Bronchiolitis is a viral infection of the small airways (the bronchioli) deep inside the lungs, that affects mainly infants and small children below 1 year of age. Bronchiolitis mainly occurs in winter, between November and March.
The illness often starts with symptoms that you would associate with a cold – you may find that the child has more nasal secretions and is snuffly and sneezing. This can develop into a dry cough, but later the child may cough up clear phlegm. The phlegm in the back of the throat may also cause vomiting of phlegm and food. At this stage, the chest may sound very rattly, and the breathing may be noisy and you may hear a wheeze. Some children may also have a temperature which is usually mild.
Most children cope with the infection very well, but some children may experience difficulty when breathing. You may notice that the child is struggling to breathe, has very rapid breathing and indrawing of the chest (the lower chest wall goes in when the child breathes in). At this point, some children don't like their feeds as much, because it is hard for them to swallow and breathe at the same time.
How can I treat bronchiolitis at home? When do I need to see a doctor?
If the child continues to be their normal self, meaning:
they are alert, smiling and playing as normal or just less than normal
have pink lips
are not working hard to breathe
they continue to feed well,
the child's illness can be managed at home. But if you are in any doubt, contact your GP.
Make sure the child drinks plenty of fluid (the usual milk, or you can add water or diluted juice if the child appears thirsty). If the child is unsettled, in discomfort, or has a temperature, you can give Paracetamol (egCalpol) or Ibuprofen (eg Nurofen for children).
The illness usually lasts between 5-10 days like most viral infections. Antibiotics are not useful as they do not act against the virus causing bronchiolitis (called the respiratory syncytial virus, or RSV). Cough medicines are not very effective either. You can help the child to bring up phlegm by ensuring they are drinking plenty of fluids (making phlegm less sticky) and gently clapping the back to help to move secretions.
However, if the child has one or more of the following symptoms, you should get them seen by your GP on the same day:
- · appears very tired and sleepy, not really interested in playing, not smiling
- · breathing is very fast and appears laboured
- · is taking less than two thirds of the normal amount of feeds, or having dry nappies for 12 hours or longer
- · has a temperature that does not respond to Paracetamol and/or Ibuprofen
- · the child is less than 3 months old
If you see one or more of these symptoms, you should take the child to the nearest hospital's A&E department.
If any of the following symptoms appear, you should call an ambulance:
- · Lips, tongue, fingernails or skin have a blueish tinge
- · Child appears drowsy and less responsive, or unresponsive
- · Breathing is very laboured, slows or pauses between periods of fast breathing, or stops breathing