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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Laryngomalacia In New Born

Dear Sir/Madam My son is 1 month old right now. He is having strider from the time he was born. We consulted the pediatric ENT specialist and got confirmed that this is a case of Laryngomalacia. I came to know your details online and would like to get your valuable suggestion on my son s case. Below are the details: Weight at birth: 3.55Kgs (7lb 13oz) Lowest weight observed during first week: 3.29Kgs (7lb 4oz) Gained to birth weight by 11th day. Increased the weight to 3.60Kgs (7lb 15oz) We detected UTI on his 19th day. He already lost weight by that time. 3.40Kgs (7lb 8oz) He has been hospitalized and is on IV antibiotics for 5 days. Gained a few ounces. 3.52Kgs (7lb 12oz) Got discharged from hospital and is on oral antibiotics for 5 days. Gained a few ounces. 3.62Kgs (7lb 15.5oz) His Pediatrician suggested continuing the antibiotics (1 dose a day) for another few weeks and ordered VCUG test. He is having Strider almost all the time and the sound has been increasing. He has chest and throat retractions. He is on breast feeding but is not able to feed well because of the strider and the retraction. We tried pumping the milk in bottle which helped a little but not to the desired extent. On his Pediatrician referral we consulted Pediatric ENT specialist Initially on April 26th he thought its in moderate stage but yesterday May 16th he evaluated again and mentioned that its in severe stage and mentioned that a surgery is needed for correcting the same. We are already worried with the strider and the UTI (all the antibiotics). In this situation hearing about the surgery made us even more worried. I would like to get your valuable suggestion in this case. Should we go for the surgery? What could be the details we need to consider if at all you suggest us to go for surgery? I would really appreciate if you can please reply back at your earliest possible. Thank you so much in advance for all your guidance. Thanks Suresh
Tue, 20 Sep 2016
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Pediatrician 's  Response
differentiating between stages of laryngomalacia is very important , because it direct us toward the managment .
moderate laryngomalacia symptoms and signs include : feeding difficulties , esophageal reflux , retracting chest along with the noisy breathing , usually these children outgrow their illness by 12-18 months of life , they require treatment for the reflux because it makes the condition worse .
while in sever laryngomalacia babies may have hypoxia ( lower tissue oxygen ) , sever reactions that require multiple ER visits , recurrent chest infections due to checking.
if any of these symptoms occur, surgery is advisable and it includes ( supraglottoplasty) which removes the flabby tissue above vocal cords and it's done through the baby's mouth , and the baby stays in the Pedicatic ICU for 1-2 days before removing the breathing tube .
keep in mind surgery doesn't remove the problem completely , you will hear the noise but there is a dramatical improvement In feeding and breathing
I hope this helps
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Suggest Treatment For Laryngomalacia In New Born

differentiating between stages of laryngomalacia is very important , because it direct us toward the managment . moderate laryngomalacia symptoms and signs include : feeding difficulties , esophageal reflux , retracting chest along with the noisy breathing , usually these children outgrow their illness by 12-18 months of life , they require treatment for the reflux because it makes the condition worse . while in sever laryngomalacia babies may have hypoxia ( lower tissue oxygen ) , sever reactions that require multiple ER visits , recurrent chest infections due to checking. if any of these symptoms occur, surgery is advisable and it includes ( supraglottoplasty) which removes the flabby tissue above vocal cords and it s done through the baby s mouth , and the baby stays in the Pedicatic ICU for 1-2 days before removing the breathing tube . keep in mind surgery doesn t remove the problem completely , you will hear the noise but there is a dramatical improvement In feeding and breathing I hope this helps