A tracheotomy tube, or trach, is a special breathing tube. Elective decannulation is the process to remove this tube. After deciding that your child no longer needs the tracheotomy tube to breath well, your doctor will tell you when you can safely start this process. This process is done slowly to make sure that your child is truly ready for decannulation and will adjust to breathing without the tracheotomy tube. The steps leading up to decannulation might be different for each child, and may include using a speaking valve, capping the tracheotomy tube, using a smaller tube or putting a hole (fenestration) in the tube. Your doctor will let you know what steps will be needed for your child.