Tracheotomy in children has been associated with significant operative and post-operative complications and disabilities. In this study, special attention was given to the post-operative effects on the ability to swallow and the development of speech in infants following tracheotomy. In 36 infants (19 boys, 17 girls) a tracheotomy was performed before the age of one year. Indications were: 1 severe upper airway obstruction (n = 25), 2. the requirement of prolonged mechanical ventilation (n = 10) and 3. intensive tracheal-broncheal suction (n = 1). In contrast of the absence of peri-operative complications, in the post-operative follow-up period we observed many complications and disabilities, partially attributable to several underlying disorders and to the tracheotomy itself. The swallowing ability was deteriorated in nearly all infants and the speech-development was seriously delayed in 38% of all infants. Infants following tracheotomy require intensive care to minimize complications and to stimulate the ability to swallow and the development of speech. Some proposals for treatment of swallowing disorders and rehabilitation are proposed.