Effective humidification is sometimes difficult to achieve in children when normal mechanisms are bypassed by having a tracheostomy in situ. The humidification options available in the paediatric population are heat and moisture exchangers (HMEs) and heated humidifiers, both of which are reviewed and discussed. In some circumstances the humidification achieved with HMEs is inadequate. We outline the hospital and subsequent home management of two infants, both with tracheostomies in situ, who unsuccessfully trialed HMEs and subsequently achieved effective humidification with heated humidifiers. We propose that heated humidifiers would help more tracheostomized infants who are suffering from similar problems.