Tracheomalacia

Tracheomalacia occurs when the cartilage in the windpipe, or trachea, has not developed properly and instead of being rigid, the walls of the trachea are floppy. This can make it hard to breathe because the cartilage cannot keep the windpipe open while breathing. It may collapse when exhaling.

Tracheomalacia can be mild enough to not require any treatment or it can be moderate or severe (life-threatening). Most children with tracheomalacia will either outgrow it by the time they turn 2 or have symptoms that are not severe enough to require surgery.

Cause of Tracheomalacia Show

Most commonly, tracheomalacia is congenital, meaning the child was born with the condition.

Other types of tracheomalacia can occur later when something presses on the tracheal cartilage. For example, a blood vessel may cross too closely to the trachea putting pressure on the walls of the airway. It can also develop after a child has been on a ventilator for quite a while. However, these two causes are much less common than the congenital type.

Babies born with tracheomalacia may have other congenital (present at birth) abnormalities such as heart defects, developmental delay, esophageal abnormalities or gastroesophageal reflux.

Signs and Symptoms Show

Noisy breathing that may change with position and improve during sleep
Breathing problems that get worse with coughing, crying, feeding, or upper respiratory infections
High-pitched breathing or rattling during breathing
Frequent lung infections such as bronchitis or pneumonia

Diagnosis of Tracheomalacia Show

A physical exam can confirm the symptoms. A chest X-ray may show narrowing of the trachea when breathing in. A procedure called bronchoscopy, which allows a physician to see down into the airway, can confirm the diagnosis. Other tests may include:

Airway fluoroscopy
Barium swallow
CT scan
Lung function tests
Magnetic resonance imaging (MRI)

Treatment of Tracheomalacia Show

Most often, the symptoms of tracheomalacia improve as a child grows. Only severe cases require surgery. Most infants respond well to humidified air, careful feedings, and antibiotics for infections. Babies with tracheomalacia must be closely monitored when they have respiratory infections.

Congenital tracheomalacia (present at birth) generally goes away on its own by the age of 18-24 months. As the tracheal cartilage strengthens and grows, the noisy breathing and difficulties gradually stop.

Call Your Child’s Doctor If: Show

Call the doctor if your child:

Has trouble keeping food down and constantly spits it up
Is losing weight or is not gaining weight
Begins to feed less and tires easily in the middle of feeding
Begins to choke on food
Struggles between eating and breathing

Take your child to the hospital if he or she:

Stops breathing for longer than 10 seconds
Has dusky or blue color around lips along with noisy breathing
Has chest or neck retractions (sinking in with each breath) that do not stop with repositioning your child or waking your child up