If a child has tracheomalacia and the TEF “cough,” as they get older, will it get louder, worse, or hopefully, go away?
Usually this goes away at 18 month to two years, as the cartilage of the trachea gets stronger. The trachea is strutted in the fetus by the upper pouch, which may get full as the fetus swallows. Once the esophageal pouch is separated during the operation for TEF/atresia, the trachea begins to “flap in the breeze” as air goes in and out. This occurs sometimes without atresia and usually gets well. (Compare the ear cartilage of a tiny infant versus an older infant or child.) Occasionally, this narrowing of the trachea with each breath becomes so severe the breath is cut off. Then we have to pull the trachea forward to hold it open. WE do this by sewing the aorta (the large blood vessel), to which the trachea is naturally attached, to the back of the breastbone.
