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Question

My child has several colds or viruses since she has been home from the hospital. It seems when she does get a cold, it turns into a breathing problem for her. I am also concerned about pneumonia. One x-ray indicated she has a little reactive airway. She also has a cleft palate so I wonder if drainage will be an issue until it is repaired. Are these issues common in CdLS?

Answer of our experts

There is no increased incidence of asthma in CdLS, nor are there known immune system problems. On the other hand, there can be recurrent respiratory problems secondary to several things with CdLS. If she has gastroesophageal reflux (in which the food travels back from the stomach in to the esophagus) there is a chance food material could be high enough to be aspirated (breathed into) the lungs. This could potentially lead to pneumonia. Also the cleft palate carries a risk of aspiration as well. She should be followed by a Cleft Lip and Palate or Craniofacial Team. If she has reactive airways disease, or asthma, it is more likely due to family factors (asthma, allergies and eczema tend to run in families), and this should be managed by your pediatrician as if she does not have CdLS.

TK 7-13-10

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Find other pages that share the same topic as this page Reflux2 Reflux37 Mouth, nose and throat1 Mouth, nose and throat13

Recommendation(s)

Reflux

R32
Consider always gastro-oesophageal reflux disease (GORD) in any individual with CdLS owing to its frequency and wide variability in presentation, which includes challenging behaviour.
R33
Modification of nutrition and proton pump inhibitors (PPI) are the first-line treatments of GORD. Anti-reflux medications need to be used to their maximum dosage. Surgical interventions for GORD should be limited to those individuals with CdLS in whom nutritional and medical treatments have been unsuccessful or airway safety is at risk.
R34
If GORD symptoms persist, endoscopy should be strongly considered whilst an individual with CdLS is still in paediatric care.
R35
Surveillance for Barrett’s Oesophagus needs to be discussed with and decided together with the family, balancing the potential gain in health and burden for the individual with CdLS.

Recommendation(s)

Mouth, nose and throat

R42
The anaesthesiologist should be aware of the potential difficulty with intubation in individuals with CdLS.

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