Seeking Guidance on Possible Laryngomalacia for My 8-Week-Old
I have an 8-week-old baby who was born full term with a straightforward pregnancy and delivery. Although he did ingest some amniotic fluid during delivery—which was a C-section—everything appeared fine afterward. Early postpartum, I experienced hypertension, but I’ve since stopped taking labetalol after treatment. At birth, I recall querying the pediatric team about a wheezy noise in his breathing. They explained it was likely due to his C-section delivery, as he didn't experience the usual chest compression. Approximately two weeks later, I noticed a stridor occurring at night, happening once or twice along with a gasp for air. Additionally, he makes a distinctly nasal sound when latching, reminiscent of a pug. Fortunately, his weight gain has been consistent, and he is growing well without any issues related to latching. However, he does cough during feedings, often after he’s dozed off while nursing, likely because of my strong milk letdown. The whistling sound he makes on inhalation has intensified, particularly during feeding or when he’s excited, and it is becoming more common during nighttime hours. Although he manages to sleep through much of it, there are times—mostly post-feeding or when settling to sleep—when he appears to gasp for air, which causes me concern as he seems almost apneic. To alleviate this, I have to hold him upright and gently pat his back. Our pediatrician has made a referral to an ENT specialist due to the possibility of laryngomalacia, but our appointment isn’t for another three weeks. I am anxious about the risk of airway collapse and wonder if he might stop breathing. I always lay him down on his back when he sleeps, try to feed him in an upright position, and take breaks during meals to ensure he burps properly. Additionally, he is on famotidine due to some indicated concerns about silent reflux. Notably, he contracted RSV at seven weeks, but thankfully he did not require hospitalization and has since recovered well. I'm reaching out for advice on what other steps I might take to ensure his safety and comfort as we await the ENT visit. Any guidance would be immensely appreciated.
Answers (1)
3/18/2025, 3:50:56 PM
OpenHealth AI
Thank you for sharing your concerns about your 8-week-old baby. It sounds like you're understandably anxious about his breathing patterns, especially with the possibility of laryngomalacia. Let’s break this down and focus on what steps you can take to ensure his safety while you wait for the ENT appointment.
Main Points:
- Your baby's current situation, including his symptoms and growth, is being monitored well.
- Maintain safe feeding practices and environment to manage his symptoms.
- Be alert for any concerning changes that would require immediate attention.
Explanation:
Laryngomalacia is a common condition in infants where the soft tissue of the larynx collapses inward during inhalation, leading to noisy breathing, particularly during excitement or feeding. It is often not serious and many babies outgrow it without treatment, especially if they are growing well and gaining weight, as your baby is.
Given your baby’s symptoms of stridor and coughing during feeds, it’s great that you've already implemented some strategies like feeding him in an upright position and ensuring he burps properly. Your concern about his apparent breathlessness gives valid reason to monitor his condition closely, especially following an illness such as RSV.
Next Steps:
-
Feeding Adjustments:
- Continue feeding him in an upright position.
- Consider smaller and more frequent feeding sessions to prevent overfeeding and reduce the risk of aspiration (choking or coughing during feeds).
- If he coughs during feeding, gently burp him and then continue after a brief pause if he seems comfortable.
-
Environmental Control:
- Keep the air humidity comfortable; a humidifier can help if your home's air is dry.
- Avoid irritants like smoke or strong smells that could exacerbate his respiratory sounds.
-
Comfort Measures:
- Continue to hold him upright when he appears uncomfortable, especially post-feed. Gentle back pats can help ease any distress.
- If he gasps for air or seems apneic, remain calm; repositioning him (upright) can help.
-
Monitoring Symptoms:
- Keep a diary of his symptoms (when stridor occurs, duration, any associated factors such as feeding or sleeping) to discuss with the ENT specialist.
- Watch for any worsening symptoms such as increased difficulty breathing, fever, or changes in his feeding patterns.
-
Emergency Signs:
- If he experiences severe respiratory distress (severe stridor at rest, cyanosis, extremely rapid breathing), seek medical attention immediately.
While it’s natural to feel anxious, it’s reassuring that you are proactive in caring for your baby. Following these measures can help manage his symptoms effectively until your ENT visit. If there's anything more specific you'd like to discuss, feel free to reach out.
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