Laryngomalacia: What is it and How is it Diagnosed?

All women hope that the child they will soon give birth to is born healthy. We count fingers and toes, check them over with a fine-toothed comb. In some cases, parents don't realize that there is even a problem until some time later.

In my case, it was a few hours after my oldest child was born that I noticed he was breathing strangely. I brought this to the nurse's attention and her response to me was, "That's normal. All newborns breathe like that." She had reassured me that everything was okay and I was appeased.

When he was a month old, however, the rattled and wheezing breathing sounded worse. I made an appointment with his pediatrician and took him in to be checked out. We were referred to an ENT specialist at John Sealy Hospital in Galveston. To my surprise, things at this point went rather quickly because they needed to be sure of what we were dealing with. I admit that I was scared because I had this otherwise healthy baby boy who just wasn't breathing right.

Two weeks later, my baby boy was admitted into the hospital to undergo a Laryngoscopy. He spent the night in the hospital and the next morning, a team of doctor's came to his room and told us he had Laryngomalacia (which literally means "soft larynx") and the condition is quite common in babies. The good news was that he was expected to grow out of it by the time he was two-years old. My son is now a very happy and healthy 23-year old who is full of life and energy.

What is Laryngomalacia?

Essentially, the soft cartilage of the upper larynx collapses during inhalation and causes the airway to become partially obstructed and seems to be more pronounced when the infant is lying on their backs due to the epiglottis falling backwards. Though not usually life threatening, some babies will experience severe airway obstruction and exhibit signs of cyanosis.

Symptoms of Laryngomalacia include:

1. A high-pitched "squeaking" noise that sounds like a wheeze when the baby inhales (stridor). The stridor may get worse when the baby is crying, sleeping, and may have difficulty feeding.

2. Aspirating food (this occurs when the baby inhales food into the lungs)

3. Gastroesophogeal reflux

4. Poor weight gain

5. Cyanosis (lack of oxygen causes the infant to turn blue)

6. Choking while eating/feeding

Larygomalacia is diagnosed by doing a bronchoscopy or fiberoptic laryngoscopy.

In bronchoscopy, a tube is passed into the airway so that the physician can visualize the airway while the child is breathing.

In fiberoptic laryngoscopy, the endoscope is inserted into the nose and passed into the throat. This allows the physician to visualize the throat, voice box and areas that are normally unseen during traditional examinations such as the entrance to the hypopharynz (swallowing passages).

While this may seem a bit overwhelming, the good news for parents is most children will grow out of the condition by the time they are 2 years old. According to Children's Memorial Hospital, only 10% of cases require medical or surgical intervention.