Information
Laryngomalacia means “Soft Larynx”. It is caused by floppiness of the laryngeal tissues above the vocal cords. During inspiration these tissues collapse inwards causing a partial obstruction. This creates inspiratory stridor.
Stridor is a high pitched, musical noise that can occur in either phase of breathing (inspiration or expiration) or both (biphasic). It is different from stertor, which is a noise originating in the nasopharynx and sounds like snoring.
Laryngomalacia is the most common cause of noisy breathing in infants. More than 50% will present during the first week of life and most have developed symptoms by 2-4 weeks of age.
Signs and Symptoms
- Inspiratory stridor, louder with exertion, feeding and crying.
- May be accompanied with a by mild tracheal tug
- Symptoms are often worse when lying flat or after a feed and improve when sleeping or quiet.
- Stridor will become louder over the first few months as the infant grows and becomes more active. Things will then improve over the first year of life.
- The majority of children will have completely outgrown this by 2 years without need for intervention or any sequalae.
- Commonly associated with Gastro-oesophageal Reflux Disease.
Red Flags
- Difficulty feeding such as increased effort in breathing when feeding or struggling to take full volumes due to work of breathing.
- Poor weight gain
- Apnoeas
- Cyanotic episodes
- Hoarse voice / cry
- Biphasic stridor.
C.M. & G.T. 20-01-25
