What is bronchiolitis?
Bronchiolitis is a viral infection that affects small breathing tubes in the lungs called bronchioles. The infection causes mucus and inflammation, which narrows the bronchioles.
Bronchiolitis can be caused by many different viruses, but it’s most often caused by a virus called respiratory syncytial virus (RSV). This virus spreads through sneezing, coughing or hand contact.
Bronchiolitis is most common in babies younger than 18 months.
What are the symptoms of bronchiolitis?
When bronchiolitis starts, the symptoms look a bit like a cold. They include a runny nose and sneezing, a mild cough and sometimes a fever.
Your child might also be hard to feed, irritable and upset.
Fast, laboured or difficult breathing
As bronchiolitis develops, your child’s breathing might become fast and laboured and the cough might get worse.
You might notice signs that your child is working hard to breathe. For example, your child’s:
- ribs might move in and out more than usual
- nostrils might flare
- breathing might sound like a high-pitched whistle when they breathe out
- lips might look blue in severe cases.
How long do bronchiolitis symptoms last?
Bronchiolitis is usually at its worst on the second or third day, but it can last for up to 10 days. As your child improves, the wheezing and the fast breathing settles. The cough can last for up to 4 weeks.
The viruses that cause bronchiolitis are very contagious, which means they spread easily from person to person. They spread through coughing, sneezing, breathing, laughing, talking and touching infected surfaces. Children and teenagers with these viruses are usually contagious for 3-8 days, including 1-2 days before they show signs of illness.
When to take children with bronchiolitis symptoms to a doctor
Take your child to see your GP if your child:
- is breathing very fast or has difficulty breathing
- is coughing and distressed
- has a cough that’s getting worse
- has difficulty feeding or drinking and has fewer wet nappies than usual
- is changing colour in the face when they cough
- is tired or more sleepy than usual.
You know your child best, so trust your instincts if your child doesn’t seem well. Call 000 for an ambulance if your child has significant shortness of breath or pauses in breathing, their skin or lips are pale or blue, or they’re drowsy or hard to wake up.
How to treat mild bronchiolitis
If your child has mild bronchiolitis, you’ll be able to manage it at home.
It’s very important to make sure your child is drinking enough so they don’t get dehydration. Our article on preventing and treating dehydration explains how much fluid children of different ages need and how often they need it.
Children of all ages: tips for comfort
- Try giving your child saline nose drops or sprays, which might help clear their nose of mucus.
- If your child has a fever and looks uncomfortable, you can give your child paracetamol, according to the recommended dose and frequency. Or you could give ibuprofen if your child is older than 3 months.
- Make sure that your child gets as much rest as possible.
- Let your child eat according to their appetite. Your child might not be hungry while they have a fever. Their appetite will come back as they start to feel better.
- Make sure your child is in a smoke-free environment.
Don’t give aspirin to children under 12 years unless it’s prescribed by a doctor. Aspirin can make children susceptible to Reye’s syndrome. If you’re giving your child any over-the-counter medicines, check with your pharmacist or doctor to make sure these have no aspirin.
How to treat severe bronchiolitis
If your child has more serious bronchiolitis, your child might need to go to hospital. This might be because your child:
- isn’t feeding properly
- has become dehydrated
- needs help to breathe.
Your doctor will tell you whether your child needs to go to hospital.
In hospital, your child might get fluids via a nose tube or a drip into a vein in their arm. Your child might also get oxygen. Sometimes your child might get asthma medicine like Ventolin. This can help some children breathe more easily by opening up their airways, but it’s generally not effective in children younger than 6 months of age.
If your child has bronchiolitis with a fever and wheezing, keep your child away from other young children and people at risk of severe respiratory infections. This includes people with cancer, chronic lung disease or heart disease.
Can you stop your baby from getting bronchiolitis?
Here are simple things you can do to reduce your child’s chances of getting bronchiolitis:
- Wash your hands regularly with warm soapy water.
- Keep your hands away from your face as much as possible.
- Cough or sneeze into a tissue or your elbow.
And as your child gets a little older, you can start teaching your child how to wash their hands, and cough and sneeze hygienically.
RSV immunisation helps to protect children from bronchiolitis. Under the National Immunisation Program (NIP) in Australia, pregnant women and some young children can get immunised for free against RSV.