Laryngolamacia and abnormal breathing

Why does my baby squeak while breastfeeding?

A baby’s breathing sounds can be a sign that there is an abnormality in the baby. Watch for rapid breathing (more than 60 breaths a minute) or grunting after each inhalation when the baby is not breastfeeding. You may see the skin between the ribs or at the bottom of the ribs or at the top of the breastbone sink into the chest when your baby inhales. Breathing problems can cause abnormal breastfeeding patterns and poor growth. One example of a breathing problem is laryngomalacia, an abnormality in the voice box that causes a high-pitched squeak when babies breathe in. Almost all babies with the condition grow out of it but some need surgery. Talk to your health-care provider as soon as possible if you have concerns about your baby’s breathing.

A) Describing breathing problems

Most of a baby’s sounds such as gulping, panting, clicking, choking, and goat-like noises are normal. Occasionally a baby’s sounds while breathing can be a sign that there is an abnormality in the structure and function of the baby’s throat or swallowing or breathing tube.

Consider making a video recording of the behaviour to show your health-care providers if you think your baby is breathing abnormally.

B) Describing laryngomalacia

Some babies have abnormalities in the area of the voice box (larynx) in the throat that cause them to make a high-pitched squeak when they breathe in. It can be quite loud. This condition is called laryngomalacia.

Almost all babies with the condition grow out of it and need no treatment. A small number may have breastfeeding problems or need surgery because of breathing problems or poor growth. Positioning the baby in the laid-back hold may help the baby breathe and reduce the risk of choking (Mills 2020).

The video below shows a baby who has laryngomalacia breastfeeding. He is growing well and is otherwise healthy.

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C) Signs of concern

Babies with laryngomalacia and other problems may have significant breathing difficulty. Please see your health-care provider as soon as possible if you have concerns about your baby’s breathing or you notice any of these:

  • Breathing abnormalities:
    • Breathing faster than 60 breaths a minute.
    • Grunting after each inhalation when not breastfeeding.
    • Nostrils flaring while feeding.
  • Chest area:
    • The skin between the ribs sinks into the chest when the baby breathes in.
    • The skin covering the notch at the top of the baby’s breastbone (where the vertical bone in the middle of the chest ends, just under the throat) sinks into the chest when the baby breathes in.
    • The skin at the lower edge of the ribs sinks in when the baby breathes in.
  • Feeding abnormalities:
    • Difficulty breathing when crying.
    • The lips, tongue, and area around the mouth turning blue or purple during feeding.
    • Being too weak or tired to breastfeed effectively.
    • An abnormal breastfeeding pattern.
  • Not growing well.

References

Mills N, Keesing M, Geddes D, et al. Flexible Endoscopic Evaluation of Swallowing in Breastfeeding Infants With Laryngomalacia: Observed Clinical and Endoscopic Changes With Alteration of Infant Positioning at the Breast. Ann Otol Rhinol Laryngol. 2020 Oct 22:3489420965636