Laryngomalacia and Breastfeeding

Laryngomalacia and Breastfeeding: Expert Nursing Tips [2024]

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Facing the challenges of ‘laryngomalacia and breastfeeding’? You’re about to embark on a journey of empowerment and resilience.

Laryngomalacia, the most common cause of noisy breathing in infants, affects nearly 58.80% of babies delivered at term. This condition, arising from a birth defect in the child’s voice box, leads to a softening of the tissues above the larynx, resulting in distinctive stridor or noisy breathing. Present at birth, it’s a reality many mothers and their newborns navigate together.

Imagine mastering breastfeeding techniques that cater specifically to your baby’s unique needs, transforming each feeding session into an opportunity for growth and connection. With specialized insights and tailored advice, you can ensure your child not only thrives but also significantly benefits from the nurturing aspects of breastfeeding, even in the face of laryngomalacia.

As a breastfeeding counselor and mother of a baby with severe laryngomalacia, I have created this expert-led guide rich in actionable tips to overcome the hurdles of laryngomalacia. Begin your journey towards a fulfilling breastfeeding experience today, and watch as you and your baby overcome together, one feed at a time.

Key takeaways

  • Laryngomalacia may affect breastfeeding, but with support and flexibility, you can still breastfeed your baby.

  • Be prepared to adapt your breastfeeding techniques to achieve a good latch and maintain a good milk supply.
  • Seeking support and resources, while prioritizing emotional well-being and self-care, is crucial for mothers facing this challenge.

Understanding laryngomalacia

Laryngomalacia, also known as “floppy larynx,” is a congenital condition in which the tissues around a newborn baby’s voice box are softer and tend to collapse, partially obstructing the airway. This can lead to various issues, including breathing difficulties and feeding problems. As a result, mothers with babies diagnosed with laryngomalacia may face some unique challenges when it comes to breastfeeding.

This results in a malformed and floppy laryngeal structure that can partially block the airway, often leading to noisy breathing in infants and breathing problems. The floppy tissue surrounding the baby’s voice box can make feeding a challenge, especially when it comes to breastfeeding infants.

Laryngomalacia diagram showing the vocal folds. Image credit: Cleveland Clinic.
Laryngomalacia diagram showing the vocal folds. Image credit: Cleveland Clinic.

Laryngomalacia and breastfeeding: Tips for moms

You may have heard that breastfeeding a baby with laryngomalacia is not possible – but I am here to tell you that it is! I did with my baby, and so can you too. It may just take a little more support and flexibility.

Seek medical advice

When you have a baby with laryngomalacia, it’s important to work closely with healthcare professionals to ensure you can successfully breastfeed. Reach out to your pediatrician, lactation consultant, and a speech therapist if needed. They can guide the best breastfeeding positions and infant positioning to reduce aspiration risk, maintain a good latch, and minimize feeding difficulties.

Create a supportive environment

As a mother of a baby with laryngomalacia, you need to create a comfortable and supportive environment for both yourself and your baby. Ensure that your baby’s feeding area is warm, quiet, and free of distractions. Consider using a supportive breastfeeding chair with pillows to support your arms and baby during breastfeeding, as this can help to keep both of you relaxed and comfortable, minimizing stress for a successful breastfeeding experience.

Laryngomalacia-specific challenges

Babies with laryngomalacia sometimes face breastfeeding difficulty during breastfeeding, such as difficulty maintaining latch and coordinating sucking, swallowing, and breathing. To help your baby, try the following tips:

  • Experiment with breastfeeding positions: Find a position that allows your baby to breathe more easily, such as an upright or side-lying position. These positions can help reduce the risk of aspiration and maintain a better latch. Some moms find that feeding in a baby carrier can be benefical.

  • Take breaks: Allow your baby to take breaks to catch their breath during feeds. This will help prevent them from getting overtired and will give them a chance to swallow more easily after each attempt.

  • Support your baby’s head: Ensure that your baby’s head and neck are well-supported during breastfeeding to help maintain proper positioning and allow for easier breathing.

  • Feed more frequently: Infants with laryngomalacia may become tired more easily when feeding due to their increased effort to breathe. Offering more frequent but shorter feeds can help your baby get the nutrition they need without becoming too exhausted.

  • Monitor weight gain: Keep track of your baby’s weight gain by scheduling regular check-ups with your pediatrician. This will help ensure that they are getting enough milk and growing appropriately for their age. Read this post for more advice: Is My Newborn Getting Enough Breast Milk? 5 Surefire Signs to Look For

  • Express your milk: Many moms, myself included, find that using a breast pump to express their breast milk can be hugely beneficial. You can store your breast milk in the freezer or use the Pitcher Method. If you or your baby becomes tired from frequent breastfeeds, you can reach for your pumped milk and feed your baby using a bottle instead. Frequent pumping means you maintain a steady milk supply and continue to give your baby highly nutritious feeds.
  • Give formula milk: You may decide to supplement feeds using formula if you experience poor milk transfer due to your baby’s laryngomalacia.

Symptoms of laryngomalacia

  • Trouble breathing: Babies with laryngomalacia may exhibit difficulty breathing, especially during exertion or while feeding, usually noticed in the first few weeks of life. This can manifest as noisy breathing, stridor (a high-pitched sound during inhalation), or retractions (visible pulling in of the chest or neck muscles during breathing). Sometimes they can appear to be choking on milk.

  • Difficulty feeding: Breastfeeding difficulties can be common in infants with laryngomalacia. This may include challenges with latching, maintaining a consistent latch, and difficulty coordinating sucking, swallowing, and breathing. Reduced volume intake and frequent feeds might be observed.

  • Swallowing compromise: Laryngomalacia can affect swallowing dynamics due to altered vocal fold function and reduced airway protection. Babies may experience swallowing difficulties (dysphagia), leading to disrupted milk flow and compromised feeding.

  • Apnea: Laryngomalacia can cause episodes of apnea, which are pauses in breathing. These episodes may be brief and resolve spontaneously, but they can still be concerning and require medical attention.

  • Aspiration: Due to compromised swallowing and airway protection associated with laryngomalacia, there is an increased risk of food or liquid entering the airway (aspiration). This can lead to coughing, choking, and respiratory issues.

  • Poor weight gain: Infants with laryngomalacia may have difficulty feeding effectively, resulting in reduced volume intake and frequent feeds. This can contribute to poor weight gain and inadequate growth if not addressed and managed appropriately.

  • Identifying anterior positioning: Babies with laryngomalacia may prefer anterior positioning of their head and neck during feeding. In layman’s terms, this means tilting their head slightly forward. This position can help improve dynamic airway obstruction by allowing for better airflow.

Common breastfeeding positions

How is laryngomalacia diagnosed?

  1. Clinical examination:

    • One of the key aspects of this examination is listening to the chest sounds of the infant. By placing a stethoscope on the baby’s chest, healthcare providers can listen for any abnormal breathing sounds, such as wheezing, stridor, or gurgling noises. These chest sounds can provide important clues about the functioning of the airway and any potential issues.
    • In the case of laryngomalacia, healthcare providers may listen carefully for the distinctive stridor, which is a high-pitched, crowing sound that can occur when there is partial airway obstruction. This auditory information, combined with the physical examination findings, helps the healthcare team assess the severity of laryngomalacia and plan the appropriate treatment strategies.
  2. Flexible endoscopic evaluation:

    • A thin, flexible tube with a camera (endoscope) is used.

    • Direct visualization of the larynx and supraglottic structures during inspiration.

    • The dynamic collapse of the supraglottic structures confirms the diagnosis.

  3. Medical imaging (if necessary):

    • X-rays, fluoroscopy, or CT scans provide detailed information about airway anatomy.

    • Helps assess severity or rule out other conditions.

Differential diagnosis

Several conditions share symptoms with laryngomalacia – here are some conditions that should be considered in the differential diagnosis:

Tongue TieAnkyloglossia, commonly known as tongue tie, occurs when the lingual frenulum restricts the movement of the tongue. This restriction can affect breastfeeding by impairing the baby’s ability to latch effectively and extract milk.
Upper Respiratory InfectionInfections of the upper respiratory tract (upper airway), such as a cold or flu, can cause nasal congestion and affect the baby’s ability to breathe and feed comfortably. Symptoms like a runny or stuffy nose, coughing, and sneezing may be present.
Swallowing DisordersCertain conditions can affect a baby’s ability to coordinate sucking, swallowing, and breathing. Swallowing disorders can arise from various underlying factors and may require further assessment, including medical imaging and consultation with specialists.
Airway CompromiseConditions such as subglottic stenosis or other congenital anomalies of the airway can lead to airway compromise, causing symptoms similar to laryngomalacia. These cases often require more extensive evaluation and may require surgical treatment and intervention.
Differential diagnosis of Laryngomalacia

Impact on breathing and feeding

Babies with laryngomalacia may struggle with both breathing and feeding. The soft and floppy laryngeal tissue can obstruct the airway during inspiration, causing temporary partial blockage. When a baby exhales, the tissue is pushed back out, opening the airway again.

This condition can also affect breastfeeding, as infants with laryngomalacia may have difficulty transferring milk. Lactation consultants are often among the first health professionals to notice this issue, as it can present itself early in the breastfeeding journey.

Prevalence of laryngomalacia

Laryngomalacia is the most common cause of noisy breathing in infancy. The incidence of laryngomalacia in the general population is relatively unknown but has been estimated to be anywhere from 1 in 2000 to 3000.

While it can be concerning to hear your baby struggling to breathe, it is important to remember that this condition is generally not severe and many babies will outgrow it.

Always seek advice from a medical professional if you are concerned about your baby’s breathing – do not try to diagnose the condition yourself.

When does laryngomalacia resolve?

Laryngomalacia is generally benign and resolves on its own as the child grows.

In most cases, laryngomalacia tends to improve significantly by the time the child is 12 to 18 months old and usually resolves completely by the age of 2 to 3 years.

However, the severity and duration can vary from child to child. Some may experience more significant symptoms that require medical intervention, such as severe stridor, difficulty feeding, or poor weight gain. In these cases, treatment options may include medication or surgery, depending on the severity of the symptoms (more on this later).

Seeking support and resources

Joining supportive communities

As a parent of a baby diagnosed with laryngomalacia, it’s crucial to connect with supportive communities that understand your journey. Engaging with other parents facing similar challenges can provide invaluable advice and strength. Join online forums, social media groups, or attend local gatherings dedicated to laryngomalacia and breastfeeding. These communities offer a safe space to discuss your experiences, learn about successful breastfeeding techniques for infants with voice box abnormalities, and find resources to help you and your baby throughout this journey.

Benefits of connecting with others

Connecting with others who share your experiences can have numerous benefits, both emotionally and practically. By interacting with fellow parents of infants with laryngomalacia, you can:

  • Share tips and strategies for improving sleep quality

  • Gain insights on breastfeeding positions that accommodate your baby’s airway and aspiration risk

  • Learn about pre- and post-surgery care, ensuring your baby’s comfort and wellbeing

  • Discover new resources and information on laryngomalacia that can help you advocate for your baby’s needs

Ultimately, the connections and friendships you build within these supportive communities can help you feel less isolated and more confident in your journey as a parent.

Finding specialized support

Expert advice from lactation consultants, speech therapists, or medical professionals with experience in laryngomalacia can make a significant difference in your breastfeeding experience. They can provide personalized guidance to overcome any breastfeeding difficulties, such as adjusting your baby’s positioning to accommodate their airway or lessen the risk of aspiration. In addition, these specialists can work closely with you to monitor your baby’s progress, ensuring that they are feeding effectively and comfortably while addressing any concerns that may arise.

Remember that you are not alone, and there are resources and people who understand your journey and are ready to assist you and your baby.

Collaboration with healthcare professionals

moms at a support group with their babies

Regular communication

Regularly share your concerns, updates, and progress with your healthcare professionals. This helps in better understanding your baby’s needs and modifying the feeding plan accordingly.

Don’t hesitate to reach out for support or advice when needed, as healthcare professionals have experience dealing with such situations.

Treatment options

As you navigate laryngomalacia and breastfeeding, it’s essential to explore and discuss treatment options with your healthcare professionals. This can include different breastfeeding positions or supplemental feeding methods. For example, an elevated feeding or breastfeeding position may help reduce the likelihood of choking or aspiration.

How is laryngomalacia treated?

  1. Observation and supportive care:

    • Mild laryngomalacia cases may not require specific treatment.

    • Close monitoring of symptoms and growth.

    • Ensuring proper feeding techniques and positions.

  2. Acid reflux management (if applicable):
    • Lifestyle modifications to manage gastroesophageal reflux (GER).

    • Reflux medications to alleviate symptoms and improve feeding.

  3. Surgical intervention (in severe cases):

    • Rarely needed but considered for severe laryngomalacia.

    • Specific procedure depends on the individual case.

    • May involve tissue removal or correction of anatomical abnormalities.

Work closely with your healthcare team to find the best approach for your baby. Don’t be afraid to ask questions or share your concerns about treatment options — maintaining an open and honest dialogue promotes better decision-making and individualized care.

Managing gastroesophageal reflux (GER)

Gastroesophageal reflux is a common condition in infants, and it can aggravate laryngomalacia symptoms. Babies with laryngomalacia are often found to have stomach acid gastroesophageal reflux. To help manage this condition, collaborate with your healthcare professionals to develop a reflux management plan. This may include changes in feeding patterns, smaller and more frequent feedings, or adjusting your baby’s position during and after feedings.

Your healthcare team might also recommend reflux medication to alleviate symptoms related to reflux or GER. Ensure you follow their instructions and discuss any side effects or concerns that arise during treatment.

Emotional well-being and self-care

mom holding baby in a carrier

Emotional toll of breastfeeding challenges

Breastfeeding can be an emotionally challenging experience for most babies, especially if your baby has laryngomalacia. The condition results in noisy breathing, which might cause you to feel anxious or worried. These emotions are completely normal and it’s important to recognize that many mothers face breastfeeding difficulties.

Self-care practices

In order to take care of yourself and promote your emotional well-being while breastfeeding, prioritize your needs. Here are some essential self-care practices:

  • Rest: As a breastfeeding mom, getting enough sleep is crucial for your overall well-being and milk production. Aim to take naps when your baby sleeps and ask for help from loved ones when needed. Establishing a sleep routine can make a significant difference in how you feel.

  • Nutrition: Eating a balanced diet is vital to your physical and mental health. It’s important to consume about 500 extra calories a day to maintain your energy levels and support your baby’s growth. Include nutrient-dense foods rich in vitamins, minerals, and healthy fats in your meals. Consider protein shakes designed for women as a quick, easy, and nutritious supplement to your diet.

Learn more here: 13 Self-Care Ideas for Moms: Top Tips for Daily Relaxation

Coping strategies

Adopting effective coping strategies can make a difference in how you manage the emotional toll of breastfeeding challenges. Consider trying some of the following methods:

  • Acceptance: Acknowledge that breastfeeding can be hard, and that it’s okay to feel a range of emotions. Give yourself permission to experience these feelings without judgment or guilt.

  • Support: Reach out to friends, family, or a professional support network to express your feelings and seek advice. Talking about your experience can alleviate some of the stress and help you feel less isolated.

  • Mindfulness: Practice mindfulness and deep breathing exercises to help you stay present while breastfeeding and manage your emotions. Regular meditation can also play a crucial role in maintaining a healthy state of mind.

Find the courage to be anxiety free

Grab this essential guide to take control of your anxiety. With daily journaling spaces and practical strategies, it’s a great tool to identify triggers and manage mental health. Stylish and handy, this book is your first step towards a stress-free journey into motherhood. Find The Courage To Be Anxiety Free: Coping skills and tips for women for a positive mindset

Remember, your emotional well-being plays a significant role in your overall health, and taking care of yourself is just as important as taking care of your baby. Prioritizing self-care and employing effective coping strategies can help you navigate the challenging journey of breastfeeding with laryngomalacia.

Statistics and research about babies and laryngomalacia

Laryngomalacia is a very common condition in infants. Over half of all newborn babies have laryngomalacia during the first week of life, and even more develop it when they’re two to four weeks old.
The prevalence of laryngomalacia within children presenting with sleep-disordered breathing was 3.9%.
In one study, around 52.46% of children had normal birth weight and 40.14% of children had low birth weight. However, the majority of the children were of normal birth weight. Some studies suggest low birth weight be a strong predictor of laryngomalacia
Almost 76% of children with laryngomalacia didn’t show sufficient weight gain
A small percentage of babies with laryngomalacia do struggle with breathing, eating, and gaining weight, and their symptoms require prompt attention.
Approximately 15% of infants with laryngomalacia have symptoms that persist beyond 18 months of age.
Statistics and Research About Babies and Laryngomalacia


I want to extend my heartfelt support to all the incredible moms navigating breastfeeding with laryngomalacia. Remember, you are not alone in this journey. Reach out to your supportive community, connect with other moms facing similar challenges, and seek guidance from knowledgeable healthcare professionals. You possess the strength and resilience needed to overcome obstacles and create a nurturing bond through breastfeeding. You’re doing an amazing job!

Final thoughts

My second child was born with severe laryngomalacia which meant he also had severe symptoms. His breathing was noisy and the poor boy couldn’t swallow properly so I was breastfeeding him every hour (exhausting!!). He would often choke and splutter – as an HCPC registered paramedic, I knew what to do but it was still distressing.

Katie and Tommy as a baby with an NG tube

He had surgery at 11 weeks old and improved slowly after that (learning to manage a nasogastric tube in a baby is no joke!). Even so, his gag reflex was strong and he was always able to clear his airway with a good few coughs and careful supportive positioning. Now, as a breastfeeding counselor, I always tell every new parent to trust their instincts – if you think something isn’t right then take your baby to your child’s doctor urgently.

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