What is a key difference in airway management between infants and older children?

• A. Infants have a proportionally larger occiput, larger tongue relative to oral cavity, and relatively larger epiglottis; use appropriate positioning to open the airway; avoid excessive neck flexion.
• B. Infants have smaller occiput and smaller tongue.
• C. There is no difference; same technique as older kids.
• D. Infants require bypassing the epiglottis.

Answer: (A)

Infant airways require special attention to anatomy and positioning. Infants have a proportionally larger occiput, a tongue large relative to the oral cavity, and a relatively large epiglottis. These features make the airway more prone to obstruction when lying flat, because the big occiput tends to flex the neck and narrow the airway. To keep the airway open, you position the infant so the head and neck are aligned with the airway rather than letting the airway fold into flexion—often by placing a small roll or towel under the shoulders to achieve a neutral or slightly extended position and avoiding excessive neck flexion. The epiglottis is not something to bypass routinely; you manage the airway with appropriate positioning and standard airway techniques as needed. The other ideas—smaller occiput or tongue, no difference in technique, or bypassing the epiglottis—don’t fit the true anatomical differences and management approach.