I too find that many pediatricians minimize even severe cases of 
laryngomalacia.

Babies with laryngo or tracheomalacia often find breastfeeding easier 
than bottle feeding, especially if mom leans way back and allows the 
baby to be more prone with his or her head extended. This position opens 
the airway more and makes it easier for baby to just spit out any excess 
milk instead of having to swallow. Again, patience and not prodding the 
baby to feed faster than is comfortable are both important. And the 
paced bottle feeding is very helpful for babies who cannot yet 
breastfeed or need a little extra milk.

Congratulations on starting your practice!

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com


On 4/28/2011 9:31 AM, Deb Bouchard wrote:
> Hi Everyone,
> This is my first post :)  I am a brand new IBCLC just passed the exam this fall.  I have been a LLLL for almost 6 years.  I saw my 3rd ever client the other day a mother of twin baby girls and I'm thinking that one of the babies might have tracheo or laryngomalacia, which I learned about courtesy of Cathy Watson Genna :).
>
> Baby was very "squeaky" (I'm kicking myself b/c I can't remember whether it was an inspiratory or expiratory squeak!) and mom had to pause frequently while feeding baby from a bottle so baby could catch it's breath (babies haven't been to the breast much at all @ 14 days old- they were born vaginally at 36 weeks-and are being supplemented EBM).  I asked mom if she makes that sound a lot and mom said, "Yes, all the time."  Mom said baby never turns blue.  Mom said that the Pedi (which she had seen the same day she saw me) said that both the babies were doing great and mom didn't need to return for a month.  I gave the parents info about paced bottle feeding and taught them about watching their baby's cues etc.
>
> My question is this, how do I approach this?  I'd like to simply plant the seed that perhaps, maybe there might be a problem but I do not what to scare her.  She has a lot on her plate right now!
>
> I just don't feel like I have enough experience with such small babies and preemies to be able to differentiate the normal sounds they make and what might potentially be a problem.  How frequently do docs miss this diagnosis?
> LOL I'm pretty sure I'm overthinking this but I just wanted to know how more experienced LCs handle situations like this.
> Thanks!
> Deb Bouchard, RN, IBCLC Eastern Long Island, NY
>
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