Bronchiolitis

Bronchiolitis is a common condition affecting babies and young children. It is caused by inflammation of the small airways in the lungs which restricts the air flow in and out of the lungs and can make it more difficult for babies to breathe.

What do I need to do?

97% of cases are not serious and resolve with care at home. If you are caring for your baby at home, you can expect them to be unwell for 1-2 weeks, but be aware that the cough can be persistent beyond this and last for over a month.

When should I be concerned?

If your baby or child has any of the following symptoms, you should take the recommended course of action:

If your baby or child
  • has blue lips;
  • is unresponsive and very irritable;
  • is finding it difficult to breathe;
  • pauses in breathing; or
  • has an irregular breathing pattern

Action

You need to see a doctor or nurse today.
Please ring your GP’s surgery, out-of-hours GP service or call NHS 111.

If your baby or child

  • has symptoms which are getting worse;
  • feeds less than 50% of his or her usual amount;
  • is passing less urine than normal;
  • is vomiting more than three times in 24 hours;
  • has a temperature above 39°C

Action

You need to see a doctor or nurse today.
Please ring your GP’s surgery, out-of-hours GP service or call NHS 111.

If none of the above factors are present

Action

Care for your baby at home.

More Information

Bronchiolitis affects one in three babies in the UK during the first year of their life. Most commonly these children are aged 3-6 months; however, it can affect any child under the age of two years.

The earliest symptom of bronchiolitis is a cold, with nasal congestion. The other symptoms of bronchiolitis tend to develop over three days, and then gradually improve.

The symptoms of Bronchiolisit are FACT:

  • Fast breathing – shallow, quick breaths
  • Appetite – inability to feed as much
  • Cough
  • Temperature – a high temperature

Bronchiolitis is caused by a viral infection. The main virus that causes bronchiolitis is respiratory syncytial virus (RSV). However, most other viruses that can cause a cold-like illness, such as rhinovirus, human metapneumovirus, parainfluenza virus or any number of others, can cause bronchiolitis too. Most viruses, particularly RSV, are more common in winter, which is why most cases of bronchiolitis occur in winter months.

It is possible to have bronchiolitis more than once, because your baby may get a different viral infection and develop the bronchiolitis symptoms to that virus too.

Bronchiolitis cannot be fully prevented; however you can reduce your child’s likelihood of catching it.

  • Wash your hands regularly with soap and water, and encourage visitors to do the same before they touch your baby.
  • Wash or wipe toys regularly to prevent the spread of germs.
  • The viruses are spread by droplets, so cover your child’s nose and mouth when they cough or sneeze.
  • Try to keep very young babies, or especially vulnerable babies (ex-premature, babies with heart problems or chronic health problems) away from children and adults who are sick or who have signs of a cold.
  • Ensure your baby is kept away from tobacco smoke and never allow anybody to smoke around your baby.

Some vulnerable children will be offered an immunisation programme in winter, your paediatrician will advise you on this.

Give smaller amount of feeds than usual, but more often. Aim to give your baby 50-75% of their usual daily amount.

  • Prop your baby’s mattress up to a small incline so he or she doesn’t cough as much.
  • It is safe to use age-appropriate nasal decongestant rubs.
  • It is safe to take your baby outside provided they are wrapped up warmly.
  • You may wish to check on your baby regularly in the night.
  • If your baby has a fever and is miserable it is safe to give them paracetamol. All babies less than three months old with a fever must be seen by a GP to ensure a focus for the fever is found.
  • Monitor your baby for signs he or she is getting worse and seek further help if needed.

Medication for bronchiolitis Children with bronchiolitis are not prescribed antibiotics as the condition is caused by a virus. Inhalers are rarely effective in children under the age of six months, and only sometimes effective in children 6-12 months old. Steroids are not useful.