Depending on the type of congenital airway abnormality a child has, doctors at Hassenfeld Children’s Hospital at NYU Langone recommend using medication, devices that help your child to cough, eat, or breathe properly, and speech or feeding therapy to manage these conditions.
A cough assist device helps to clear secretions from the lungs by simulating a natural cough. Your child’s doctor may recommend this device to help your child cough more effectively, especially if problems with swallowing cause saliva, liquid, or food to enter the lungs.
To use this device, a plastic mask attached to a flexible plastic tube is placed over the mouth and nose. Sometimes, the device is attached to a tracheostomy tube in a child’s throat. Either way, the device supplies air to expand the lungs and reverses airflow to remove secretions.
The doctor determines how long your child needs to use the device, as well as how often to use it each day.
An oscillating chest vest helps a child breathe more easily. This device is an air-pulse generator that inflates a lightweight vest, which wraps around the chest. It creates pressure on the chest wall to mobilize secretions in the lungs.
If your child has obstructive sleep apnea, his or her doctor may recommend a continuous positive airway pressure, or CPAP, machine. This device increases air pressure in the throat to keep the airway open in children with sleep apnea, which is characterized by a narrowing of the airway during sleep.
Before your child goes to sleep, a small mask is placed over the nose or nose and mouth. A tube connects the mask to the machine, which delivers continuous air pressure through the tube.
A bilevel positive airway pressure, or BiPAP, machine delivers two levels of pressurized air through a mask for children with sleep apnea. This keeps the airways from narrowing during breathing while asleep.
Unlike a CPAP machine, the BiPAP has two pressure settings, including a lower pressure for exhalation that can make it easier to release air from the lungs. It’s typically used when CPAP fails to work adequately.
A gastrostomy tube, or G-tube, may be recommended for children who have difficulty eating food or swallowing liquids. The tube is inserted through the abdomen and delivers nutrition directly into your child’s stomach.
The procedure to insert the tube requires general anesthesia. The doctor first inserts an endoscope, which is a tube with a camera at the tip, through the mouth and down the esophagus into the stomach to determine where an incision in the abdominal wall should be made. After the incision is made, the G-tube is inserted and secured to the abdomen with tape.
This procedure takes 30 to 45 minutes to complete. The tube may be used until your child has surgery to correct a feeding problem, or longer if necessary.
If your child experiences chronic lung infections, such as pneumonia, as a result of a congenital airway abnormality, antibacterial therapy may be prescribed.
This includes the use of liquid antibiotics, which are given by mouth, to kill bacteria in the lungs. The doctor determines the right dosage based on your child’s needs.
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