You are seeing a 5-month-old infant who has had intermittent stridor since age 2 months.

Laryngomalacia is the most common cause of chronic stridor in infants. It presents with inspiratory stridor that worsens with feeding, supine positioning, or agitation. The child remains otherwise well and meets developmental milestones.

Toronto Notes 2023 – Pediatrics, Airway Disorders:

“Laryngomalacia presents with intermittent inspiratory stridor, typically beginning in the first few months of life. Diagnosis is clinical and prognosis is usually good.”

MCCQE1 Objectives – Pediatrics > Respiratory Disorders:

“Candidates must recognize the typical presentation of laryngomalacia and differentiate it from other causes of pediatric stridor.”

Vascular ring (A) or subglottic hemangioma (C) often present with more severe or progressive symptoms. Foreign body aspiration (D) presents acutely. TE fistula (E) usually causes feeding difficulties from birth.