Tracheomalacia is a softening of the cartilage rings of the windpipe. When the baby breathes out, the Bernoulli effect causes the pressure inside the trachea to be lower than that outside, and the weakened rings collapse, narrowing the airway and making the baby work very hard to breathe. There will be a high pitched whistling sound when this happens, which is called stridor. (Newborns with tracheomalacia may have inspiratory stridor as well as expiratory, due to lower muscle tone.) Feeding is aerobic exercise in infants. Therefore anything that makes a baby work harder to breathe leaves less respiratory reserve for feeding. Failure to thrive is common in infants with moderate to severe airway malacias. To help the baby feed, positions that minimize milk flow and maximize head extension to reduce airway resistence are helpful. Some babies with malacias feed well in prone on mom's chest while she is reclining or laying supine. If effort of breathing is high, baby will probably need short, frequent feeds to allow him to recharge his oxygen in between. If the baby cannot breatfeed, fingerfeeding in prone with a slow flow device can be helpful until respiratory capacity improves. Babies usually grow out of this condition by 6-18 months of age, and sometimes pediatricians fail to take it seriously since it is developmental. Most of the time the baby can compensate, but if the baby has feeding problems, everyone in the health care team should cooperate to help. Reflux is also very prevalent (80% risk) among babies with respiratory malacias, because of the excess pressures they need to exert in order to move air through their narrowed airways. Catherine Watson Genna, IBCLC NYC *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html