What is Laryngomalacia in Children?

Laryngomalacia is a congenital condition seen in infants and young children where the tissue above the vocal cords (in the larynx or voice box) is soft and floppy. This causes the tissue to collapse into the airway during breathing, partially blocking it. It is the most common cause of noisy breathing in babies. Most cases are mild and resolve naturally by 18 to 20 months of age. However, severe cases may require medication, home care, or surgery.

What are the types of laryngomalacia?

Doctors classify laryngomalacia into three types based on its anatomical cause:

Type 1: Short or tight mucous membranes of the voice box
Type 2: Excess soft tissue in the upper larynx
Type 3: Associated with underlying conditions like GERD or neuromuscular disorders

What are the symptoms of laryngomalacia in children?

Symptoms may appear at birth or during the first few weeks of life and can worsen before improving (typically between 4 to 8 months of age). Most children outgrow this condition by 18 to 20 months. Common signs include:

Stridor – high-pitched noise while inhaling
Noisy breathing, especially during feeding or when lying down
Feeding difficulties or choking
Poor weight gain
Apnea (brief pauses in breathing)
Retractions – visible pulling in of the chest or neck during breathing
Cyanosis – bluish skin tone
Gastroesophageal reflux (frequent vomiting)
Aspiration – food or liquid entering the lungs

What causes laryngomalacia in children?

The exact cause is unknown, but it is believed to be due to weak muscle tone in the upper airway. It is present from birth and can be worsened by GERD. Symptoms may be more noticeable when the child is crying or lying flat.

How is laryngomalacia diagnosed in children?

Your healthcare provider will ask about your child’s breathing and feeding patterns. A test called nasopharyngolaryngoscopy (NPL) is commonly used. It involves passing a small camera through the nose to view the larynx. Additional diagnostic tools may include:

Neck X-ray
Fluoroscopic airway evaluation
Microlaryngoscopy and bronchoscopy (MLB)
Esophagogastroduodenoscopy (EGD) with pH probe
Functional endoscopic evaluation of swallowing (FEES)

How is laryngomalacia treated in children?

Most cases resolve naturally. Treatment depends on the severity of symptoms.

Home treatment for mild cases:

Feed more frequently or thicken formula if feeding difficulties occur
Elevate the head of the crib mattress
Follow medical advice on managing symptoms

Medication:

If GERD is present, anti-reflux medications such as proton pump inhibitors (PPIs) or H2 blockers may be prescribed.

Surgery:

In severe cases, a procedure called supraglottoplasty may be needed. This surgery trims excess tissue around the larynx and is performed under general anesthesia. The child may need to stay overnight post-surgery.

Can laryngomalacia in children be prevented?

No, laryngomalacia is a congenital condition and cannot be prevented. However, symptoms can be managed effectively with timely medical care. Most cases improve on their own over time.

Should I worry if my child has laryngomalacia?

Although noisy breathing can seem alarming, most children outgrow laryngomalacia without complications. Medical attention is important if your child has trouble feeding or breathing.

When should I call my child’s doctor?

Contact your doctor if your child shows symptoms such as:

Persistent noisy breathing
Choking during feeds
Feeding or weight gain issues

When should I go to the ER for my child?

Seek emergency care if your child:

Stops breathing for more than 10 seconds
Shows visible chest or neck retractions while breathing
Turns blue around the lips or face

Why Choose Tender Palm Super-Speciality Hospital for Laryngomalacia Treatment in Children in Lucknow, India?

Tender Palm Super-Speciality Hospital has the most trusted team of Pediatric ENT specialists and surgeons with advanced diagnostic equipment and child-friendly care for Pediatric Laryngomalacia treatment in Lucknow, India. Our Pediatric ENT department follows international safety standards and has years of experience in successfully managing children's ear, nose and throat diseases.