Christine asks 'is it easy to diagnose' and to that I will answer,
'no, unless you let Cathy Genna see the baby for a few seconds, in
which case it's a cinch'.  Thanks, Cathy, for your reply to this
question.
I wondered whether this could be tracheomalacia rather than laryngo,
myself.  I've seen a number of babies with inspiratory stridor that
makes it hard to be around them during feeds, and they often have
other features such as strong preferences for certain positions and
aversions to others, all consistent with what we know about
laryngomalacia, but they do fine, and love breastfeeding.  The
distress Christine describes is more severe than the cases I've seen
but it sounds reminiscent of tracheomalacia.

Have followed one baby with tracheomalacia whose condition was
misdiagnosed by pediatric specialists for MONTHS until Cathy got
involved, long distance, by telemedicine.  Took her no time at all to
notice all the salient features of the case and she was right on all
counts.  Sure impressed me!

And yours truly learned tons about it in the process!  If you are able
to follow a baby over time, you can learn so much more about the
course of the condition than if you just see them once. One visit is
way better than just trying to read about it too.  Once you have seen
a few cases of something like that, you get a lot better at
recognizing it.  I could cringe when I think of all the tongue-ties I
must have missed over the years, before I had a clue about it.  (Some
days I think all the babies on the ward are tongue-tied but maybe I am
just making up for the ones I didn't see?)

It has been through working with babies whose physical challenges
really do interfere with their ability to feed, that I learned how
much more helpful it is to wonder what is preventing a baby from
feeding normally, rather than trying to convince them to stop refusing
the breast.  When they can, they generally do. Babies who don't
breastfeed well always have reasons for their behavior. Knowing the
reason tells you how to find the solution.

Rachel Myr
Kristiansand, Norway
grateful as always for all the learning that has fallen into my lap
through this list

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