Hi, All.
 Unfortunately I have become somewhat of an expert in this condition- my
second child, Toby, born this past June had a variety of unexpected medical
conditions and this is one of them.  The correct name is laryngomalacia...
"malacia" means a softening, and it usually effects the trachea or the
larynx. Thus, tracheomalacia is a softening of the trachea so that the
tracheal rings of cartilage are not able to prevent the airway from
collapsing in on itself, especially during expiration. Laryngomalacia is a
collapse of the laryngeal structures. The breathing tubes just flop closed
when the baby breathes out.
  You will likely hear noisy respirations (I describe it as a gurgley
snore), and expiratory stridor (like a wheeze) is usually present from
birth or within the first month. You may also note a hoarse cry.  A lot of
effort with breathing (during inspiration) is visable, watch for
retractions or 'pulling in' at the neck or the chest. Depending on the
severity (which varies), some babies will have a very hard time
co-ordinating the suck-swallow-breathe, and either pull off the breast to
breathe and pant, choke during feeds, or tire very easily and fail to gain
weight.  If the malacia is interfering with feeding (slow weight gain) or
causing aspirations, or the baby is unable to oxygenate well and having
apnea spells, that might be an indication for surgery to help keep the
airways open.  Certainly any baby you can hear breathing from across the
room, and can see "pulling" and respiratory effort should probably be seen
by the pediatrician and hopefully get referred to an ENT. A fiber optic
scope through the nose and into the airways can diagnose the condition,
this is usually an office procedure.  Most kids with a minor case will
simply outgrow it in a year or two, very few will require supportive
surgery but from what the two babies described in recent posts sound like,
they should be receiving close follow-up.
 Anyway, my baby Toby is doing fairly well... he just turned six months
old, is 100% breastfed, 18 lbs, and just got his first taste of solids this
week.  He is also being treated for hypotonia (low muscle tone), and
multiple orthopedic problems (dislocated hips, contracted hands, spine
scoliosis), and being worked up for various genetic disorders, Cerebral
Palsy, and Marfan's syndrome.  But he is a cutie, and I just try to deal
day to day.  Sorry so long, but... there, now you know lots about
laryngomalacia!
See him at http://www.holtzman.net/toby
Nancy Holtzman RN BSN MOM
Great Beginnings New Mothers Groups
Boston MA
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