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What is tracheomalacia?

Tracheomalacia is a condition in which the walls of the windpipe (trachea) are very weak or soft. The windpipe is the airway that leads from the throat to the lungs. It is made of muscles and a tough flexible tissue called cartilage. Rings of cartilage support the windpipe and keep it open when you breathe. When a child has tracheomalacia, the windpipe may be so weak that it collapses and may block the airway.

What is the cause?

Tracheomalacia is most common in infants and small children. Most of the time it is a birth defect. It may also develop if your child has:

  • A breathing tube in the throat for a long time
  • An abnormal connection between the windpipe and the food tube that connects your throat to your stomach (esophagus)
  • Severe gastroesophageal reflux disease (severe and frequent heartburn, also called GERD)

What are the symptoms?

Symptoms of tracheomalacia include loud noisy breathing (stridor) and a loud barking cough. Your child may wheeze constantly. The wheezing may be worse when your baby cries, feeds, or coughs. Symptoms usually get better when the baby lies on his or her stomach or sleeps.

Most babies with this disorder seem happy and do not seem to be struggling when they wheeze.

If tracheomalacia is severe, the child may struggle very hard for breath. Over time, the chest wall may become deformed. Babies may not be able to breathe and eat at the same time, and may not gain weight properly. If the airway is severely collapsed or blocked, the baby may need extra oxygen or other kinds of help with breathing.

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine your child. Tests may include:

  • Laryngoscopy or bronchoscopy, which use a thin, flexible, lighted tube passed through your child’s mouth and down into the throat or lungs to examine your child’s airways
  • X-rays or other scans

How is it treated?

Tracheomalacia usually gets better without medical treatment by the time a child is 6 to 12 months of age and goes away by 24 months of age. Children with this condition do need to be carefully watched when they get colds or other respiratory infections because the infection can make their symptoms worse.

If the condition is severe, does not get better, or slows your child’s growth, your child may need:

  • Continuous positive airway pressure (CPAP) machine. This is a machine that sends air into the child's airway through a special mask placed on the face. The machine does not breathe for your child, but it helps keep the airway open.
  • Tracheostomy (also called a tracheotomy). This is a surgical procedure that makes a small opening in your child’s neck and windpipe. A tube is then placed in the opening to keep it open. Your child then breathes through this tube rather than through the mouth and nose.

How can I take care of my child?

Follow your child’s healthcare provider's instructions for treatment.

Ask your child’s provider:

  • How long it will take for your child to recover
  • What activities your child should avoid and when your child can return to normal activities
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup.

Developed by RelayHealth.
Pediatric Advisor 2013.2 published by RelayHealth.
Last modified: 2013-03-25
Last reviewed: 2013-02-07
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2013 RelayHealth and/or its affiliates. All rights reserved.
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