When Ashley’s son, Bradley, was delivered via C-section, she waited for that reassuring, first newborn wail. Instead, she heard a cough.

“It wasn’t a cry, it was a bark – like a seal’s bark,” Ashley recalls. “I remember thinking immediately, ‘Something is not right.’”

For the first 6 months of Bradley’s life, that feeling persisted. While local doctors in Northern New Jersey dismissed his symptoms as acid reflux or “just the way he communicates,” Ashley watched her son struggle. He was lethargic, had difficulty keeping food down – even after trying six different formulas – and his skin had a jaundiced, yellow-orange tint.

But it was the sounds he made – a persistent cough and a stridor when he breathed – that kept Ashley up at night, terrified he might stop breathing altogether. “I felt like I was crazy,” Ashley says. “I just kept getting told he’s fine, but my mother’s intuition was screaming that he wasn't.” 

Searching for answers

After multiple ER visits, NICU stays, sleep studies and consultations with specialists in North Jersey, Ashley had had enough.

No one could explain Bradley’s symptoms or offer treatment options. She and her husband, Jeff, refused to accept this was “normal” for their suffering son. Ashley started googling Bradley’s symptoms and found Children’s Hospital of Philadelphia (CHOP). 

She called CHOP’s Center for Pediatric Airway Disorders and detailed Bradley’s condition. Clinicians recommended an evaluation with the Esophageal and Airway Treatment (EAT) Program at CHOP. The EAT Program is one of only a few in the country led by a multidisciplinary team of pulmonologists, gastroenterologists, ear, nose and throat (ENT) specialists and surgeons who work together to diagnose and treat children with rare and complex breathing and swallowing difficulties.

Coming to CHOP

The first thing Ashley noticed during Bradley’s initial visit with the EAT Program was the staff – particularly Duy T. Dao, MD, MPH, an attending pediatric surgeon. They listened. They heard her frustration. They heard her concern for her son, and they agreed Bradley’s condition was concerning.  

The next day Bradley underwent a bronchoscopy performed by Joseph Piccione, DO, MS. The imaging test uses a flexible tube to pass a camera, light and tools into Bradley’s throat, windpipe (trachea) and bronchial tubes to view his airways and lungs. Doctors also performed a dynamic CT scan, which showed how Bradley’s lungs expanded and contracted while breathing.

“I was so grateful we were able to get testing the next day,” Ashley said. “After our first visit I felt like we were finally at the right place – it gave me hope for a healthy future. Whether it turned out to be good news or bad, these doctors were going to figure it out and fix it.” 

After testing, Dr. Dao kindly and delicately shared the results: Bradley had tracheomalacia, a congenital condition that causes the cartilage in the windpipe (trachea) to be weak and floppy. With tracheomalacia, the windpipe can collapse when a child is breathing, crying or coughing. This leads to many of the symptoms Bradley had experienced since birth: wheezing, rattling breath, chronic cough and feeding difficulties.   

“It’s like every time he coughs, his airway completely shuts,” Ashley said. “Looking back, I was petrified at all the times we could have lost him.” 

Medication, then surgery

Initial treatment was conservative and included medications – bronchodilators and steroids – to open Bradley’s airway. But after months, Bradley still struggled.

Dr. Dao recommended a surgical procedure called tracheopexy that would support Bradley’s windpipe and prevent it from collapsing by surgically attaching the back wall of his trachea to a spinal ligament. This would keep Bradley’s airway open and reduce respiratory distress. 

Typically, tracheopexy requires a large incision through the back and a lengthy recovery period. But Bradley was young and had not had any prior chest surgeries. CHOP doctors hoped they would be able to perform Bradley’s procedure minimally invasively – passing tools through small incisions on the skin to perform the complex operation. This would help Bradley avoid open surgery and speed his recovery.

In July 2025, then-15-month-old Bradley had surgery at CHOP’s Philadelphia hospital. As they hoped, Dr. Dao and the surgical team were able to perform the procedure without opening Bradley’s chest.

“I remember them coming out of surgery and saying ‘We fixed it. We found it and fixed it. He did tremendously and he’s good,’” Ashley said. “It felt like a weight lifted.” 

The first night in the hospital, Ashley heard Bradley cry – a real cry, not a stifled bark – and she knew the operation was a success. Twenty-four hours later, Bradley was back to his quirky, crazy self. Once his chest tube came out, he was ready to go: standing, taking a bottle, eating baby food and trying to crawl. “It was like he woke up – he finally felt better.”  

Though Ashley had planned a multi-week stay at the hospital, Bradley was doing so well that he was discharged 2 days after surgery, and the family headed home. 

Embracing each new adventure

If you met Bradley today, you’d never guess his rocky start. Now 19 months old, the toddler is known to his family as an “outdoorsman.” He loves everything about being outside: riding his scooter, climbing rocks, chasing his big brother Bennett, riding the tractor with his dad and hunting for frogs in the creek behind his home.

“He’s my wild child and completely fearless,” Ashley says, laughing. “He embraces everything.” 

When the family returned to CHOP for a follow-up visit, Ashley proudly told the EAT team, “You didn’t give me back my baby, you gave me back a healthy toddler! Bradley grew up so much after surgery. His personality has exploded and he’s finally living his best life.”