Tracheomalacia? - Mothering Forums

 
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#1 of 7 Old 04-19-2008, 02:15 PM - Thread Starter
 
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DD was diagnosed with this yesterday and I'm just wondering if any other momma's have babe's with it. Hers isn't bad at all, but it sounds scary sometimes.

She also has a VSD and GERD, which I guess are really common in babies with tracheomalacia.

We are just starting solids, and it looks like this causes a higher risk of aspiration pneumonia, so I'm also wondering if we should be more careful with chunks and self feeding than normal...
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#2 of 7 Old 04-19-2008, 02:52 PM
 
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My son had laryngo and possibly trachelomalacia as an infant and toddler. His was moderate, he sounded like an airraid siren a lot of the time, retracted when he was breathing, but never lost O2 saturation. They gave us an apnea monitor, although it turned out we never needed it (we didn't have any "true" alarms. He also had problems with reflux and recurrent aspiration and ended up needing a feeding tube due to them. He's now 9 and except for the fact that his cough sounds a little more dramatic when he's sick and he has asthma (maybe due to lung damage from the aspiration) that's not too severe, he's doing great with feeding, breathing, etc . . .

In our case the malacia seemed to be caused by the reflux damaging his airway. It got dramatically worse when he was about 6 weeks old and put on a very strong antibiotic that messed up his system and aggravated the reflux. Twe had a cycle to break -- his lungs and airway were damaged from the aspiration which made him use his stomach muscles to breathe, which put pressure on his stomach which made him reflux/aspirate. Getting everything back in control took a long time, but we did. Has your DD's just appeared recently (I'm assuming she's not a newborn if you're starting solids) or has she had it all along and was just recently diagnosed? If the latter I wouldn't worry too much about aspiration -- liquids are a much bigger risk for aspiration and if she's lasted for months without pneumonia/pneumonitis I'd say she's probably handling things fine.

If you wanted to take some aspiration precautions -- some of the things that we did were:

-- only feeding him when he was relatively still and relatively upright, so in a high chair or a bouncy seat or sitting up on my lap (not crawling around with something)

-- not feeding him if he was struggling to breathe -- e.g. calming him down if he was crying before offering food, or if he was so excited that it started the stridor up.

-- not feeding him textures that had a mixture of liquid and solid (e.g. soup, oranges, liquidy fruit salad) in the beginning because they're the hardest liquids to manage.

-- really paying attention to her cues as to when she's done eating and not pushing it.

Also, I'd stay away from any kind of straight oil such as salad dressing, or sometimes you'll hear people advocate giving baby straight cod liver oil or straight mineral oil if they're constipated. Food cooked with oil is fine, but aspirated oil is very very bad.
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#3 of 7 Old 04-19-2008, 06:27 PM - Thread Starter
 
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Thanks so much for the reply! DD is 7.5 months - no idea why it didn't present itself earlier. No history of upper respiratory issues.

I've been feeding her in her Bumbo seat with the tray. I was planning on letting her do self-feeding with chunks, but have been spoon and finger feeding her mushed foods instead. That seems to be working okay for her.

Thanks for the heads up on the liquidy/solids too. I never would have guessed, but that makes perfect sense. We'll avoid those for a while.

Isabella is only loud when she's excited mostly - then she wheezes VERY loudly and ends up coughing a bit then slowing down to catch her breath. It only started within the last week or so, so I do wonder if allergy season and/or her cold a few weeks ago have something to do with it becoming symptomatic.
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#4 of 7 Old 04-19-2008, 10:52 PM
 
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Originally Posted by veganone View Post
Thanks so much for the reply! DD is 7.5 months - no idea why it didn't present itself earlier. No history of upper respiratory issues.

I've been feeding her in her Bumbo seat with the tray. I was planning on letting her do self-feeding with chunks, but have been spoon and finger feeding her mushed foods instead. That seems to be working okay for her.

Thanks for the heads up on the liquidy/solids too. I never would have guessed, but that makes perfect sense. We'll avoid those for a while.

Isabella is only loud when she's excited mostly - then she wheezes VERY loudly and ends up coughing a bit then slowing down to catch her breath. It only started within the last week or so, so I do wonder if allergy season and/or her cold a few weeks ago have something to do with it becoming symptomatic.
I actually think self-feeding chunks is fine. Unless she has significant problems with oral motor (is she babbling, making consonant sounds etc . . .?) I wouldn't worry -- chunks are less likely to be aspirated than liquids and if she's handling breastmilk fine then she should be fine with them.

I bet this is a temporary reaction to either the cold or the allergy -- my son still gets "allergic croup" which sounds like what you're dealing with. Is it actually wheezing -- which is on the exhale, or stridor (which is typical with malacia) on the inhale?

Also, is the reflux also new or did she have that along. If the answer is the latter it could also be that something is making her reflux flare (could she be outgrowing her med dose?) and that's irritating her throat? Maybe you introduced something that's causing or aggravating the reflux?
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#5 of 7 Old 04-20-2008, 03:31 PM - Thread Starter
 
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She's had reflux all along, so maybe she does need a med adjustment. Hmm.. She's been fussier than normal at night, which I attributed to teething, but maybe it's her reflux acting up. I'll call her ped about that.

It's definitely stridor - she sounds like a siren when she takes a deep breath.

I hope that rice cereal didn't aggravate her reflux, which is the only thing we added in that time period... She really likes it and really seems to like eating.

Thank you so much!
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#6 of 7 Old 04-21-2008, 10:42 PM
 
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Originally Posted by veganone View Post
She's had reflux all along, so maybe she does need a med adjustment. Hmm.. She's been fussier than normal at night, which I attributed to teething, but maybe it's her reflux acting up. I'll call her ped about that.

It's definitely stridor - she sounds like a siren when she takes a deep breath.

I hope that rice cereal didn't aggravate her reflux, which is the only thing we added in that time period... She really likes it and really seems to like eating.

Thank you so much!
Rice cereal (and anything else constipating) were big reflux triggers for us. We switched to Barley cereal and saw huge improvement. DS liked them equally well, maybe you could try that?
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#7 of 7 Old 04-22-2008, 02:04 PM - Thread Starter
 
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I wondered about barley cereal - we'll try that. She LOVES rice cereal.

She hasn't had any constipation at all, and her reflux actually seems under control other than the tracheomalacia appearing. She's definitely teething, though.

Thank you again!
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