In this section
A tracheostomy (track-ee-os-tohmee) is a small, surgical opening through the skin into the windpipe (trachea).
There are many reasons why children may need a tracheostomy. The most common is to relieve severe breathing difficulties due to an obstruction (blockage) or narrowing in the upper airway. Other reasons include a child needing to be connected to a machine (ventilator) that helps
with their breathing, or they need to have frequent suctioning of mucus from their airway if they can't swallow their saliva properly.
While your child is asleep under a general anaesthetic, a curved plastic tube (tracheostomy tube) will be inserted into their windpipe through a cut in their throat, and secured. Your child will breathe through this tube instead of their nose and mouth. The tube doesn't go into the lungs.
Children normally recover from the operation quickly. Your child will need to stay in an intensive care unit to make sure the first tube can be safely changed (normally between five and seven days after surgery). Once the tube has been changed without any complications, your child will be
transferred to a ward.
In most cases, a child with a tracheostomy can eat and drink without any trouble once they have recovered from the operation. A speech pathologist may assess your child's ability to swallow before your child is given any food or drink.
The tracheostomy tube usually affects speech to some degree, and at first your child may not be able to produce any vocal sounds (speech or crying). The amount of sound your child will be able to make depends on several factors, including:
Your child may have a speaking valve attached to the end of their tracheostomy tube. This one-way valve directs exhaled (breathed-out) air through the trachea and upper airway, helping your child to speak.
Even if they are not able to speak, spend time talking to your child. Allow them time to respond and be encouraging. By observing their facial expressions and behaviour, you will be able to recognise and understand their needs.
Speech pathologists are available if you need help. You may also consider learning some simple sign language with your child so that you can communicate together.
Extra care and supervision is required for a child with a tracheostomy. A specialist team will help you learn the different procedures you will need to do when caring for your child after they leave hospital. This may include suctioning, planned replacement, emergency
replacement and flushing. Although these things may seem scary at first, the more practice you have, the more confident you will feel. Once you feel comfortable doing all the care that your child needs, your child can go home.
You will need to keep a supply of the following with your child at all times:
It is a good idea to keep these together in a container or bag, labelled with your child's name and contact details.
Children with a tracheostomy tube must not immerse the tube under water, because there is a risk of drowning.
During a bath:
Some older children may be able to swim and shower safely. You will need to discuss this with your child's doctor.
Avoid using powders or aerosol sprays around the tracheostomy tube, as they may cause breathing problems.
When your child goes home, they will be able to carry on with most of their normal activities. Your child should be encouraged to play, but you will need to watch them at all times. Don't have small toys or objects around a young child, as there is a risk of them breathing small items in
through the tube.
Careful supervision is necessary when your child is around sand. If possible, avoid sand pits and beaches. Older children may have to avoid contact sports such as football and basketball.
Your treating team will arrange regular follow-up to ensure your child's tracheostomy is safe and functioning well. You will be given an individual action plan for tracheostomy management and emergency scenarios.
A tracheostomy may be permanent, long-term or short-term, depending on the needs of your child. Your child will have regular medical appointments, and the removal of the tracheostomy tube will be planned once the medical team is confident that your child can breathe well without it.
Your child will need to stay in hospital for at least one to two nights when the tube is removed. Usually a smaller size tracheostomy tube is put in, and then this is blocked overnight to see how well your child can breathe through their nose and mouth, rather than through the tracheostomy
tube. Your child will be monitored closely by the nursing staff. If your child can breathe well with the tube blocked, it is taken out the next morning.
Global Tracheostomy Collaborative page
Does my child need to wear special clothing?
You don't need to buy special clothing for your child. Any type of clothing is fine as long as the clothing doesn't block the tracheostomy tube (e.g. polo necks or plastic bibs), or have loose fibres/threads or beads that may get into the tracheostomy tube and affect your child's breathing. Young children should wear
a filter over the tracheostomy tube, or cover it with a light scarf.
If my child doesn't make
any sound when he cries, how will I know when he needs me when we are back
If your child is unable to vocalise, you may consider buying an intercom (baby monitor), bell or microphone to place close to them so that you can hear when they wake and require suction.
Developed by The Royal Children's Hospital Respiratory and Sleep Medicine department. We acknowledge the input of RCH consumers and carers.
Reviewed April 2018.
This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.