Mumbai : Narayana Health SRCC Children’s Hospital, Mumbai, recently diagnosed and successfully treated an extremely rare and potentially life-threatening airway condition in an eight-month-old female infant who had been experiencing recurrent breathing difficulties and poor weight gain since birth.
The child was brought to the hospital with a history of continuous noisy breathing since birth, which worsened whenever she cried or when she was in a lying down position. She also had difficulty in feeding and failure to gain weight, raising concerns about underlying airway compromise. At just six weeks after birth, she required hospitalisation for breathlessness and was managed symptomatically. In spite of the treatment, the symptoms persisted for a few months, leading to the infant being admitted to a hospital again at seven months, wherein she required intensive care for severe respiratory distress.
The child presented to Narayana Health SRCC Children’s Hospital, Mumbai, with a third scenario of similar complaints, which led to a prompt and detailed evaluation by the Paediatric Pulmonology and ENT teams. Clinical examination revealed stridor (noisy breathing) and signs of failure to thrive.
A flexible bronchoscopy performed at the hospital revealed a large airway haemangioma extending from the vocal cords to the lower end of the trachea (windpipe). The lesion was classified as a Grade 3 airway haemangioma, causing significant narrowing at the airway inlet — which explained the recurrent breathlessness, feeding difficulty and poor weight gain.
Dr. Indu Khosla, Senior Consultant – Paediatric Pulmonology, Narayana Health SRCC Children’s Hospital, Mumbai, said, “Airway haemangiomas are rare but serious causes of noisy breathing in infants. They are often mistaken as laryngomalacia, infections, or reflux. Early diagnosis is crucial because, when detected in time, many of these cases can be managed effectively with medical treatment, avoiding surgical intervention.”
Following the diagnosis, the child was started on oral propranolol, along with anti-reflux therapy using lansoprazole, and calcium and vitamin D supplementation. The parents were also informed and counselled regarding care and precautions at home, after which the child was discharged following close monitoring.
In subsequent follow-ups, the infant showed marked clinical improvement, with a significant reduction in noisy breathing and breathlessness. Feeding improved steadily, and the child demonstrated healthy weight gain, indicating a positive response to treatment.
“Conditions like recurrent stridor, feeding difficulties, or poor weight gain in infants require prompt and early specialist evaluation. These symptoms occur due to a variety of causes and procedures like flexible bronchoscopy can aid a correct diagnosis. Airway haemangiomas, though uncommon, are highly treatable when diagnosed early, and can be effectively treated if medications are started early.This can improve outcomes and quality of life,” Dr Khosla added.
Dr. Zubin Pereira, Facility Director, Narayana Health SRCC Children’s Hospital, Mumbai, said, “Persistent noisy breathing, especially when present since birth, should never be ignored. This case highlights how advanced diagnostic tools like bronchoscopy available at our hospital, can help provide timely treatment and specialist care to paediatric patients, thus preventing repeated hospitalisation and long-term complications.”
