What Is Bronchomalacia? Symptoms, Causes, Diagnosis, and Treatment in Babies and Adults
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is bronchomalacia?
Bronchomalacia is weakening of the cartilage in the bronchi, the main lung airways, causing them to collapse and narrow, especially when breathing out. It most often affects premature newborns and often resolves as the lungs mature. Symptoms include wheezing, stridor and a barking cough. Treatment ranges from check-ups to CPAP or a ventilator; in adults, the cause is treated. [1]
Key takeaways
Bronchomalacia is weakness of the cartilage in the bronchi, the firm, flexible airways in the lungs. [1]
Without C-shaped cartilage support, the bronchi narrow — especially during exhalation. [1]
It usually affects newborns, particularly those born prematurely or with Down syndrome, and in rare cases older children and adults. [1]
Symptoms include a barking cough, cyanosis, fatigue, frequent infections, shortness of breath, stridor, and wheezing. [1]
Mild cases in newborns often resolve on their own as the lungs mature — Cleveland Clinic cites around 6 months of age [1], while other pediatric centers report 2 to 3 years. [2]
CPAP devices and ventilators keep the airways open; adult treatment targets the underlying lung condition. [1]
What the research says
Airway malacia is uncommon but more frequent in some children. Tracheobronchomalacia (TBM) is estimated to be present in about 1 in 2,100 children. In a study of 167 children with cystic fibrosis who had bronchoscopies up to age 4, 41% were diagnosed with TBM at least once; it was persistent in 22% and severe in 19% (Depiazzi et al., Pediatr Pulmonol, 2023) [3].
In very premature babies, severe airway malacia can need surgery. In a two-center study of 49 children under 3 years with bronchopulmonary dysplasia and severe TBM, posterior tracheopexy (a surgery that stabilizes the airway) lowered median ventilator pressure (PEEP) from 11 to 7 cmH2O at 3 months, and 63.3% of children who had severe respiratory events no longer had them afterward. This was a highly selected group of severe cases (Law et al., J Pediatr Surg, 2026) [4].
In adults, airway collapse becomes more common as asthma gets more severe. In a bronchoscopy study of 202 adults with asthma, TBM was seen in 18.46% of those with severe asthma, compared with 1.61% of adults without airway obstruction (Dal Negro et al., Multidiscip Respir Med, 2013) [5].
What Is Bronchomalacia?
Bronchomalacia is a condition where the cartilage in the bronchi is weak. Your bronchi are flexible but firm airways in your lungs. Normally, C-shaped cartilage structures surround your bronchi like protective shells. These firm structures allow your bronchi to open as your lungs expand and contract. Without their support, your bronchi become narrow, especially during exhalation (when you breathe out). [1]
How Common Is Bronchomalacia?
Bronchomalacia usually affects newborns, especially those who were born prematurely (early) and those with Down syndrome. In rare cases, it affects older children and adults. [1]
How Does Bronchomalacia Affect My Baby?
Bronchomalacia can block or narrow the bronchi. When the bronchi are blocked or too narrow, your baby may have breathing problems and difficulty getting enough oxygen. In very severe cases, the condition can be life-threatening. [1]
What Is Tracheobronchomalacia (TBM)?
In many cases, people with bronchomalacia also have tracheomalacia, which is a weakness in the tracheal walls. These two conditions together are called tracheobronchomalacia (TBM). [1]
Like bronchomalacia, tracheomalacia can interfere with breathing and is more common in newborns. Tracheomalacia is often linked to a rare birth defect known as esophageal atresia. [1]
Term | What it means |
Bronchomalacia | Weak cartilage in the bronchi (lung airways) |
Tracheomalacia | Weakness in the tracheal (windpipe) walls |
Tracheobronchomalacia (TBM) | Both conditions together; often linked to esophageal atresia |
Bronchomalacia Symptoms
If you or your child has bronchomalacia, you may notice:
Symptom | What it involves |
Barking cough | A cough without phlegm |
Cyanosis | Blue-tinted skin from low oxygen |
Fatigue | Ongoing tiredness |
Frequent infections | Repeated colds and respiratory illnesses |
Shortness of breath (dyspnea) | Trouble catching a breath |
Stridor | A noisy, vibrating sound when breathing |
Wheezing | A whistling sound when breathing |
Is bronchomalacia contagious? No. You cannot catch bronchomalacia from someone else or spread it to others. Bronchomalacia is not caused by upper respiratory infections, influenza (flu), or other contagious illnesses. [1]
What Causes Bronchomalacia?
Bronchomalacia in newborns, known as primary bronchomalacia, is usually a result of:
Primary cause (present at birth) | Details |
Congenital heart disease | Heart defect present from birth |
Underdeveloped lung cartilage | Due to being born early (prematurely) |
Williams-Campbell syndrome | Congenital (inherited) condition that causes weakened cartilage in the bronchi |
Bronchomalacia that is not present at birth is known as secondary bronchomalacia, and causes include:
Secondary cause (develops later) | Details |
Chest injury | Trauma to the chest |
Chronic bronchitis | Long-term inflammation of the bronchi |
Emphysema | Damage to the air sacs of the lungs |
Long-term ventilator therapy | Extended use of a breathing machine |
Tuberculosis (TB) | A serious bacterial infection of the lungs |
Tumors or growths | Benign (noncancerous) growths in the lungs |
How Is Bronchomalacia Diagnosed?
Your provider will perform a physical examination and listen to your or your child's lungs. If appropriate, they will order additional testing or place additional referrals. [1]
Imaging tests allow your provider to see inside the lungs. [1] You or your baby may need:
Test | Why it is used |
Bronchoscopy | A camera examines the airways directly |
CT scan | Detailed imaging of the lungs and airways |
MRI | Detailed imaging without radiation |
X-ray | Basic imaging to view the chest |
How Is Bronchomalacia Treated?
Newborns with mild bronchomalacia may only need regular check-ins with their healthcare provider. [1] The condition often resolves on its own as their lungs mature — Cleveland Clinic cites 6 months of age [1], while other pediatric centers report improvement by age 2 to 3. [2]
If bronchomalacia is interfering with your baby's oxygen levels, providers may recommend a continuous positive airway pressure (CPAP) device. A CPAP device is a mask that goes over your baby's nose and mouth and connects to a machine. The machine delivers gentle, continuous air pressure to the mask, which can help keep the bronchi open. Your baby may need this device for a few weeks or until their lungs have fully developed. [1]
In very severe cases of bronchomalacia and respiratory failure, your baby may need a ventilator to keep their bronchi open and help them breathe. [1]
Bronchomalacia treatment in adults depends on the cause. If you have emphysema or chronic bronchitis, you may need medications and regular checkups to help manage your symptoms. A CPAP device may also be helpful, especially when sleeping. In severe cases, patients may need ventilator support in a hospital. [1]
Treatment | Who it is for | What it does |
Regular check-ups | Newborns with mild cases | Monitors the condition as it often resolves as the lungs mature |
CPAP device | Babies with low oxygen levels; some adults | Gentle continuous air pressure keeps the bronchi open |
Ventilator | Very severe cases with respiratory failure | Mechanically keeps the bronchi open and helps breathing |
Medications and checkups | Adults with emphysema or chronic bronchitis | Manages the underlying lung condition and symptoms |
Is Bronchomalacia Curable?
Many babies with bronchomalacia recover and thrive once their lung cartilage has matured and hardened. [1] If the condition is caused by a blockage like a tumor, removing the blockage usually cures bronchomalacia. [1]
In adults with emphysema or chronic bronchitis, bronchomalacia usually requires ongoing care and cannot be cured. However, your healthcare provider can help you manage symptoms and feel better. [1]
How Can I Prevent Bronchomalacia?
There is no known way to prevent bronchomalacia in newborns. It is not a result of something you did during pregnancy. [1] If you are pregnant, learn the signs of premature labor so you can seek medical care right away. [1] Prompt care may prevent your baby from being born too early.
Because bronchomalacia in adults is often a result of lung disease, good lung care may help prevent it [1]. Adults can take these steps to keep their lungs as healthy as possible:
Prevention step | Why it matters |
Don't smoke or vape | Smoking and vaping raise the risk of chronic bronchitis, emphysema, and lung cancer |
Get your home tested for radon | Radon gas cannot be seen or smelled, but it can cause lung cancer |
Wear personal protective equipment (PPE) | A respirator protects you when working with gases, vapors, fumes, dust, and soot |
When Should I See My Healthcare Provider?
See your provider regularly for well checkups and to discuss any changes to your health. Seek emergency care if you or your child has:
Emergency sign | What it looks like |
Bluish lips or skin | Cyanosis from low oxygen |
Chest retractions | Skin pulling inward with breathing |
Fainting | Or inability to wake |
Shortness of breath | Trouble breathing |
Wheezing or stridor | Noisy, vibrating breathing sounds |
Conclusion
Bronchomalacia is a weakness of the cartilage that keeps the bronchi open, and for most newborns — especially premature babies — it is a temporary hurdle rather than a lifelong condition. As the lung cartilage matures and hardens, the airways stabilize and most babies recover and thrive. Monitoring, CPAP devices, and in severe cases ventilator support give families and providers the tools to keep oxygen flowing through this vulnerable period.
For adults, bronchomalacia is typically tied to underlying lung disease such as emphysema or chronic bronchitis, which means ongoing care rather than a cure — but symptom management can make a substantial difference in quality of life. Whether you are caring for a newborn or managing a chronic lung condition, regular checkups and knowing the emergency warning signs are the foundation of good care.
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Frequently Asked Questions
What is bronchomalacia?
Bronchomalacia is a condition where the cartilage in the bronchi is weak. Your bronchi are flexible but firm airways in your lungs. Normally, C-shaped cartilage structures surround your bronchi like protective shells, allowing them to open as your lungs expand and contract. Without their support, your bronchi become narrow, especially during exhalation.
Who does bronchomalacia affect?
Bronchomalacia usually affects newborns, especially those born prematurely and those with Down syndrome. In rare cases, it affects older children and adults.
Is bronchomalacia life-threatening?
Bronchomalacia can block or narrow the bronchi, causing breathing problems and difficulty getting enough oxygen. In very severe cases, the condition can be life-threatening.
What is the difference between bronchomalacia and tracheomalacia?
Bronchomalacia is weakness of the cartilage in the bronchi (lung airways), while tracheomalacia is weakness of the tracheal (windpipe) walls. When both occur together, the condition is called tracheobronchomalacia (TBM), which is often linked to a rare birth defect called esophageal atresia.
What are the symptoms of bronchomalacia?
Symptoms include a barking cough without phlegm, cyanosis (blue-tinted skin), fatigue, frequent infections like colds and respiratory illnesses, shortness of breath, stridor (noisy, vibrating breathing), and wheezing.
What does a stridor sound like?
Stridor is a noisy, vibrating sound when breathing, caused by turbulent airflow through a narrowed airway.
Is bronchomalacia contagious?
No. You cannot catch bronchomalacia from someone else or spread it to others. It is not caused by upper respiratory infections, influenza, or other contagious illnesses.
What causes bronchomalacia in newborns?
Primary bronchomalacia in newborns is usually a result of congenital heart disease, underdeveloped lung cartilage due to being born early, or Williams-Campbell syndrome, a congenital (inherited) condition that causes weakened cartilage in the bronchi.
What is Williams-Campbell syndrome?
Williams-Campbell syndrome is a congenital (inherited) condition that causes weakened cartilage in the bronchi.
What causes bronchomalacia in adults?
Secondary bronchomalacia, which is not present at birth, can be caused by chest injury, chronic bronchitis, emphysema, long-term ventilator therapy, tuberculosis (TB), or tumors or benign growths in the lungs.
How is bronchomalacia diagnosed?
Your provider will perform a physical examination and listen to your or your child's lungs. Imaging tests that may be ordered include bronchoscopy, CT scan, MRI, and X-ray, which allow the provider to see inside the lungs.
What is a bronchoscopy?
A bronchoscopy is a procedure in which a camera examines the airways directly to view the bronchi and assess cartilage weakness.
How is bronchomalacia treated in newborns?
Newborns with mild bronchomalacia may only need regular check-ins with their healthcare provider, as the condition often resolves on its own as their lungs mature. Cleveland Clinic cites around 6 months of age, while other pediatric centers report improvement by age 2 to 3.
When does a baby need a CPAP device?
If bronchomalacia is interfering with a baby's oxygen levels, providers may recommend a CPAP (continuous positive airway pressure) device — a mask over the nose and mouth connected to a machine that delivers gentle, continuous air pressure to help keep the bronchi open. A baby may need it for a few weeks or until their lungs have fully developed.
When does a baby need a ventilator?
In very severe cases of bronchomalacia and respiratory failure, a ventilator may be needed to keep the bronchi open and help the baby breathe.
How is bronchomalacia treated in adults?
Treatment in adults depends on the cause. If you have emphysema or chronic bronchitis, you may need medications and regular checkups to manage symptoms. A CPAP device may also help, especially when sleeping. In severe cases, patients may need ventilator support in a hospital.
Is bronchomalacia curable?
Many babies recover and thrive once their lung cartilage has matured and hardened. If the condition is caused by a blockage like a tumor, removing the blockage usually cures it. In adults with emphysema or chronic bronchitis, it usually requires ongoing care and cannot be cured, but symptoms can be managed.
Can bronchomalacia be prevented?
There is no known way to prevent bronchomalacia in newborns, and it is not caused by anything a parent did during pregnancy. Adults can protect their lung health by not smoking or vaping, testing their home for radon gas, and wearing a respirator when working with chemicals or particles like gases, vapors, fumes, dust, and soot.
What signs of premature labor should I know about?
If you are pregnant, learn the signs of premature labor so you can seek medical care right away — prompt care may prevent your baby from being born too early.
When should I seek emergency care for bronchomalacia?
Seek emergency care if you or your child has bluish lips or skin, chest retractions (pulling inward with breathing), fainting or inability to wake, shortness of breath or trouble breathing, or wheezing or stridor.
What should I expect if my baby has bronchomalacia?
With successful treatment, most babies recover and thrive as their lung cartilage matures and hardens. Regular checkups and, when needed, CPAP or ventilator support keep oxygen levels stable while the airways strengthen.
Related Reading
Tracheomalacia: Symptoms, Causes, Diagnosis and Treatment — What You Need to Know
Down Syndrome: Symptoms, Causes, Types & Life Expectancy — Complete Guide
Congenital Heart Disease (CHD): Types, Causes, Symptoms, and Survival Outlook
Cyanosis: Symptoms, Causes, Types, Diagnosis, and Treatment — A Complete Guide
References
Cleveland Clinic. Bronchomalacia. Cleveland Clinic. Last updated April 21, 2022. https://my.clevelandclinic.org/health/diseases/22771-bronchomalacia
Cincinnati Children's Hospital Medical Center. Bronchomalacia. Cincinnati Children's. Last updated January 2026. https://www.cincinnatichildrens.org/health/b/bronchomalacia
Depiazzi J, Bourke C, Stick S, et al. Prevalence of tracheobronchomalacia is higher than previously reported in children with cystic fibrosis. Pediatr Pulmonol. 2023;58(9):2568-2573. PMID 37294078. https://doi.org/10.1002/ppul.26550
Law W, Shieh HF, Leslie-Roberts R, et al. Tracheopexy for Severe Tracheobronchomalacia in Children with Bronchopulmonary Dysplasia: A Two-Center Study of Patient Characteristics and Outcomes. J Pediatr Surg. 2026:163404. PMID 42628598. https://doi.org/10.1016/j.jpedsurg.2026.163404
Dal Negro RW, Tognella S, Guerriero M, et al. Prevalence of tracheobronchomalacia and excessive dynamic airway collapse in bronchial asthma of different severity. Multidiscip Respir Med. 2013;8(1):32. PMID 23673082. https://doi.org/10.1186/2049-6958-8-32
Medical disclaimer
This article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions about a medical condition. Seek emergency care for bluish lips or skin, chest retractions, fainting, trouble breathing, or noisy breathing in a baby.
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