No one expects to get any sleep with a new baby. It takes a while for babies to settle into a sleep cycle, and they have to eat often. Yet these usual reasons are not what kept Katie and Ryan Bridge awake when their daughter Claire was just 4 weeks old. It was her noisy breathing.
“It got so loud that we couldn’t sleep,” says Katie. “Our friend said she sounded like a goose honking.”
Because Claire wasn’t fussy, the couple didn’t think her noisy breathing was too worrisome, but they contacted their pediatrician to be on the safe side. She responded immediately and set up a same-day appointment with a specialist at a nearby clinic.
“The specialist said her noisy breathing was called stridor and that it was really bad. She called Stanford Medicine Children’s Health, and Claire had a scope with Douglas Sidell, MD, FACS, an airway specialist, the very next day,” Katie says.
Diagnosing laryngomalacia, a common airway condition
Dr. Sidell performed an in-office laryngoscopy—a simple procedure whereby a small flexible camera is passed through the nose to view the larynx, or voice box. He quickly diagnosed Claire as having laryngomalacia, a condition in which floppy tissue above the vocal cords falls into the airway when a baby breathes in, resulting in stridor. Stridor is a noise that is caused by turbulent airflow as it passes through the voice box or trachea (the windpipe). When there is obstruction, it causes high-pitched noisy breathing, and the obstruction from laryngomalacia can be visualized on the laryngoscopy.
“Dr. Sidell made us feel like he had all the time in the world to speak to us. He answered every question and gave us confidence in our decisions. He made sure we had a way to contact him, and he made us feel like it was not a burden to reach out,” Katie says.
Claire’s laryngomalacia was more severe than most. Her condition was making it difficult to breathe without struggle or eat enough to gain adequate weight.
“Laryngomalacia is the most common cause of stridor in infants. It is usually not concerning because kids with laryngomalacia often breathe and eat just fine, and they tend to grow out of it in the first year. But a small number of children need surgical intervention,” says Dr. Sidell.
Breathing easy after a simple airway surgery
Dr. Sidell recommended a surgical procedure called a supraglottoplasty. Despite its long name, it is a fairly simple procedure involving trimming excess tissue to make room for air to pass through the larynx and into the trachea. Claire was given a surgery date, but Dr. Sidell bumped it up because her stridor continued to get worse.
“When Claire was being wheeled into surgery, people said, ‘Oh wow. That’s really loud.’ We could hear her in the waiting room. But when we went to see her afterwards in the intensive care unit, we couldn’t hear the stridor anymore. There was an immediate ease in her breathing,” Katie says.
The Aerodigestive and Airway Reconstruction Center at Stanford Children’s is one of the busiest pediatric airway centers in the United States. The center provides multispecialty, coordinated care for a range of conditions affecting the airway, esophagus, and upper digestive tract.
“We see a large number of children each year for laryngomalacia. Because we tend to care for kids with more severe or complex laryngomalacia, a higher number of those children need surgery, approximately 20% to 30%,” Dr. Sidell says.
A supraglottoplasty takes less than 15 minutes in the operating room and is done under general anesthesia. It is performed through the mouth, so no incisions are made. Most children go on to lead completely normal lives and eat, drink, and grow with ease.
“Claire’s surgery went exactly as expected. The surgery made a dramatic improvement in her breathing, and she’s doing very well. She had a very typical outcome,” Dr. Sidell says.
The end of stridor
Claire went home the next day. She was given some anti-reflux medication to help her cope with swallowing more food than she was used to being able to swallow, but Katie is confident that she won’t need the medication soon.
“Honestly, the surgery fixed it. In theory, this is the last time we will have to deal with it,” she says.
Katie and Ryan were so impressed with the care they received at Stanford Children’s that they gave Dr. Sidell a five-star review in a survey from the Pediatric Otolaryngology (ENT) clinic. When asked why she had given such a rave review, Katie named his attentiveness, ease of access, and high level of care.
“Doctors have a lot on their plates these days, so to have Dr. Sidell stop and give us his presence and do that continuously throughout our infant’s care was incredible,” Katie says. “He’s kind, genuine, and thoughtful.”
As a father himself, Dr. Sidell understands how scary it is when your child needs care immediately. It’s why he shares his contact information and guides parents each step of the way through care—a trait that reflects the culture of care among doctors at Stanford Children’s.
“We take care of these babies the same way we would want others to care for our own kids,” Dr. Sidell says. “Katie and Ryan were honest about their apprehension and fears, and they were not afraid to ask questions. Knowing that they would call me if a problem or question came up was an integral part of Claire’s success. In my opinion, giving parents a direct line to me makes my job easier—not harder.”
Growing well and sleeping soundly
Today, Claire is 4 months old. The family enjoys watching Stanford University games (Katie works for Stanford Athletics, and she and Ryan are both serious volleyball players) and going on long walks and hikes. The Stanford Dish Loop Trail is one of their favorite spots.
“Claire is waking up to the world. She’s a happy, calm baby. She’s grabbing at toys and studying them with curiosity,” Katie says.
Best of all, Claire is breathing easy. And the whole family is sleeping through the night.
Learn more at aerodigestive.stanfordchildrens.org.