Hi Denise,
Babies with tracheomalacia have  a weak trachea.  It partially collapses
every time they breathe out.  Therefore, they have increased work of
breathing, and lower aerobic capacity.  Since feeding is aerobic
exercise, you can see how that would make them have to work even harder
to breathe while feeding.

Some things that can help:  feeding baby in positions where the head is
a bit extended on the neck.  This helps to open the airway a bit more,
and can ease breathing.

feed baby very, very often.  A few sucks every 3 minutes, that sort of
often.  This way the baby never gets beyond his respiratory capacity,
and has a little time to recover before feeding again.  Some moms are
willing to do this, it requires easy clothing so she does not have to
take a lot of time to get the breast out.  I had a baby with Down
syndrome and a very very severe cardiac defect in my practice whose mom
bf him this way, and he was exclusively breastfed and gained well, in
fact he was chubby.  His breathing sounded like a cat purring at rest,
and he could only suck a few times before he had to let go and recover.
  Mom was very determined.

see if baby feeds better on one side than the other.  Some babies have
asymmetrical tracheomalacia, and can feed better laying on one side
thant he other.  Wolf and Glass talk about a case like this.  If so,
position appropriately.

might need to supplement this baby by ng tube or gastronomy if he is
unable to breathe well enough to feed.
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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