Laryngomalacia

When Molly was just a baby she spit up ALL the time. Her reflux was so bad and really just would drench everything. It drove me totally crazy! I hated it! I hated when people would ask to hold her because I knew that she would slime them! I was always so embarrassed by it. She was spitting up solids when she was a year. It seamed it would never end. One of the cute ladies I was serving with in YW at the time brought this clip to me one Sunday! She said that she saw it and thought of me! I love that Cindy Evans! I have hung on to it through the years to remind me that even though some things are hard and seem to last forever, eventually it will be over and things will be ok. Well this was the first thing that came to mind when Nora was born. I knew from the time I first fed her that she had reflux. There was even one time in the hospital she stopped breathing and seemed to be choking. She was fine by the time the nurses got there, but she will do that a lot, just stop breathing... we will come back to that.

I never thought that a baby could spit up as much as Molly did... OH WAS I WRONG! Nora has way out done Molly. I captured this picture of Kris and Nora. Kris wasn't too happy about me running for the camera and not a towel, but when I talk about Nora spitting up this is totally normal...

I don't know that you can tell but it has gone down the couch cushion and was dripping on the floor. My floor is always soaked! (really I don't know that these pic still do it justice).

Really this is normal at my house! There are 3 kinds of spit up (according to my sister Cydne)

1- the drool (this is just a light little drool like spit up, maybe need a burp cloth, but not bad at all)

2- the babbling brook (not a ton but others might thing so. It just comes all the time like... well a babbling brook)

3- the geyser (this picture is the geyser! It drenches her you and everyone around you. It comes out of her mouth and nose typically shooting straight up and out! she needs a good bath and you a shower after as well as a towel and scrub brush to clean up the couch, carpet, wall or anything else in close proximity after.)

Now really to the bring this all together. She has always been a super noisy eater, she snores in her sleep and on a regular basis stops breathing or chokes. When talking to her Dr about all of this she was then diagnosed with Laryngomalacia. All of these things were symptoms of this and there were more that fit her situation exactly. She is still taking the meds for Reflux and as they get older they are supposed to grow out of it. I feel so bad for the poor thing. It will typically be around 12-18 mon. Here is some of the info on Laryngomalacia.

Laryngomalacia

Laryngomalacia is best described as floppy tissue (epiglottis and arytenoid cartilages) above the vocal cords that falls into the airway when a child breaths in.

• Laryngomalacia is the most frequent cause of noisy breathing (stridor) in infants and children.
• Laryngomalacia is the most common congenital anomaly (birth defect) of the voice box (larynx).
• The cause of laryngomalacia and the reason why the tissue is floppy is unknown. The part of the nervous system that gives tone to the airway is most likely underdeveloped.

Infants with laryngomalacia have intermittent noisy breathing when breathing in (inspiratory stridor) becomes worse with agitation, crying, excitement, feeding or position / sleeping in the supine (on the back) position. These symptoms are often present at birth and are usually apparent within the first 10 days of life. However, noisy breathing (stridor) of infantile laryngomalacia may be present in babies up to one year of age.

Signs and Symptoms of Laryngomalacia:

Symptoms will often increase or get worse over the first few months after diagnosis, usually between 4-8 months of age. Most children with laryngomalacia outgrow the noisy breathing (stridor) by 12-18 months of age.

Other symptoms that can be associated with laryngomalacia include:

• Poor weight gain
• Difficulty with feeding
• Regurgitation of food (vomiting or spitting up)
• Choking on food
• Apnea (stops breathing)
• Chest and / or neck retractions (chest and / or neck sinking in with each breath)
• Turning blue (cyanosis)
• Gastroesophageal reflux (spitting up of acid from the stomach)

Mild Laryngomalacia

Infants in this category have non-complicated laryngomalacia with typical noisy breathing when breathing in (inspiratory stridor) without significant airway obstructive events, feeding issues, or other symptoms associated with laryngomalacia. These infants have noisy breathing (stridor) that is annoying to the caregivers but does not cause other health care problems. These patients will usually outgrow the stridor by 12-18 months of age. Even though your child may have mild laryngomalacia, it is still important to watch for signs or symptoms of worsening laryngomalacia.

Moderate Laryngomalacia

Infants in this category have the following symptoms:

• Noisy breathing when breathing in (inspiratory stridor)
• Regurgitation (vomiting or spitting up)
• Airway obstruction (from floppy voice box tissue)
• Feeding difficulties without poor weight gain (failure to thrive)
• Clinical history of airway symptoms severe enough to warrant multiple visits to an emergency department or hospital
• Gastroesophageal reflux (spitting up of acid from the stomach)

These patients also will typically outgrow the stridor by 12-18 months of age but may require treatment for gastroesophageal reflux. Even though your child may have moderate laryngomalacia, it is still important to watch for signs and symptoms of worsening laryngomalacia.

Severe Laryngomalacia

Patients in this category often require surgical intervention for treatment and to lessen the degree of symptoms. Your doctor may recommend surgery if your child has any of the following symptoms:

• Life-threatening apnea
• Significant cyanotic (blue) spells
• Failure to thrive with feeding difficulty
• Significant chest wall and neck retractions with breathing
• Requires oxygen to breathe
• Heart or lung problems as a result of chronic oxygen depravation

(We are lucky Nora only has a Moderate case)

You can read more about Laryngomalacia here

For Now we will just try to keep our sense of humor about all of this and post this cartoon all over the house...