Pediatrics

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Laryngomalacia

Laryngomalacia is the most common cause of noisy breathing (stridor) in infants. It occurs when the tissue above the vocal cords is floppy and falls into the airway when the child breathes in, causing noisy breathing. This creates a high-pitched noise known as stridor, which is caused by turbulent air flow.

Laryngomalacia is the most common cause of noisy breathing in infants. More than half of infants have noisy breathing during the first week of life, but some develop true laryngomalacia within the first 4-6 weeks of age. Rarely, laryngomalacia occurs in older children, or adults, particularly those with other medical problems.

Signs and Symptoms

  • Noisy breathing on inspiration (noisy breathing/stridor)

  • Stridor may be louder with exertion, feeding and crying. It may also be worse when lying on the back. It may be quieter when sleeping or resting quietly.

  • Stridor will typically get louder over the first several months of life, as an infant gets stronger, then to improve over the first year of life.

  • Signs of more severe laryngomalacia include difficulty feeding, increased effort in breathing, poor weight gain, or pauses in the breathing.

Diagnosis

Laryngomalacia is usually diagnosed by a physician using a flexible laryngoscopy, a clinic procedure where a small flexible camera is passed through the nose to view the larynx (voice box).  If the results are unclear or do not show laryngomalacia, further tests may be necessary.

Treatment

The vast majority of infants with laryngomalacia will improve without treatment. Most infants will have resolution of stridor by 1 year of age, and nearly all by 2 years of age. Sometimes medications are recommended to help control acid reflux from the stomach, as this condition may worsen the symptoms of laryngomalacia.  Thickening the feeds and using different formulas may be recommended by your pediatrician.

For severe symptoms that are resulting in poor feeding or poor weight gain, pauses in the breathing (apnea) or turning blue (cyanosis), surgical treatment may be recommended. Surgery for this condition is done through the mouth and has a fairly quick recovery. Rarely, more invasive procedures might be recommended.

For Questions or Emergency Care:
Call the office at 601-984-5160. You may need to speak with the doctor on-call.

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