In infants with laryngomalacia, which positions improve their condition?

Infants with laryngomalacia often experience stridor and respiratory distress, which can be aggravated by certain positions due to the way the anatomy of the airway is structured. The condition is characterized by the collapse of the soft tissues above the vocal cords during inhalation, especially when in more supine positions.

When infants with laryngomalacia are placed in the prone position (on their stomachs), gravity helps keep the airway open, reducing the degree of airway collapse and associated stridor. This position can also allow for better lung expansion and improved respiratory effort. Similarly, being upright can help minimize the severity of respiratory symptoms, especially during feeding, as this position helps manage airway dynamics and can reduce laryngeal obstruction.

In contrast, while sleeping supine can lead to worsening symptoms due to potential airway obstruction, being prone allows for a more favorable alignment of the airway. Therefore, for infants with laryngomalacia, the combination of prone positioning and being upright typically offers the best improvements in reducing respiratory distress and stridor. Thus, the choice indicating a prone position is optimal for the management of this condition.