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 18 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, 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.

Your child might also be hard to feed, 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 child improves, the wheezing and the fast breathing settles. The cough can last for up to 4 weeks.

Medical help: when to get it for children with bronchiolitis symptoms

Take your child to see your GP if your child:

is breathing very fast, has difficulty breathing or has pauses in 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.

Bronchiolitis treatment: mild symptoms

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.

Babies 0-6 months: tips for avoiding dehydration

If your baby is breastfed, offer feeds more often.
If your baby is formula fed, offer the usual total amount of formula but in smaller, more frequent feeds.

Babies 6-12 months: tips for avoiding dehydration

If your baby is breastfed, offer feeds more often.
If your baby is formula fed, offer the usual total amount of formula but in smaller, more frequent feeds.
Offer water between feeds.

Children 12 months and older: tips for avoiding dehydration

Offer water or an oral rehydration fluid like Gastrolyte or Hydralyte. You can buy these from pharmacies and many supermarkets.
Offer small amounts of water or oral rehydration fluid more frequently, especially if your child is very unwell. For example, offer a few mouthfuls every 15 minutes.

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.

Bronchiolitis treatment: severe symptoms

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.

Bronchiolitis prevention

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 hands, and cough and sneeze hygienically.