Laryngomalacia is usually hard to detect in the first few days of life 
because the milk flow is slow, and there is less challenge to the baby's 
respiratory stability. It shows up as soon as the milk is copious, and 
there is significant stridor during and after feeding, crying, stress, 
etc. You'll HEAR it if the baby has laryngomalacia. You can also hear it 
over the telephone - a mom called me to rent a pump because her baby's 
weight gain was slow, and I could hear him in the background. She never 
did come in for a consult, but I was able to tell her to take the baby 
back for examination.
You'll also see the suprasternal retraction (sucking in of the tissue 
right above the breastbone) which gets worse with increases in the 
stridor, and when the baby is supine. It's a visual representation of 
the collapse of the airway, and the stridor is the sound that air makes 
when it's being forced through a narrow area in the airway.

Catherine Watson Genna, IBCLC  NYC

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