Baby sounds raspy after feeding

Aspiration in Babies and Children


What is aspiration in babies and children?

Aspiration is when something enters the airway or lungs by accident. It may be food, liquid, or some other material. This can cause serious health problems, such as pneumonia. Aspiration can happen when a person has trouble swallowing normally. This is known as dysphagia. It can also happen if a child has gastroesophageal reflux disease (GERD). This is when the contents of the stomach come back up into the throat.

When your child swallows food, it passes from the mouth down into the throat. This is called the pharynx. From there, the food moves down through a long tube (esophagus) and into the stomach. This journey is made possible by a series of actions from the muscles in these areas. If your child has dysphagia, the muscles don’t work normally. They cause problems with the swallowing process.

The pharynx is also part of the system that brings air into the lungs. When a person breathes, air enters the mouth and moves into the pharynx. The air then goes down into the main airway (trachea) and into the lungs. A flap of tissue called the epiglottis sits over the top of the trachea. This flap blocks food and drink from going down into the trachea when your child swallows. But in some cases, food or drink can enter the trachea. It may go down as your child swallows. Or it may come back up from the stomach. A child with dysphagia is much more likely to aspirate. A child with a developmental or health problem is more likely to have dysphagia.

Aspiration can happen during a feeding or meal. And it can happen after a feeding or meal. This is common in babies and children with certain health conditions. Aspiration can also happen at any time when your child swallows saliva.

If your child aspirates a small amount of material, it may not cause much harm. This can happen in children who don’t have a health problem. It can happen when eating, sleeping, or talking. But aspiration that happens often or in a large amount can be serious.

What causes aspiration in babies and children?

Aspiration is often caused by dysphagia. This is when the muscles don’t work normally in the throat and lead to swallowing problems. Different medical conditions can lead to this, such as:

  • Abnormal anatomy, such as a cleft palate or a problem in the esophagus
  • Delayed growth, from premature birth or a condition such as Down syndrome
  • Brain damage or other problems, such as from cerebral palsy or infection
  • Problems with the cranial nerves that control the muscles of swallowing
  • Neuromuscular disease, such as spinal muscular atrophy
  • Medical procedures, such as a nasogastric tube or a tracheostomy

Gastroesophageal reflux disease (GERD) can also cause aspiration. This is when the contents of the stomach come back up into the throat.

What are the symptoms of aspiration in babies and children?

Aspiration can cause signs and symptoms in a baby such as:

  • Weak sucking
  • Choking or coughing while feeding
  • Other signs of feeding trouble, like a red face, watery eyes, or facial grimaces
  • Stopping breathing while feeding
  • Faster breathing while feeding
  • Voice or breathing that sounds wet after feeding
  • Slight fever after feedings
  • Wheezing and other breathing problems
  • Repeated lung or airway infections

And aspiration can cause signs and symptoms in an older child such as:

  • Choking or coughing while eating
  • Voice that sounds wet after eating
  • Slight fever after meals
  • Complaints of food feeling stuck or coming back up
  • Wheezing and other breathing problems
  • Repeated lung or airway infections

Signs and symptoms can happen right after eating. Or they may happen over time. Your child may not have all of these signs and symptoms. The signs and symptoms may depend on the age of your child, and how often and how much your child aspirates.

Some children who aspirate do not have any signs or symptoms. This is called silent aspiration.

How is aspiration in babies and children diagnosed?

Your child will need to be checked for aspiration if he or she has:

  • Any signs or symptoms of aspiration
  • Health problem that can cause trouble swallowing
  • GERD

The healthcare provider will ask about your child’s medical history and symptoms. This may be done by a speech-language pathologist (SLP). The SLP may ask about what foods or drink cause problems, and when your child’s symptoms happen. He or she may want to watch your child during a feeding.

Your child may also need tests. These can check for problems and show if food and fluid is going into your child’s lungs. The tests may include:

  • Chest X-ray or CT scan
  • Modified barium swallow test (MBS)
  • Fiber optic endoscopic evaluation of swallowing (FEES)

How is aspiration in babies and children treated?

Treatment for aspiration may vary depending on the cause and severity. Treatments for your child may include:

  • Making changes in position and posture during meals
  • Changing the thickness of liquids
  • Changing the types of foods in your child’s diet
  • Doing exercises to help with swallowing (for an older child)
  • Medicines for GERD
  • Medicines or Botox injection for children who make excess saliva
  • Surgery to reduce reflux
  • Surgery to correct a problem such as a cleft palate

If your child still has a high risk of aspiration despite these methods, he or she may need a special tube to help with eating for a while. The feeding tube will help your child get good nutrition until his or her risk of aspiration improves. Your child will not eat or drink normally until the tube is removed. A thin tube may be put through the nose down into the stomach. This is called a nasogastric tube. This may be used for a short time while other treatment is considered. Or a tube may be put directly into your child’s stomach during a surgery. This is called a gastrostomy tube.

In some children, aspiration lessens over time. In other cases, a child may need more treatment to address the cause. Your child’s healthcare providers will carefully watch your child so that he or she can return to normal eating as soon as possible.

Talk with your child’s healthcare provider if your child has a tracheostomy tube. You may need to suction food or liquid from the tube.

What are possible complications of aspiration in babies and children?

A major complication of aspiration is harm to the lungs. When food, drink, or stomach contents make its way into your child’s lungs, it can damage the tissues there. The damage can sometimes be severe. Aspiration also increases the risk of pneumonia. This is an infection of the lungs that causes fluid to build up in the lungs. Pneumonia needs to be treated with antibiotics. In some cases, it may cause death.

Other possible complications from aspiration include:

  • Dehydration
  • Malnutrition
  • Weight loss
  • Increased risk of other illness

When should I call my child's healthcare provider?

Let your child’s healthcare provider know right away if your child has any signs or symptoms of aspiration. It needs to be treated as soon as possible.

Key points about aspiration in babies and children

Aspiration is when something enters the airway or lungs by accident. It may be food, liquid, or some other material. This can cause serious health problems, such as pneumonia. Aspiration can happen when a child has trouble swallowing normally. This is known as dysphagia.

  • Your child might have aspiration caused by problems with growth, development, or certain health conditions.
  • Your child may have a signs such as breathing problems and a wet-sounding voice after meals.
  • Some children with aspiration don’t have any signs or symptoms. This is known as silent aspiration.
  • If your child has any symptoms of aspiration, he or she needs to be checked and treated right away.
  • Aspiration may be treated by addressing the cause of dysphagia. It can also be managed with methods to help your child feed better.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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

Wheezing in children | Nestlé Health Science

  1. Nestlé Health Science
  2. health care
  3. wheezing

Wheezing or noisy breathing is characterized by a high-pitched, whistling sound that occurs when the small airways constrict, preventing the child from breathing. This is a common problem in infants, and in general infants and children wheeze more than adults due to differences in the size of their airways. nine0013

Why does my child wheeze?
There are various causes of wheezing in children, including:

  • Food allergy, such as Cow's milk protein (CMP) allergy , or other allergies to dust or pollen
  • Chronic disease such as asthma
  • Respiratory disease or cold virus

Symptom analysis

Can wheezing be a manifestation of CMPA?
Wheezing is a typical symptom in children with CMPA. Nearly 30% of children with CMPA have wheezing as a symptom.
Children with CMPA usually have more than one symptom, and these symptoms can be very different from each other.

If you think baby is wheezing, or making wheezing sounds, it could be CMPA.
You may have noticed other symptoms (other than wheezing) that may affect other parts of the child's body.

For a simple and easy way to check for typical symptoms associated with CMPA, you can use our Checking symptoms.
in any case, if you have any doubts or concerns about the health of the child, you should consult a health care professional as soon as possible

Other symptoms of cow's milk protein allergy


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Runny nose and sneezing

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IMPORTANT NOTE: : It is possible to continue breastfeeding if the infant is allergic to cow's milk protein. To do this, the mother needs a special diet with the exclusion of all sources of cow's milk protein. Only if these measures do not bring the desired effect, the doctor recommends the use of a special therapeutic mixture intended for children from 0 to 1 year old. It is important to follow the correct methods of preparing the mixture: using boiled water, sterilized bottles and following the rules for diluting the mixture. Medicinal mixtures intended for diet therapy of CMPA should be used under the supervision of a physician. nine0013 90,000 wheezing in a baby when breathing without temperature, why he wheezes with his throat when he breathes


  • Safe reasons for
  • Dangerous situations
  • diseases with a symptom of wheezing and what to do
  • ,
  • comments

Many parents are worried when they hear the blue breathing and wheezing in the chest. This disease sometimes appears in infants after birth. Some wheezing in newborns is absolutely safe, while others, on the contrary, warn of the presence of a disease. Let's see why the baby wheezes, what are the causes of this phenomenon, possible dangerous consequences and how to prevent wheezing. nine0013

Safe causes

There are various reasons for this phenomenon. Safe most often relate to a child without fever and other signs of a cold. These include:

Physiological features of the baby's body

The baby eats well, puts on weight, does not show anxiety, did not walk in drafts, and wheezing - is. This is possible because the newborn baby has not yet fully developed airways and they are still quite narrow. This can cause wheezing when feeding or when the baby is sleeping. After all the laryngeal cartilages are formed, wheezing will disappear without a trace. This usually happens by the age of one and a half, but maybe by three. Also, in the first months of life, the baby learns to swallow and often chokes on saliva, which may cause wheezing

Dry indoor air

Babies' nasal passages are narrow enough that dust can quickly accumulate in the nasopharynx. The main reason for this is the dryness of the air. It’s a paradox, but caring and loving parents are most often to blame for this. Taking care that the child does not get sick, they mistakenly believe that closing the windows tightly, not ventilating and heating the room where the child is, is the right way to protect him from hypothermia and colds. But pediatricians recommend not to forget about regular 10-minute ventilation of the room in which the newborn is mainly located, as well as the need to periodically moisten the air with special humidifiers, or at least put some container with cold water in the room or hang wet towels on the heating radiator. According to Dr. E. Komarovsky, the air temperature in the room is 18-22°C and the humidity is 40-60%; nine0013

Dust build-up

Moms need to do regular wet cleaning of the newborn's room to prevent dust build-up, and then they will not be disturbed by wheezing in the baby. It is also advisable not to get carried away with soft toys, as they tend to accumulate dust.

Uncleaned nose

Since the nose is a filter for the air we breathe, mucus periodically accumulates in the nasal passage, which, when dried, forms dry crusts, which provokes wheezing when breathing in the baby. This also happens in adults, only babies still cannot blow their nose and clear their nose on their own. Therefore, daily you need to remove the crusts and mucus in the nose of the baby. nine0013

In the pharmacy, you need to buy special moisturizing drops or normal saline, drop a drop into each nasal passage of the child and then carefully remove the “cause of discomfort” with a cotton swab

The child’s lack of physical activity

If the baby is always in a lying position, it is not picked up, not played with, then there is a risk of "stagnation" and swelling in the lungs and airways, which leads to even more wheezing. This phenomenon is often observed in orphanage children, because nannies and educators do not have enough hands and time to pay attention to all children. nine0013

Polluted air

Wheezing and mucus in an infant can be triggered by polluted air, which contains cigarette smoke or exhaust fumes, so infants must be carefully protected from such exposure.

With all the wheezing described above, medical and medical intervention is not required, but it is necessary to monitor the general well-being of the child. With a normal body temperature of up to 37 degrees, a good appetite and a good sleep, there is no reason to worry, but during the next planned trip to the clinic, be sure to pay the attention of the pediatrician to this "little thing" so that he can exclude any diseases. nine0013

Dangerous situations

Now let's talk about wheezing, which requires immediate medical attention. The body of a newborn is weak and exposed to many external factors that can provoke the appearance of an infection and the development of any pathology. In this case, as a rule, wheezing is accompanied by additional symptoms: cough, shortness of breath, anxiety, lack of appetite, fever, etc.

To protect your baby from colds and wheezing, you need to follow simple rules when walking with a newborn baby on the street:

  • do not walk in windy weather;
  • dress the baby according to the weather according to the "+1" principle. That is, the child should be wearing 1 more clothes than you. If your child is dressed too warmly, he may sweat and get sick easily. A lightweight version of clothing, if it is cold outside, is also not suitable, since the baby will simply freeze and get hypothermia. Many mothers, "easily" dressing their children, argue that the child must be tempered. This is a controversial issue, and it also needs to be hardened correctly and competently; nine0004
  • avoid drafts. Even if the baby is in a stroller, it must be protected from wind, rain and snow;
  • Avoid contact between your baby and people with a recent, and even more so ongoing, viral disease.

Wheezing can be caused by pneumonia, bronchitis, which is very dangerous for a baby, since all diseases in babies under one year old develop rapidly and doctors do not always have time to stop dangerous symptoms.

Wheezing in a newborn also occurs due to allergies or more serious conditions such as asthma, in which the airways swell and produce excess mucus

The child develops hoarseness, cough and wheezing if a foreign object enters the larynx or airways, and such wheezing appears suddenly. Never leave your baby alone with small toys, sweets and other items that he can choke on! If this nevertheless happened, you should not panic, but urgently call an ambulance to prevent respiratory arrest.

Diseases with a symptom of wheezing and what to do

If the baby wheezes, he has snot and cough, the temperature rises, the baby behaves lethargically, refuses to eat, then, most likely, the diagnosis will sound like "acute respiratory viral disease". In this case, only a doctor should decide on the need and correctness of treatment. All that is required of you is not to force the child to eat, provide him with plenty of fluids and strictly follow all the doctor's recommendations regarding the treatment of a wheezing child. nine0013

If a newborn wheezes strongly enough, coughs with a "barking" cough, wheezes when breathing, and when the baby inhales, the intercostal spaces are drawn in, while there is a high (above 38.5 degrees) temperature, then doctors usually talk about pneumonia. If such symptoms are noticed, it is necessary to call a pediatrician to make the correct diagnosis and prescribe adequate treatment. It often happens that the baby has to be hospitalized.

If the child has a hoarse voice, the baby is breathing heavily, he has a fever, a strong dry cough and "whistling" in the chest, while all of these symptoms are aggravated at night, then you can suspect croup in the baby (difficulty breathing, which is caused by inflammation and narrowing of the lumen of the upper respiratory tract). When such an attack begins, it is necessary to call an ambulance or a pediatrician. In anticipation of medical assistance, the child should be allowed to breathe humidified air. To do this, you can use a humidifier or draw hot water into the bathroom to steam, and bring the child into the bathroom for a couple of minutes. After dripping the nose with vasoconstrictor drops and ensure the flow of cool fresh air. You can also give your baby drops for allergies, for example, Fenistil. nine0013

Babies under one year old may develop a disease such as bronchiolitis. At the same time, small sections of the bronchi become inflamed. In this case, a strong cough is characteristic, which does not subside for a long time (sometimes several hours), difficult hoarse breathing, there are signs of a cold, such as snot and sore throat, because of which the baby refuses to eat, is very irritated and naughty.

If the baby does not feel well after a few days, the pediatrician should be called for an examination. If the diagnosis is confirmed, hospitalization may be required

If the baby still has wheezing after a runny nose, the baby snores at night, his nose is constantly stuffed up, while one of the relatives suffers from asthma or allergies - this may indicate that the child has started bronchial asthma. You need to consult a pediatric allergist and conduct the necessary examinations for further treatment.

Also, when the baby breathes through the mouth, he has a runny nose, he snores in his sleep, suffers from frequent colds, clear nasal discharge and otitis media, is whiny and irritable, it is likely that he has enlarged adenoids or is allergic to some irritant . In this case, only the pediatrician will be able to determine the cause of the unsatisfactory state of health of the child, that is, to determine whether it is a runny nose, an allergy, or inflammation of the adenoids. After making the correct diagnosis, the doctor will be able to prescribe adequate therapy. nine0013

A child should drink a lot during an illness, this will reduce the intoxication of the body. And also breathe fresh and humidified air. Dr. Komarovsky constantly emphasizes this. He argues that in the acute period of the illness (fever and severe malaise), it is necessary to provide such conditions at home, and after the onset of a stable improvement in well-being (even if there is still a cough with sputum, but the temperature has dropped, the child’s appetite and good mood have returned) do not forget about walks in the open air.

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