Stridor

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KEY POINTS

• Stridor is a high-pitched sound caused by a partly blocked airway. Usually you will hear this sound when your child breathes in.
• Treatment depends on what is causing the stridor and how severe it is. Cool mist at home may help with mild croup. Children with severe trouble breathing should be treated as an emergency and need to be treated in the hospital.
• Follow your healthcare provider's instructions. Ask your child’s provider what symptoms or problems you should watch for and what to do if your child has them.

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What is stridor?

Stridor is a high-pitched sound caused by a partly blocked airway. Usually you will hear this sound when your child breathes in. It sounds different from wheezing, which happens when a child breathes out.

What is the cause?

A partial blockage or narrowing of the airway may be caused by many things, such as:

• Croup, which is a viral infection of the vocal cords and windpipe that causes swelling of the airways
• Other infections in the throat or airways
• Floppy tissue in the voice box
• Vocal cords that do not move (vocal cord paralysis)
• An allergic reaction
• Choking on food or small objects
• A growth or tumor in the airway

Some causes of stridor may be outgrown. For example, a baby born with floppy tissue in the voice box may outgrow this condition by the age of 18 months.

What are the symptoms?

In addition to the high-pitched sound of stridor, you may notice signs that your child is having trouble breathing or swallowing, such as:

• Fast breathing
• Nasal flaring, which means that your child’s nostrils widen and then narrow with each breath
• Grunting, which means that your child makes a noise at the end of each breath
• Retractions, which means that when your child breathes in, the skin sinks in above the collarbone and between the ribs
• Drooling

How is it diagnosed?

Your healthcare provider will review your child’s symptoms and examine your child. Tests may include:

• X-rays or other scans of the chest or neck
• Laryngoscopy or bronchoscopy, which are procedures that pass a flexible, lighted tube through your child’s mouth and down into the throat or lungs to look at the voice box or airways
• Breathing tests to see how well your child’s lungs are working

How is it treated?

Treatment depends on what is causing the stridor and how severe it is.

• Mild forms of croup can be treated with home care. More severe forms of croup are treated with medicine to decrease swelling.
• If your child has a bacterial infection, your child’s healthcare provider may prescribe antibiotic medicine. Your child may need to stay in the hospital. Your child may need IV fluids and medicine, and in serious cases, a breathing tube.
• If the stridor is caused by a tumor, narrowing of the windpipe, or a foreign body that is stuck in the airway, your child may need surgery.
• Your child may be given oxygen until it gets easier to breathe.

Children with severe trouble breathing should be treated as an emergency and need to be treated in the hospital.

How can I help take care of my child?

• Use a cool mist humidifier to add moisture to the air. Avoid steam vaporizers because they can cause burns.
• Keep your child away from smoke. If someone in your household smokes, ask them to smoke outside.
• Follow your healthcare provider's instructions. Ask your child’s provider:
  • How and when you will get your child’s test results
  • How long it will take for your child to recover
  • If there are activities your child should avoid and when he can return to normal activities
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them
• Make sure you know when your child should come back for a checkup.