Laryngomalcia

We made it to the pediatric ENT this morning and were only about 10 minutes late. These days I consider 10 minutes late "on time", so I was thrilled to be at the doctor's office on time this morning. This particular pediatric ENT also does hearing tests and there were several older men in the waiting room when we arrived on time. There was also an office phone on one of the coffee tables in the waiting room, so while I was signing us in at the front desk, Wyatt was calling the receptionist at the front desk to tell her that we were there. Thankfully we didn't wait long at all in the non-pediatric friendly waiting room and were ushered back to the exam room after about 25 people admired the boys and how cute they were in their matching outfits. Our exam room contained 2 tv tray type of tables which each held about 100 (no exaggeration) sterile stainless steel instruments for looking into a persons nose and mouth. I immediately whipped out the candy that I had loving packed in the diaper bag for distraction purposes and yelled out into the hall "Is the doctor going to be long, because we may need to wait back in the waiting room?" upon which the doctor arrived and introduced herself thank God! Wyatt is now officially terrified of doctors so he pretended to be a pillar of salt for the next 25 minutes and I was off the hook. The doctor examined Sam with tons of different instruments and diagnosed him with Laryngomalacia. Laryngomalacia is the most common congenital cause of noisy breathing, or stridor, in the newborn. Laryngomalcia describes a condition where the tissues of the larynx (the voice box), above the vocal cords, are soft or floppy. Because of this, when a baby with laryngomalacia breathes, these floppy tissues may fall over the vocal cords and partially block the opening into the windpipe or trachea. This results usually in a high pitched, fluttery inspiratory noise. It can be worse when the baby cries or eats. Laryngomalacia is believed to represent an immaturity of the tissues of the larynx. In the majority of cases, laryngomalacia resolves on its own without any specific treatment. The tissues of the larynx become more firm as the child grows and the stridor usually resolves slowly over the child's first 18 months of life. The stridor may be worse with feeding, because of the increase negative inspiratory pressures associated with sucking, and it is suggested that feeding be done slowly and allow the child frequent rest periods. In small percentage of children with laryngomalcia, the obstruction caused by the collapsing tissues is more severe. This can result in poor weight gain because the baby is unable to eat without developing airway obstruction so they won't eat. It can also cause severe oxygenation problems and even heart complications. In these more severe cases, surgery may be needed to trim away some of the collapsing tissue. Sammy's case is not severe and he does not have feeding difficulties or failure to thrive issues, so we are thrilled to finally have an official diagnosis. This is also exciting because it may mean that Sammy does not have, or will not develop asthma. He also may not have a weakened immune system (as I have always thought). Needless to say we are thrilled that Sammy does not have any serious respiratory complications and he will grow out of his noisy breathing in the next 2 years! **********************************************************************

I also forgot to mention that at the doctor's appointment this week Jonah weighed in at 19 pounds 4 ounces and Sammy was 19 pounds 6 ounces which is 23% and 25% respectively at 9 months. Wyatt weighed 29 lbs 9 ounces which is the 68th percentile for 24 months. I can't remember their height measurements, so I might repeat that myself at home and see where they are on the growth curve for fun. Wyatt has weighed almost the exact same amount as he did one year ago! It will be interesting if the twins start to catch up with Wyatt in terms of size, then people will really think that I have triplets!