Bronchiolitis

About bronchiolitis

Bronchiolitis is a viral infection that affects small breathing tubes in the lungs called bronchioles. The infection causes these tubes to become narrowed by mucus and inflammation.

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 12 months.

Bronchiolitis symptoms

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.

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, their ribs might move in and out more than usual, and their nostrils might flare. You might also hear a high-pitched whistling sound called a ‘wheeze’ when your child breathes out. In severe cases, your child’s lips might look blue.

Your child might be hard to feed, as well as irritable and upset.

Bronchiolitis is usually at its worst on the second or third day, but it can last for up to 10 days. As your baby improves, the wheezing and the fast breathing settles. The cough can last for up to four weeks.

Does your child need to see a doctor about bronchiolitis?

You should 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. If your child has significant shortness of breath, your child’s skin or lips are pale or blue, or your child is drowsy or hard to wake up, call 000 for an ambulance.

Bronchiolitis treatment

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 dehydrated:

For breastfed babies younger than six months, offer feeds more often.
For formula-fed babies younger than six months, offer the usual amount of formula. Offer smaller but more frequent feeds.
For breastfed babies older than six months, offer feeds more often. You can also offer water between feeds.
For formula-fed babies older than six months, offer the usual amount of formula. Offer smaller but more frequent feeds. You can also offer water between feeds.

Here are some other things you can do to make sure your child is comfortable:

Try giving your child saline nose drops or sprays, which might help clear their nose of mucus.
If your child has a fever and is 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 three months.
Make sure that your child gets as much rest as possible.
Don’t worry if your child has a fever and isn’t hungry for solids. Your child’s appetite will improve as they start to feel better.
Make sure your child is in a smoke-free environment.

If your child has more serious bronchiolitis, your child might need to go to hospital. This is usually because your child isn’t feeding properly, has become dehydrated, or 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 medication 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 six 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 or chronic lung or heart disease.

Bronchiolitis prevention

Here are some 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 hands, and cough and sneeze hygienically.