Bronchiolitis in Infants and Children

What is bronchiolitis? — Bronchiolitis is a common viral  infection that affects a part of the lungs called the “bronchioles.” The bronchioles are the small, branching tubes that carry air in and out of the lungs. When these tubes are infected, they get swollen and full of mucus. That makes it hard to breathe. Bronchiolitis usually affects children younger than 2 years of age. In most children, bronchiolitis goes away on its own, but some children with bronchiolitis need to be seen by a doctor. The most common cause of bronchiolitis is a virus called “respiratory syncytial virus,” or “RSV.”

What are the symptoms of bronchiolitis? — Bronchiolitis usually begins like a regular cold. Children who get bronchiolitis usually start off with:

  • A stuffy or runny nose
  • A mild cough
  • A fever (temperature higher than 100.4ºF or 38ºC)
  • A decreased appetite

As bronchiolitis progresses, other symptoms may develop, including:

  • Breathing fast or having trouble breathing. In infants, the first sign can be a pause in breathing that lasts more than 15 or 20 seconds.
  • Wheezing, or a whistling sound when breathing (which usually lasts about 7 days)
  • A severe cough (which can last for 14 days or longer)
  • Trouble eating and drinking — because of the other symptoms

Should I take my child to see a doctor or nurse? Many children with bronchiolitis may not need to see a doctor. However, you should watch and arrange f/u for concerning symptoms that involve increase in difficulty breathing, including wheezing; increased congestion with problems with feeding, any signs of choking or severe gagging from increased mucus, and problems with maintaining adequate hydration and urine output.

Call 9-1-1 for an ambulance if your child:

  • Stops breathing
  • Starts to turn blue or very pale
  • Has a very hard time breathing
  • Starts grunting
  • Looks like he or she is getting tired of having to work so hard to breathe

Call our clinic if you have any questions or concerns about your child, or if:

  • The skin and muscles between your child’s ribs or below your child’s ribcage look like they are caving in and there is struggling with breathing
  • Your child’s nostrils flare (get bigger) when he or she takes a breath
  • Worsening cough and congestion
  • Your infant younger than 3 months has a fever (temperature greater than 100.4ºF or 38ºC)
  • Your child older than 3 months has a fever (temperature greater than 100.4ºF or 38ºC) for more than 3 days
  • Your infant has fewer wet diapers than normal

How is bronchiolitis treated? — The main treatments for bronchiolitis are aimed at making sure that your child is getting enough oxygen, and able to breathe well despite the increased mucus that this virus produces. To do that, your child may need to receive:

  • Moist air or oxygen to breathe
  • Medicines to help open up the airways
  • Deep suctioning of the airways

Bronchiolitis does not need to be treated with antibiotics because it is a virus, however children may develop complications from the virus including ear infections or pneumonia. If your child has a persistent fever or if he was getting better and then gets sick again, please call for an appointment.

Is there anything I can do on my own to help my child feel better? — Yes. You can:

  • Make sure your child gets enough fluids. Call our office if your infant has fewer wet diapers than normal.
  • Use a humidifier in your child's bedroom
  • Treat your child's fever with non-prescription medicines, such as acetaminophen or ibuprofen (if your child is over 6 months of age).
  • Suction the mucus from your child’s nose with a suction bulb
  • If your child is older than 12 months, feed him or her warm, clear liquids to soothe the throat and to help loosen mucus
  • Prop your child's head up on pillows or with the help of a car seat. Do not use pillows if your child is younger than 12 months old.
  • Sleep in the same room as your child, so that you know right away if he or she starts having trouble breathing

How did my child get bronchiolitis? — Bronchiolitis is caused by viruses that spread easily from person to person. These viruses live in the droplets that go into the air when a sick person coughs or sneezes.

Can bronchiolitis be prevented? — You can reduce the chances that your child will get bronchiolitis by:

  • Washing your hands and your child’s hands often with soap and water, or using alcohol hand rubs
  • Staying away from other adults and children who are sick

Adapted from UptoDate.com

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