Observation & Medication for Stridor in Children

Doctors at Hassenfeld Children’s Hospital at NYU Langone recommend treatment for stridor, or noisy breathing, depending on its cause. Many children don’t need any treatment and outgrow the condition by the time they are two. Others require a brief course of medication to treat the condition responsible for narrowing the airway.

Observation

In many instances, observation without treatment—also called watchful waiting—is the only action a doctor recommends. Most children with laryngomalacia, a condition in which the soft tissues of the voice box partially obstruct the airway, don’t need treatment. The same is true for many children with mild subglottic stenosis, a narrowing of the airway below the vocal cords.

These conditions usually do not significantly restrict breathing, and the stridor goes away on its own. As a child grows, the airway enlarges, creating more space for air to flow.

If observation is recommended, your child’s doctor schedules regular follow-up appointments from infancy through age two to monitor symptoms. If stridor worsens, the doctor may recommend further diagnostic testing, such as laryngoscopy or bronchoscopy. He or she may change your child’s treatment plan based on the results.

Medication

Your child’s doctor may prescribe two or three days of anti-inflammatory medications called corticosteroids if noisy breathing is caused by croup. These medications reduce swelling around the vocal cords to ease symptoms.

The pediatrician prescribes this medication as a liquid, which your child takes twice a day. If swelling does not improve after three days, the doctor may recommend further diagnostic testing, such as a laryngoscopy or an X-ray, to examine the airway and determine whether additional treatment is needed.