Stridor in Children

What is stridor in children?

Stridor is a noisy or high-pitched sound with breathing. It's a sign that the upper airway is partially blocked. It may involve the nose, mouth, throat, voice box (larynx), or windpipe (trachea).

What causes stridor in a child?

Stridor can be caused by many things. These are some of the more common causes of stridor in children:

• Defects in the child’s throat, larynx, or trachea that the child was born with (congenital)

• Infections, such as croup, epiglottitis, or tonsillitis, and abscesses in the back of the throat

• Swallowing toxic substances

• Swallowing pieces of food or small objects that get caught in the upper airway

• Injuries to the jaw or neck

Other conditions may also cause stridor. For example, problems with the brain may interfere with normal breathing. Or an allergic reaction may cause swelling of the airways. And tumors may also block the airways.

Which children are at risk for stridor?

The upper airway in a child is shorter and narrower than that of an adult. Because of this, a child is more likely to have problems with blockage of the airway.

What are the symptoms of stridor in a child?

The main symptom of stridor is the noise that is heard while your child breathes. The sound of stridor depends on where the blockage is in your child’s upper respiratory tract.

If your child has stridor that comes back, they may have trouble eating and drinking, and poor weight gain.

How is stridor diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. They will give your child a physical exam. The provider may refer you to an ear, nose, and throat specialist (ENT). 

If your child has stridor, the healthcare provider may order tests to find the cause. The tests may include:

• X-rays. X-rays of the chest and neck may be done. 

• CT scan or MRI. These are more detailed studies of the internal organs. Your child may need these so the ENT can look at the anatomy of the chest and neck.

• Laryngoscopy. A special instrument is used to check the back of the throat and larynx. 

• Bronchoscopy. A special instrument is used to check the throat, larynx, trachea, and tubes leading into the lungs (bronchi).

• Spirometry. This is an easy test that checks how much air is breathed in and out. It also measures how quickly the air is breathed out. It is difficult to test young children with spirometry.

• Pulse oximetry. An oximeter is a small tool that measures the amount of oxygen in the blood. A small sensor is placed on a finger or toe. When the machine is on, a small red light can be seen in the sensor. The sensor is painless, and the red light does not get hot.

• Sputum culture. A sample of the material (sputum) that is coughed up from the lungs is sent to the lab to check for infection.

How is stridor treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Your child’s healthcare provider may simply watch and recheck your child for certain conditions that cause stridor. Treatment may include:

• Referral to an ear, nose, and throat specialist (ENT)

• Surgery, if the stridor is severe

• Medicines by mouth or shots to help decrease the swelling in the airways or treat an infection

• Hospital stay and emergency surgery, depending on how severe the stridor is

What are possible complications of stridor in a child?

If left untreated, stridor can block the child’s airway. This can be life-threatening or even cause death.

When should I call my child’s healthcare provider?

Call your child’s healthcare provider if your child makes a noisy or high-pitched sound while breathing.

Call 911 or get medical help right away if your child has signs or symptoms of severe blockage of the airway. These signs may include:

• Gasping for air, choking

• Nostrils that get wide when breathing

• Sinking in of the areas between the ribs when breathing

• Change in behavior

• Bluish-colored skin

• Loss of consciousness

Key points about stridor in children

• Stridor is a noisy or high-pitched sound with breathing.

• It is usually caused by a blockage or narrowing in your child’s upper airway.

• Some common causes of stridor in children are infections and defects in the child’s nose, throat, larynx, or trachea that the child was born with.

• The sound of stridor depends on where the blockage is in the upper respiratory tract.

• Stridor is usually diagnosed based on health history and a physical exam.

• The child may need a hospital stay and emergency surgery, depending on how severe the stridor is.

• If left untreated, stridor can block the child’s airway. This can be life-threatening or even cause death.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.