Newborn/infant with stridor worse when supine and improves when prone, mother is concerned, what to do? What is the next step in managing this patient?
Understand the Problem
The question is asking for the next step in managing a newborn or infant with stridor that worsens when the baby is lying on their back and improves when lying on their stomach. It presents multiple options for management, and we need to determine the appropriate course of action based on the symptoms described.
Answer
Evaluate airway for obstruction; manage supportively, consider position changes and anti-reflux medication.
The next step in managing this patient with stridor that worsens when supine and improves when prone is to evaluate the airway to ensure there is no significant obstruction, as this can indicate laryngomalacia. Management is primarily supportive, including altering feeding positions and possibly using anti-reflux medication if reflux symptoms are present.
Answer for screen readers
The next step in managing this patient with stridor that worsens when supine and improves when prone is to evaluate the airway to ensure there is no significant obstruction, as this can indicate laryngomalacia. Management is primarily supportive, including altering feeding positions and possibly using anti-reflux medication if reflux symptoms are present.
More Information
Stridor in infants that worsens when supine and improves when prone is suggestive of laryngomalacia, the most common congenital cause of stridor. This condition is usually benign, resolving on its own by 18 months, and is characterized by a dynamic collapse of supraglottic structures.
Tips
A common mistake is not considering reflux as a contributing factor. Reflux can exacerbate stridor symptoms, so it's important to address this issue if present.
Sources
- Laryngomalacia: Symptoms, Causes & Treatment - Cleveland Clinic - my.clevelandclinic.org
- Laryngomalacia (Laryngeal Stridor) - Nationwide Children's Hospital - nationwidechildrens.org
- Stridor - upper airway obstruction in neonates - Safer Care Victoria - safercare.vic.gov.au
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