Noisy Breathing Stridor

Noisy Breathing in infants & children

  • Noisy breathing in children is a common problem. It can occur due to various causes.
  • Noise during breathing is produced when some part of the baby’s airway is blocked or narrowed. Depending on the site and the degree of the blockage various sounds can be produced. These different sounds are known as snore, stertor, stridor, rattle, wheeze and grunt. We need to examine your child to identify the type of the noise.
  • The most important of these sounds is know as a Stridor. It occurs due to obstructed air flow through a narrowed airway from the Larynx and upper part of trachea (wind-pipe). Many causes can lead to a stridor.

What are the causes of stridor in children?

  • In infants, stridor usually indicates a congenital disorder (problem that your child is born with) and includes, Larynogmalacia (the neck cartilages are more floppy), vocal cord paralysis (vocal cords not working) or subglottic stenosis. Other conditions could be laryngeal webs, subglottic hemangiomas, compression of trachea by vascular rings., etc.
  • In toddlers or older children stridor is as a result of an viral infection. In rare cases, stridor can occur secondary to foreign body aspiration.

What are the red flag signs which suggest an underlying serious problem?
In some children with stridor they may have additional signs or red flags suggesting an underlying serious problem:

  • Chest indrawings or retractions during breathing
  • Poor weight gain
  • Weak cry
  • Child getting blue (cyanosis)
  • Feeding difficulty like choking

How do we investigate a child with noisy breathing?

  • We usually would examine the child in detail before getting any investigations.
  • Some children with stridor may need a one or more of these diagnostic tests:
  • Flexible Bronchoscopy is the most important investigations required for evaluation of children with stridor or noisy breathing. We thereby can exactly see the airway or wind pipe from inside and tell you the cause of the noise.
  • Plain X-ray, barium swallow, and CT scan of the chest - might also be required for a complete evaluation.

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