Just wanted to let you know that I have heard of many children being missed diagnosed with asthma when they really have laryngomalacia (which strenthens by the time the child turns two years old- most of the time). I don’t know how old your daughter is, but thought I’d pass along the info.
Laryngomalacia is a floppy sagging airway, (whereas asthma is just an inflammed airway) and is largely overlooked by doctors. There are also Tracheomalcia and Bronchiomalacia which are also immature floppy airways that can lead to recurring pneumonia because the child cannot clear the airway because they are floppy. Either way, the “malacias” and asthma are treated very similarly (with the same anti-inflamatory drugs). It just may be of comfort for you to know that if it’s ‘Malacia your child may outgrow it.
Stridor and laryngomalacia
Another sign of a problem in the airway is stridor, which is a coarse, high-pitched sound when breathing in. Stridor results from turbulent, rapid air flow through a narrowed portion of the airway. Because a number of airway disorders can cause stridor, a physician should explore all possibilities when evaluating patients with stridor, but EER may play a significant role in those conditions most commonly associated with stridor.
Airway abnormalities present at birth are responsible for 87% of stridor cases in infants (13). The most common of these congenital abnormalities is laryngomalacia (13). Laryngomalacia refers to an abnormal floppiness of the laryngeal tissues just forward of the vocal cords at the airway entrance. Stridor results because upon inspiration, these floppy tissues get pulled into the opening of the airway, narrowing the diameter of the opening by partially blocking it (Figure 4). Although inspiratory breathing is noisy, breathing on expiration is normal, as is the voice.
Parents may notice their baby has noisy breathing at birth, but usually laryngomalacia-associated stridor becomes most noticeable at 1-2 months when the infant is becoming more active and making more demands on the airway. Respiratory effort and noisy breathing typically get worse before they resolve, usually by 18 months of age.
Two studies have shown a strong association between laryngomalacia and gastroesophageal reflux. In one study, 80% of infants with stridor due to laryngomalacia also had gastroesophageal reflux (14). In another, more recent study, the severity of laryngomalacia was shown to be directly related to the severity of gastroesophageal reflux (15).
The co-association of laryngomalacia and reflux may be a common manifestation of neuromuscular immaturity that simultaneously results in flaccid airway structures and poor esophageal sphincter tone (14), which may explain why symptoms often disappear as the child matures. Another possibility is that EER is a secondary effect of the laryngomalacia in which the inspiration of air against the narrowed airway creates of suction effect that pulls reflux up and out of the esophagus (14). Either way, reflux can cause a worsening of symptoms of laryngomalacia because the inflammation and swelling of the laryngeal tissues results in still greater obstruction of the airway. Aggressive reflux therapy is recommended (5).
http://www.marci-kids.com/eerlarynx.html
My son was born with ea/tef on on their forums, there are many moms talking about the year-round (or at least all winter) preventative respitory meds their children are on, so when they get a cold they are able to get over it.
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. How are your children doing? We had found out about her reflux affecting her asthma by her pediatric pulmonary specialist.
