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Chronic passage of gastric and/or alimentary material into the airways is a frequent and difficult‐to‐diagnose condition. Because alveolar macrophages phagocytose aspirated material, it has been suggested that their identification is a useful diagnostic method. To know the usefulness of the lipid‐laden alveolar macrophages (LLAM) index as a diagnostic tool for aspiration, children from 1 month to 16 years of age were included in three groups: G‐I, children with pulmonary pathology and suspicion of aspiration by clinic or image evaluation; G‐II, with pulmonary pathology without suspicion of aspiration; and G‐III, without respiratory symptoms nor suspicion of aspiration. Bronchoalveolar lavage was obtained through bronchoscopy in G‐I and G‐II, and through endotracheal tube in G‐III, and the LLAM index (0–400) was determined. A total of 112 patients (41, 30, and 41 in G‐I to III, respectively) were studied. LLAM …