Congenital tracheomalacia is weakness and floppiness of the walls of the windpipe (trachea). Congenital means it is present at birth. Acquired tracheomalacia is a related topic.

Type 1 tracheomalacia

Tracheomalacia in a newborn occurs when the cartilage in the windpipe has not developed properly. Instead of being rigid, the walls of the trachea are floppy. Because the windpipe is the main airway, breathing problems begin soon after birth.

Congenital tracheomalacia is very uncommon.

Symptoms can range from mild to severe. Symptoms may include:

• Breathing noises that may change with position and improve during sleep
• Breathing problems that get worse with coughing, crying, feeding, or upper respiratory infections (such as cold)
• High-pitched breathing
• Rattling or noisy breaths

Most infants respond well to humidified air, careful feedings, and antibiotics for infections. Babies with tracheomalacia must be closely monitored when they have respiratory infections.

Often, the symptoms of tracheomalacia improve as the infant grows.

Rarely, surgery is needed.

Congenital tracheomalacia most often goes away on its own by the age of 18 to 24 months. As the cartilage gets stronger and the trachea grows, the noisy and difficult breathing slowly improves. People with tracheomalacia must be monitored closely when they have respiratory infections.

Babies born with tracheomalacia may have other congenital abnormalities, such as heart defects, developmental delay, or gastroesophageal reflux.

Aspiration pneumonia can occur from inhaling food into the lungs or windpipe.

Contact your health care provider if your child has breathing difficulties or noisy breathing. Tracheomalacia can become an urgent or emergency condition.

Published Date: April 28, 2023
Published By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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