Laryngomalacia is the medical term for a "floppy voice box" and is the most common cause for noisy breathing (stridor) in little babies. The noisy breathing occurs on inspiration and usually becomes worse during feeds, excitement, crying, and when lying on their backs. It is not uncommon for the noisy breathing to pop up after the first few weeks of life, but can be present at birth.
Most of the time, the noisy breathing becomes more noticeable as the child grows and becomes more active. Luckily, in the majority of cases, the floppiness also improves with growth and development and goes away between 12-18 months of age.
Sometimes, tugging of the neck and chest muscles can be seen along with the stridor. These are called "retractions". In more severe cases, babies are likely to spit up or vomit and frequently have acid reflux (GERD). This may need to be treated with medications.
Only very rarely does the treatment of laryngomalacia require surgery (somewhere between 1-5% of the time).
Some simple things to do at home:
- nursing or feeding in a more upright position
- keeping the baby in a more upright position for about 30 minutes after feeds
- avoid tight fitting clothes or diapers
- avoiding overfeeding
- burping frequently
- trying hypoallergenic formula
If your baby has worsening stridor, is not gaining weight as expected, seems to be in distress when breathing, or turns blue and has breath-holding spells, please notify your doctor immediately, as more active treatment may be required.