Baby noisy breathing when 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

Stridor & Laryngomalacia: Is My Baby’s Noisy Breathing Serious?

By: John E. McClay, MD, FAAP

If your baby's breathing is noisy sometimes, you might be wondering why. It could be stridor, a term for abnormal, loud breathing sounds. Stridor can have many different causes, including upper airway infections. When newborns and infants have stridor, however, one of the most common causes is a condition called laryngomalacia. Thankfully, stridor and laryngomalacia are usually not serious.

What is stridor?

Stridor is a type of noisy breathing. It's most common in babies because their airways are narrower. It's usually described as a repetitive or high-pitched squeaking sound. It may happen occasionally or when your baby is resting. When a baby has stridor, this is a sign that something is partially blocking the upper airway.

There are many causes of stridor in children, including:

Laryngomalacia
Narrowing of the airway (subglottic stenosis)
Inhaled foreign object
Infections such as croup or epiglottitis
Masses or lesions on the vocal cords
Vocal cord weakness or paralysis

In infants, the most common cause of stridor is a condition called laryngomalacia.

What is laryngomalacia?

Laryngomalacia is a common condition in newborns. It occurs when the tissues in the larynx (voice box) fall into the airway as your baby inhales, causing noisy breathing (stridor). The larynx is made of cartilage. In newborns, the cartilage is often soft and immature, which can make it floppy.

The good news is that for most infants this condition is not serious and goes away with time. In some cases, babies do end up needing surgery to treat the symptoms.

How do I know if my baby has laryngomalacia?

Most babies who have laryngomalacia start having symptoms within a few days to weeks after birth. These symptoms may include:

Noisy breathing
Difficulty feeding or gasping/choking noises while feeding
Spitting up a lot and being fussy after feeds.
Retractions—when the skin in your baby's neck or between their ribs is sucked in with every breath
Pauses in breathing while sleeping

If your baby has any of these symptoms, they should be checked for laryngomalacia.

How is laryngomalacia diagnosed?

A pediatric ear, nose, and throat (ENT) specialist usually makes the diagnosis of laryngomalacia.

First, the ENT will get a thorough history of the types of symptoms your baby has. Next, the doctor will examine your baby with a procedure called flexible laryngoscopy. This procedure uses a small scope that's inserted into your baby's nose in the office. The laryngoscopy lets the doctor look at your baby's vocal cords and larynx.

How is laryngomalacia treated?

Most babies with laryngomalacia don't need treatment. As your baby grows and the cartilage in their voice box becomes stronger, the symptoms usually go away by the time they're a year old. However, it can take until your child is about 18 months to 2 years of age to resolve completely. In the meantime, it's important to make sure that your child is growing and developing normally.

Babies who have laryngomalacia also commonly have gastroesophageal reflux (GER). GER is a condition in which stomach acid and food flow back up into the esophagus, the tube that connects the stomach to the mouth. GER is hardly ever serious in babies, but it can make laryngomalacia symptoms worse. Your baby may need medication for GER, which can improve their reflux symptoms and may also help with breathing.

When laryngomalacia surgery may be needed

If your baby is having serious breathing problems, feeding problems, or isn't gaining weight like they should, surgery may be needed.

The surgical procedure to treat laryngomalacia is called a supraglottoplasty. It's done microscopically through your baby's mouth. Small instruments are used to remove the tissue that's causing the breathing problems from the larynx.

The procedure generally takes less than an hour. Your baby will likely be kept overnight in the hospital after surgery, but you should be able to go home the day after surgery. In most cases, your baby's symptoms will improve very quickly after the procedure.

Remember

Don't hesitate to talk with your child's pediatrician if you have any concerns about your child's health.

More information

Cough: 1-12 Months
Croup and Your Young Child
RSV: When It's More Than Just a Cold

About Dr. McClay

John E. McClay, MD, FAAP, is a fellowship trained pediatric otolaryngologist–ear nose and throat surgeon–who has taken care of children for more than two decades. Dr. McClay has authored over 30 professional articles in peer reviewed medical journals describing his research studies. He was an academic professor in the Department of Otolaryngology/Head and Neck Surgery at the University of Texas at Southwestern Medical School in Dallas for 17 years, where he had an academic Professorship in his honor. He has now been in private practice for more than 6 years. He has been named one of D Magazine's Best Pediatric Specialists every year since its inception in 2003, and one of the best pediatric specialists in the state of Texas by Texas Monthly for the last 13 consecutive years. Within the American Academy of Pediatrics, he is the Education Committee Chair for the Executive Committee of Otolaryngology.

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Hiccups in newborns

home

reference Information

Resources for Parents

Hiccups in newborns

Hiccups is a physiological process in which there is a convulsive contraction of the diaphragm, which is a muscular barrier between the abdominal and chest cavities. During hiccuping, the glottis is closed, which leads to the appearance of a characteristic sound and movement. In newborns, the diaphragm contraction mechanism is very excitable, and therefore children in the first months of life are often prone to hiccups.

Causes of hiccups in newborns: hypothermia, overeating, swallowing large amounts of air during feeding, or the rapid absorption of food.

As a rule, hiccups most often occur due to mistakes in feeding the baby. In the process of overeating, a large amount of food absorbed stretches the stomach walls, which leads to a contraction of the diaphragm and hiccups.

Prolonged hiccups that do not subside can be a dangerous signal. This condition often occurs with pneumonia, diseases of the gastrointestinal tract, injuries of the spinal cord and chest. Sometimes the cause of hiccups can be helminthiasis and infectious pathologies.

A very common cause of hiccups is hypothermia. This is a kind of signal from the child's body for parents about the problem that has arisen.

Sometimes hiccups can occur in case of emotional shock, stress or fear. Loud music, bright lights, screams and other “noisy” manifestations of the life of those around the baby can be to blame for everything.

Symptoms of hiccups in newborns. As a rule, bouts of hiccups last about 10-15 minutes and do not cause much discomfort to the baby (at the same time, he behaves quite calmly). But sometimes this condition can be longer, as a result of which the access of oxygen is difficult and it becomes difficult for the child to breathe. In this case, urgent consultation with a specialist is required.

First of all, parents need to know - if the baby has hiccups regularly for two weeks and does not subside for a long time, it must be shown to the pediatrician to exclude the occurrence of various pathologies.

To rid the child of hiccups, first of all, it is necessary to remove the provoking factor. It must be warmed in case of hypothermia, watered in case of thirst and calmed in case of excitement. Also, in the process of feeding, the baby's head must be placed so that he cannot swallow air with food.

To eliminate hiccups, a baby can drop a drop of lemon juice or chamomile infusion under the tongue. If the hiccups do not go away, the child should be allowed to drink water, and then attach it to the chest.

How to properly feed a newborn: some useful tips.

The main rule is that the child should be fed only when he is really hungry. during this period, the baby should be calm. In the process of feeding, you need to make sure that the newborn does not swallow too quickly. With very active sucking, it needs to be removed from the chest for some insignificant time and held in a “column” so that all the excess air that has accumulated in the stomach comes out. For children who are bottle-fed, it is necessary to monitor the hole in the nipple. It shouldn't be very big. After feeding the baby, you need to hold it in an upright position with your tummy towards you.

If a child’s hiccups appear due to stress, he must be protected in every possible way from emotional shocks.

That's all the simple tips with which you can defeat hiccups in newborns and thereby eliminate the worries of their parents. After all, the greatest happiness is a healthy baby.

What to do if a child chokes

It is impossible to control 100% of all the actions of the baby, therefore, cases when children get something into the respiratory tract or they choke on something often occur. Most often, parents do not need to take any action, because. the child's body is able to independently get rid of a foreign object with the help of a cough. A sign that the airway is not blocked is that the child may cry and/or call for help. Then you just calm the baby and keep the situation under control.

Signs that intervention is needed?

eyes wide open in panic
he cannot utter words, cry and scream, or does it quietly and wheezing
there is increased salivation
baby opens mouth wide
skin turns red and then turns blue
older children may hold their throats
loss of consciousness

The first thing to do is to call an ambulance. It is advisable to have someone else do this so that you can immediately begin to provide first aid.

First aid for children under one year old

As a rule, infants choke while eating or drinking due to incorrect posture.

Your possible actions:

1. Raise the baby's hands up. Despite its unusualness and simplicity, this method helps to normalize the breathing process by expanding the airways.

2. Put the child on your hand with your stomach down and make five pats between the shoulder blades with the edge of your palm.

3. In the case when the baby choked on a small object, it is necessary by the child's legs so that the head is down and also pat between the shoulder blades

4. Tilt the body of the child down, press on the root of the tongue, thereby causing vomiting.

5. If the baby choked on the liquid and began to cough, choke with a cough, breathe noisily, and also in case of a solid object getting stuck, it is necessary to turn it with its back to you, hug your hand while pressing it on the stomach area, tilt the child forward and pat on the back, as described in the first paragraph.

If there are no signs of improvement, lay him on his back so that his head is lower than his torso. Place your middle and index fingers under your baby's breastbone. Do five pressures to a depth of 1-2 cm, making sure that after each of them the baby's sternum straightens without removing the fingers. You should alternate pressure and pats on the back until the doctors arrive. After each pop, check to see if the airway blockage has been cleared.

Attention! All pressing and patting should be gentle but sharp!

You can find on the Internet a recommendation to check the child's larynx with your finger and, if possible, remove the stuck object. Such advice is useful if the foreign object is something soft, such as cotton wool. In other cases, there is a great risk of aggravating the situation by accidentally moving the subject even further.

First aid for a child older than one year

Remain calm so as not to aggravate the child's panic.

You can use the above methods for older children as well. 5 point will differ by the posture of the child. See picture below:

Also for children aged from a year (in no case for children younger!) The Helmich method is effective. The sequence of your actions will be as follows:

stand behind the baby, you can kneel if his height is still small
clench the hand of one hand into a fist and place the thumb inside between the ribs and the navel of the child
clasp the fist with the palm of the other hand
spread your elbows to the sides and press on the child's stomach from the bottom up
continue until the foreign object is out of the respiratory tract

If the child's breathing has stopped

If the child's breathing stops during removal of the foreign body and does not resume after removal, this may be the result of a spasm in the throat due to stress. Breathing resumption method: