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It’s always scary when our kids have trouble breathing. Noisy breathing can set off alarm bells for parents. But it’s more common than you might think. In the medical world, we call noisy breathing stridor. It’s something pediatricians are very familiar with. In some cases, your child will need treatment; in others, she’ll outgrow the conditions that cause noisy breathing. The most important thing parents can do is stay vigilant and keep the lines of communication open with their family doctor.
Does My Child Have Stridor?
Stridor can happen to adults but is more common in children because their airways are smaller. It often sounds like a high-pitched whistle, but parents also describe it as noisy breathing, congestion or wheezing. Noisy breathing can be chronic (long-term) caused by congenital conditions or acute (short-term) because of an infection or an outside object or piece of food stuck in the airway. Three leading causes are:
- Congenital conditions affecting the tissue in the larynx in babies
- Respiratory infections, including croup
- Outside objects getting stuck in a child’s airway
Physicians divide stridor into three categories based on where in the airway it happens:
- Blockage of the throat or voice box (inspiratory stridor) causes noise when you breathe in.
- Blockage of the windpipe above the lungs (expiratory stridor) causes noise when you breathe out.
- Biphasic or laryngeal stridor: a narrowing of the cartilage below the vocal cords causes symptoms when you breathe in and out.
What Causes Noisy Breathing?
According to the American Family Physician, croup (a flu-like virus) is the most common cause of acute stridor. The most common cause of chronic stridor is laryngomalacia, a congenital condition where the tissues of the larynx (or voice box) soften and partially block the airway.
Other causes include:
- A foreign object in the airway–usually food. (This occurs most often in children 1 to 2 years old.)
- Epiglottitis is caused by the HIB bacteria (this diagnosis is now much less common thanks to the HIB vaccine).
- Swollen adenoids or tonsils cause snoring or noisy breathing.
- Vocal cord paralysis is caused by birth trauma or an underlying medical condition.
How Do I Know If My Baby Has Chronic Noisy Breathing?
According to the Cleveland Clinic, over half of newborn babies have laryngomalacia during the first week of life, and even more develop it when they’re two to four weeks old. It is more common in baby boys than baby girls. It usually goes away on its own in the first year. Most infants with this condition don’t have trouble feeding or breathing. Your pediatrician can help you monitor and manage symptoms as your baby grows and the issue resolves. However, in some cases, more severe symptoms mean your baby will need immediate medical attention. Call your pediatrician if your baby shows the following symptoms:
- Difficulty swallowing
- Apnea (long pauses in breathing)
- Cyanosis (a condition that causes the skin to develop a bluish hue)
- Aspiration (pulling food into the lungs)
- Poor weight gain
- GERD (chronic acid reflux)
- Tugging at the neck or chest when breathing
Tracheomalacia is a more severe congenital condition where the windpipe (trachea) doesn’t form properly. It’s much less common than laryngomalacia. Symptoms include:
- Noisy breathing
- Chronic coughing
- Frequent respiratory conditions, including pneumonia and bronchitis
- Shortness of breath
- Trouble swallowing
Concerned About Noisy Breathing? Call Your Pediatrician
If your baby or young child has noisy breathing without other symptoms, don’t panic. In most cases, it’s not an emergency. However, if your child has other symptoms, you will want to see your pediatrician immediately. Your provider will check for other symptoms (like croup or another virus) and check for food or an outside object in the airway. If your baby has signs of a congenital condition, your pediatrician can make a diagnosis and walk you through the next steps to keep your baby safe and healthy.
At Loudoun Pediatric Associates, we understand that breathing issues usually mean alarm bells for parents. Thanks to our team’s decades of experience, we can help you determine whether there’s cause for concern or a common condition that your child will outgrow. As always, we’re happy to be your first resource for answers and support as you navigate the early years.