • breathing pauses (apnea)
  • blue skin or lip color (cyanosis)

Call the doctor right away if your baby has these symptoms or breathing suddenly gets worse.

Babies with laryngomalacia often have gastroesophageal reflux (GER). This happens when food and acid go back up into the esophagus. If stomach acid reaches the voice box, symptoms may get worse. Formulas or medicines to help with reflux may help with breathing symptoms.

What Causes Laryngomalacia?

Doctors don't know what causes laryngomalacia, but it may have something to do with how the voice box formed before the baby was born. The muscles supporting the voice box may be weak or don't coordinate well with breathing. Gastroesophageal reflux may also play a role.

How Is Laryngomalacia Diagnosed?

Doctors often suspect laryngomalacia at birth or soon after based on the baby's symptoms and an exam. To confirm the diagnosis, a pediatric ear, nose, and throat (ENT) specialist will do a procedure called flexible laryngoscopy. To do this, the doctor passes a thin tube through the baby's nose or mouth to look at the airway and vocal cords in the voice box.

The doctor may check oxygen levels and order other tests to check for swallowing problems or GER. The baby's good weight gain and growth are very important.

How Is Laryngomalacia Treated?

Most of the time, laryngomalacia gets better on its own, usually by a baby's first birthday. Doctors will do regular exams to check the baby's breathing and weight. Because most babies also have GER, doctors usually prescribe anti-reflux medicine.

A baby who has severe breathing problems or poor growth may need a surgery called supraglottoplasty (soo-pruh-GLOT-oh-plass-tee). Doctors do this procedure through the baby's mouth to tighten the floppy tissue above the voice box. This will improve the baby's feeding and breathing.

What Else Should I Know?

Noisy breathing and other laryngomalacia symptoms usually get worse over several months, then start to improve after 3–6 months. Symptoms clear up completely in most kids. Occasionally, an older child with a history of laryngomalacia may have noisy breathing while exercising, during a viral infection, or when sleeping.

Reviewed by: Steven M. Andreoli, MD

Date reviewed: October 2019

Is My Child's Noisy Breathing Serious?

Naturally, it can be concerning for parents to hear their babies make noises when they breathe. One common condition that causes noisy breathing in babies is called laryngomalacia. This occurs when the tissue above the vocal cords is floppy and falls into the airway when a child breathes in, which causes noisy breathing (called stridor).

For most infants, this condition is not serious and will resolve on its own. However, 15-20% of infants end up needing surgery.  If a baby will require surgery to treat the laryngomalacia, we will usually know by the time the baby is about 12 months old—give or take a few months because each baby is different.

Signs and Symptoms

Most babies who have laryngomalacia start to show symptoms at or shortly after birth. Symptoms may worsen a bit during the first few weeks of life, usually around 4-6 months old. Most children outgrow laryngomalacia by about 9-18 months old, once the tissue in the larynx has grown stiffer.

Symptoms for laryngomalacia include:

  • Noisy breathing (stridor), a high-pitched squeaking noise you hear when your baby breathes in.
  • Difficulty feeding and gasps or chokes during feeds.
  • Trouble gaining weight.
  • Baby’s skin between the ribs and in the neck is being sucked in with every breath.
  • Pauses in breathing while sleeping.

Even though your child’s laryngomalacia may be mild, it’s still important to watch for signs or symptoms of it worsening.

More About Stridor

Stridor can be alarming if you’ve not heard this type of noisy breathing before. Sometimes it sounds like a squeak or a wheeze.

A couple of important points about stridor:

  • It can get worse when babies are eating and crying, because they’re working harder to breathe at these times.
  • Some babies are noisier when they’re asleep; others are noisier when awake.
  • The stridor itself is not the main cause for concern. The noisy breathing will not harm your child.

While most parents get used to the sound of their baby’s stridor, it might cause concern in others. Share what you know about laryngomalacia with family members, daycare providers and babysitters. Assure them that the noise in and of itself isn’t scary. Educate them about the above signs you are watching for at home so they know what to keep an eye on as well.

Questions Your Doctor Will Ask You

When your pediatrician is evaluating your baby, he or she will ask several questions to assess how serious your baby’s condition is. These are the types of questions you’ll want to be prepared to answer:

  1. Describe the noise you hear when your baby is breathing. When do you hear it (asleep, awake)? What makes it worse (feeding, sleeping, crying)?
  2. How is your baby feeding? Is he gaining weight?
  3. What is your baby’s breathing like when she sleeps? Does she gasp or choke? Does she stop breathing or have pauses in her breathing?
  4. Does he ever turn blue around his lips?

The answers to these questions help gauge further medical care your child might need, and when a referral to an ENT specialist is necessary.

I know how concerning it is for parents when their baby’s medical condition relates to breathing. I hope this information helps you feel empowered about what to watch for with laryngomalacia, so you feel confident caring for your child.

To speak to someone about how our ENT specialists care for patients with laryngomalacia, or to schedule an appointment, call 513-636-3200.

About the author: Catherine Hart, MD

Dr. Catherine Hart is a pediatric otolaryngologist (ear, nose and throat specialist) at Cincinnati Children’s. Dr. Hart’s areas of interest include pediatric airway disorders and general ENT problems. Her research interests focus on improved outcomes in pediatric airway surgery.

Sounds that a baby makes in a dream: how to distinguish normal from disturbing ones


The image of a baby sleeping like an angel is touching only when you have no children. Because every mom is faced with the fact that her baby spends half the night grunting, gurgling, sneezing, food and whimpering.

All these strange sounds often seem very disturbing to parents: what if something is wrong with their child? Let's try to figure out in which cases it is really worth worrying.

kieferpix / iStock / Getty Images

Babies naturally sleep restlessly. Sounds and movements in sleep are the result of the immature nervous system and reflexes of the newborn. Circadian rhythms do not develop until about six weeks of age. This means that the sleep cycles of these young children are irregular, it is difficult for them to distinguish between night and day, and they often wake up.

Until about six months old, babies spend at least 50% of their time in REM sleep. This is the period when the brain is most active and often produces vivid dreams. During REM sleep, a child may move according to their dreams or simply because of the activity taking place in their brain. All this movement can be accompanied by sounds from gurgling to whimpering - and this is absolutely normal.

Infant sleep cycles are only about 50 minutes long, with many transitions between sleep states and phases. It is between the phases of sleep that babies move, make noise and wake up.

Since young children want to eat every few hours, including in the middle of the night, hunger can also be the cause of some of the sounds. While sleeping, they may smack their lips, suck their fists, and even begin to whimper.

Amax Photo / E+ / Getty Images

Sounds to worry about

Gurgling / guttural sounds : newborns do not develop the mechanism of swallowing at first, so they may "gurgle" regularly during sleep.

Nasal obstruction : newborns have noisy breathing due to the tiny nasal passages of the newborn and the protective role of mucus. In addition, their respiratory system is not yet fully developed.

Sneeze / snort / wheeze / whistle : again, this is because they "breathe through the nose" and not "breathe through the mouth" and because their nasal passages are very narrow. It stops after about six months.

Cough : newborns often cough during their sleep, and this is normal. If the cough persists, you can hold the baby in your arms, hold him in a column to help burp, or lightly pat him on the back to clear his lungs.

Tummy sounds : Babies tend to continue digesting food during the night. Therefore, perfectly healthy sounds can be belching, hiccups, growling in the stomach, gurgling or gassing.

Ridofranz / iStock / Getty Images

These are the signs to take your baby to the doctor

Get help immediately if you notice any of these breathing difficulties:

  • Baby's face turns blue.

  • Difficulty or limited breathing.

  • Breathing pauses lasting more than a few seconds.

  • Breast retraction.

  • Fever that accompanies any breathing or digestive problems.

  • Rapid breathing that lasts longer than usual or has 60 or more breaths per minute.

  • Repeated groaning at the end of each breath.

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Wheezing/noisy, hard, heavy breathing in a child home > Symptoms of childhood illnesses: section information > Wheezing / noisy breathing in a child

A B C D E F G H I K L M N O P R S T U F X C H W Shch E Yu Ya

When the airways are normal, the child breathes silently and effortlessly. When their patency is disturbed, a high-pitched sound may appear during breathing, as the air passes through the narrowed breathing tubes with effort. Wheezes are sounds that occur when a child breathes in and out through a narrowed airway. Airway obstruction can occur due to swelling caused by infection, foreign body, inflammation, and bronchial muscle spasm in asthma. Sometimes a rough wheeze is heard only on inspiration: this may be a symptom of croup. This wheezing is called stridor (see Help for Croup).


Call "emergency care" for the child if wheezing is present:

  • shortness of breath
  • the child has blue skin around the lips
  • unusual drowsiness, lethargy
  • inability to speak or make normal sounds


Wheezing in a child may appear suddenly when a foreign body has entered the respiratory tract. Small wheezing may be accompanied by SARS. If you experience wheezing when breathing, contact your doctor immediately.




Does an infant have rather loud wheezing only when he inhales? Is he eating and growing normally?


If the child eats, sleeps and grows normally, noisy breathing simply shows that the tissues of the airways are still quite elastic. Such noisy breathing should pass by 1.5 years, when the cartilages of the larynx (windpipe) become denser. Nevertheless pay attention to the noisy breathing of the child attention of the pediatrician at the next examination

Does the child also have a runny nose or cough?

Colds (ARVI)

Call the pediatrician . Give plenty of fluids, make the child comfortable (see also Runny nose in a child)

Child under one year old? Does he have a cough that lasts 2 hours or more? Has he had a cold the last day or two? Rapid and labored breathing? Does he refuse to eat? Irritable?

Bronchiolitis is a disease, usually viral, affecting the smallest bronchi

Call "emergency" . If the diagnosis is confirmed, hospitalization may be required

Does the child cough often? Do you have bouts of difficulty breathing, especially at night or during exercise? Does anyone in the family suffer from asthma or allergies?


Make an appointment with pediatrician . He will examine the child and prescribe the necessary examinations; advise treatment based on results (see also If child has asthma)

Does the child have difficulty breathing, choking? Short, dry cough that sounds like a dog barking; hoarse voice? Elevated temperature? Do symptoms get worse at night?

Croup - difficulty in breathing caused by inflammation and narrowing of the upper airway

Although most seizures can be relieved by home remedies (see Help for Croup), if a seizure occurs, call "emergency " . Before the doctor arrives, take the child to the bathroom, close the door, pour hot water into the bath to create steam, Let the child breathe humidified air. Drop Naphthyzinum in your nose. If the condition does not improve, give the child a breath of cool night air

Does the child suddenly have difficulty breathing, wheezing?

Foreign body in the airways (most common in children 6 months to 2 years of age)

This is an emergency. Call an ambulance ; first aid measures - see Respiratory arrest)

Shortness of breath, wheezing, severe cough? The temperature is raised to 38.3 about C or more? Is the child not feeling well? Do the intercostal spaces retract when you inhale?


Urgently call the pediatrician , he will make a diagnosis and prescribe treatment. Hospitalization may be required (see Difficulty breathing, Cough)

Does your child snore while sleeping? Do you wake up irritated every morning? Does he often breathe through his mouth because his nose is stuffed up? Tired quickly? Does he speak through his nose? Does he have frequent colds and ear infections?

Enlarged adenoids; allergy

Consult a pediatrician , he will examine the child to detect enlarged adenoids (see also Runny nose in a child, or an allergic disease), prescribe treatment


Why wheezing is more common in young children

Wheezing is common in children under 3 years of age. Since their airways are smaller, obstruction due to spasm of the bronchial muscles, inflammation and swelling of the mucous membrane, and accumulation of secretions occurs more easily than in older children. Respiratory tract diseases can be provoked by air pollution, including cigarette smoke. If anyone in the family smokes, you must insist that no one smokes in the house.

Avzalova Darya Evgenievna

Pediatrician, neonatologist

Experience: 18 years
Reviews: 7

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Barzenok Tatyana Arsenievna

Chief physician, head of the pediatric department, pediatrician of the first category

Experience: 28 years
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Belousova Elena Sergeevna

Pediatrician, Nephrologist

Experience: 18 years
Reviews: 14

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Bykov Mikhail Viktorovich

Pediatrician of the highest category, specialist in ultrasound diagnostics, candidate of medical sciences

Experience: 25 years
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Kazakova Liliya Valentinovna

Pediatrician, neonatologist, head of breastfeeding consultant service

Experience: 28 years
Reviews: 31

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Sedova Maria Sergeevna

Pediatrician, allergist-immunologist

Experience: 20 years
Reviews: 30

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Sergienko Tatyana Yakovlevna

Pediatrician, pediatrician on duty at the pediatric hotline

Experience: 39 years
Reviews: 21

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A complete list of symptoms (more than 70) that require the help of a pediatrician can be found here.

Learn more