Tracheomalacia

What is that, you might ask?

It is the answer to what ails our Andy.

The last post details our bout with Croup (which is still the devil). Andy has also had three prior hospitalizations for bronchiolitis. We assumed he had asthma, so we started pulmicort last week with albuterol treatments when he wheezed.

But something strange was happening. The albuterol did nothing. NOTHING. We were holding him down for these nebulized treatments for no perceived benefit. And Coby and I would listen to him, and we had been saying to each other that it sounded like the wheezing was coming from his upper airways, not really in his lungs. But with babies, it can be difficult to tell what part of the airway is making noise.

Then it all clicked into place yesterday. Prematurity + multiple hospitalizations for lung infections + almost daily "noisy breathing but not quite wheezing" = tracheomalacia. It is when the muscles that surround the trachea are not as strong as they should be, so they are floppy. Babies will breathe loudly, wheezing a lot of the time. These noises are made as air is inhaled or exhaled, vibrating the floppy muscles. But the baby is fine and happy, despite what sounds like a respiratory problem. And it is usually self-limiting, so no therapy is needed. He should grow out of it sometime this year.

So he doesn't have a lung problem so much as a trachea problem. We are hopeful that it is mild, as he doesn't have the other issues that can arise with severe tracheomalacia, such as poor weight gain, cyanotic spells, or reflux. Which means we can stop the pulmicort for now, as well as the liquid steroid and albuterol.

You would think I could have figured this out sooner. It only took 9 days and a dozen doctors' opinions (seriously, at least a dozen...most of my friends are doctors) for us to figure this out.