What is Tracheomalacia

Tracheomalacia is a common condition in which the walls of the body’s main airway (trachea) are not as strong as normal. Tracheomalacia results in a partial closing or collapsing of the trachea. This can make it hard for your child to breathe and to get enough air.

Tracheomalacia can be present at birth or develop later in life. This condition usually goes away on its own in the first few years of life, but some children continue having symptoms into adulthood.

What are the causes?

This condition may be caused by:

• Improper development of the trachea.
• Damage to the trachea, such as from an infection or from having a breathing tube in place for a long time.
• Pressure on the trachea, such as from abnormal blood vessels, a mass, or a tumor.

What are the signs or symptoms?

Symptoms of this condition depend on how severe the condition is and where the trachea has narrowed. Symptoms of this condition include:

• Trouble breathing.
• Noisy breathing.
• A barking cough.
• Wheezing.
• A harsh sound when breathing out (expiratory stridor).
• The skin between the ribs or above the chest getting sucked in when breathing in (chest retractions).
• Repeated respiratory infections.
• Difficulty feeding.

Symptoms may be worse when your child:

• Lies down.
• Eats.
• Cries.
• Has a respiratory infection, such as a cold.

How is this diagnosed?

This condition may be diagnosed with a physical exam and a test, such as:

• Bronchoscopy. This is a test done to look at the trachea and lungs. It may be done along with an X-ray test called fluoroscopy.
• A CT scan.
• An MRI.
• A sleep study. This shows whether there is a problem with your child’s breathing during sleep.
• X-rays of the neck or chest.

How is this treated?

This condition usually goes away on its own with time. Until it goes away, treatment may involve:

• Antibiotic medicine. This may be prescribed if your child keeps having infections.
• Chest physiotherapy. This treatment helps clear the airway and prevent respiratory infections.
• Nutritional supplements. These may be recommended if your child is not gaining weight.
• A type of breathing support called bilevel positive airway pressure.
• Surgery. This may be needed if your child is not always able to get oxygen, gets infections often, or does not develop normally. Surgery may involve.
  • Creating a new airway.
  • Moving a blood vessel called the aorta away from the trachea.
  • Putting a tube in the trachea to keep it open.
  • Strengthening the trachea with cartilage or another material (splinting).
  • Removing part of the trachea.

Follow these instructions at home:

• Take a certified CPR course. CPR is a series of steps to help someone who has stopped breathing. If your child stops breathing because of tracheomalacia, performing CPR can save his or her life.
• If your child was prescribed an antibiotic medicine, give it to your child as told by your child’s health care provider. Do not stop giving the antibiotic even if your child starts to feel better.
• Give nutritional supplements only as told by your child’s health care provider.
• Try to keep your child quiet and calm. Crying and excitement can make it harder for your child to breathe.
• Feed your child slowly and carefully.
• Tell your health care provider if your child is catching a cold.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your child has symptoms of a respiratory infection, such as a cough or a runny nose.
• Your child’s breathing changes.
• Your child does not seem to be eating or drinking enough.
• Your child has a fever.

Get help right away if:

• Your child has trouble breathing.
• Your child has trouble swallowing.
• Your child seems less alert than usual.
• You have trouble waking up your child.
• Your child has blue skin, lips, or fingernails.
• Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.