Understanding tracheostomies (1007)

Key points below

What is a tracheostomy?close up of child with  trach vent

What is a tracheostomy tube?

Why does my child need a trach tube?

- Birth defects that affect breathing.
- A windpipe or breathing tube that is narrow or scarred.
- Vocal cords that don’t move like they should.
- A problem such as softening or collapse of the windpipe or bronchial tubes.

- A need for a ventilator to help with breathing.

- A disease that affects the muscles or nerves that control breathing.

What extra care must I take to keep my child safe?child by blue chair with trach vent

What happens after surgery?

After surgery, your child will go to the Intensive Care Unit (ICU). The doctor will change the first tube after 5 to 7 days. Your child will get medicine that helps with pain and keeps your child quiet and still while healing takes place during the first week. 
Sutures (stitches) are put on each side of the new trach tube. They help open the trachea so the tube can be replaced if needed. Your child’s doctor will remove the sutures after 5 to 7 days. A ventilator and oxygen may also be needed to help your child’s breathing.

When will my child be ready to go home?

Your child will be ready to go home when:

What follow up medical care will my child need?

After discharge, your child will need follow up medical care from the:

The nurse on the Tracheostomy Team will coordinate your child’s follow up care.

Will my child be able to talk?

The trach tube will not keep your child from learning how to speak. There are some things that will affect the amount of sound your child will make:

In the hospital and after discharge, your child will have speech therapy to help with talking.

Will my child need to be monitored at home?

Your child will go home on a monitor. It may be an apnea monitor or a pulse oximeter. You must use the monitor whenever your child is not in direct eye contact with you (for example, when sleeping, in another room, or in the car). The monitor will alert you to any problems with your child’s breathing. 
Many families also use an intercom or baby monitor to hear their child. 

Will the trach change the way my child eats?diagram of trach tube and human body

The trach tube does not affect the way your child eats food.

Some children who have trach tubes have a hard time with swallowing and gastric reflux. Because of this, some children are at risk to aspirate (inhale) food into the airway. 

If your child has feeding or swallowing issues, your doctor will talk with you and decide if tube feedings will help prevent reflux or food aspiration.

Will my child be able to do the same things a child without a trach can do?

There are only a few activities that your child cannot do. Your child cannot be under water because water would go directly into the trach tube and into the lungs. 
You also need to take special care to prevent small particles like dust, sand, and fibers from getting in to the trach tube. The particles can irritate the lungs. 
Your child cannot be around people who are smoking, because smoke can also irritate the lungs.
It is important for your child to have the chance to take part in activities that other children do.

Will my child be able to leave the house?

Yes, your child will be able to leave the house and travel with the family. All the equipment you need is portable or will work on battery power. You will learn which pieces of equipment you need to have with you at all times when you and your child go out of the house.

Will my child be able to leave the house?

Yes, your child will be able to leave the house and travel with the family. All the equipment you need is portable or will work on battery power. You will learn which pieces of equipment you need to have with you at all times when you and your child go out of the house.

What training is needed? 

Family and trained caregivers 

As you are getting ready to take your child home, you will need the help of the trach team members. More importantly, you will need the support and help of family and others.

An adult caregiver who is trained to do routine and emergency trach care must be with your child at all times.

Many of the cares need two people to perform. You will need at least one other adult to be completely trained in your child’s care. This second caregiver will learn as much about your child’s care as you have. This person should be an adult who will continue to be involved in your child’s life after discharge. This person will spend time with your child and be a resource and back up person for you when you cannot be with your child. 

Daily cares and home equipment training

Before your child can go home, you and the second caregiver will need to learn and demonstrate the care that your child needs. 

Training includes learning about your child’s:

  • Physical care
  • Care of the tracheostomy
  • Giving medicines
  • Feedings
  • Equipment care

You will work closely with the nurses and respiratory therapists to learn how to:

  • Suction
  • Do trach care
  • Change trach ties
  • Change the trach tube
  • Give breaths with the resuscitator bag
Once you master these skills, you will learn how to care for, set up, and clean the respiratory equipment. 
You will learn trach CPR.

Simulation training and independent caresman holding child

Before going home, you will use all the skills you have learned to complete simulation training. You will work together to act out emergent scenarios on a doll, using home equipment.  
Then you will do independent cares before your child goes home. This means that while you are still in the hospital, you and the other trained caregiver(s) will provide all the care your child will need at home. You will need to do this in separate shifts from each other.

You will spend 6 to 24 hours doing all the cares for your child. You will use your child’s own home equipment and supplies. 

Independent Cares simulates the home environment to make sure you are ready to provide all the care and manage all the equipment your child needs at home.


This sheet was created to help you care for your child or family member. It does not take the place of medical care. Talk with your healthcare provider for diagnosis, treatment and follow-up.