Bronchiolitis

This article covers the signs and symptoms of bronchiolitis, the treatment and the complications that can occur in babies with bronchiolitis.

What is bronchiolitis?

Bronchiolitis is a viral infection of the airways in the chest that occurs in babies – usually those aged between three and six months old.

The bronchioles are small airways in the lungs, which become swollen and blocked by mucus. Babies are more prone to this condition as their smaller airways are more likely to become plugged with mucus when inflammation occurs.

Young babies also have less well developed immune systems.

The condition is more likely to occur during winter. The virus most usually associated with bronchiolitis is RSV (respiratory syncytial virus), also known as the human pneumovirus.

Bronchiolitis usually starts with a cold (including mild fever, running nose, lack of interest in feeding, irritability) and then a few days later a dry, rasping cough begins.

The illness peaks around the second or third day and should clear between 7 and 12 days. The cough may go on for some weeks.

The condition is more prevalent in:

• Boys
• Babies who are not breastfed
• Premature babies with lung problems
• Babies with heart problems
• Babies living in crowded conditions
• Babies living with a smoker
• Babies in day care.

There is a link between bronchiolitis and the later development of asthma.

Bronchiolitis is very contagious and is contracted by being in contact with infected children or touching objects infected with the virus.

Signs and symptoms of bronchiolitis

• A couple of days of cold like symptoms (mild fever, sneezing, snuffly nose, poor feeding, irritability) followed by a dry rasping cough
• Breathlessness
• High-pitched, wheezy breathing
• Difficulty feeding
• Sometimes vomiting after feeding
• Fever – or your child is cooler than normal
• Rapid heartbeat
• Flaring of the nostrils
• Retraction – drawing in of the neck and chest with each breath
• Your baby might be producing a lot of mucus which they have trouble getting rid of
• After a couple of days the breathing becomes faster and the cough more severe

Treatment for babies with bronchiolitis

• See your doctor – he/she will do a physical exam and listen to your babies chest. they may also take swabs, a blood test and do an x-ray
• There is no specific treatment for bronchiolitis and generally you can care for your baby at home. Medications to help fever might be prescribed
• If your baby is very sick, is under a month old, is having problems breathing, is getting really tired from trying to breathe or becoming dehydrated they may need hospital treatment. This can include intravenous fluids and oxygen via a mask
• Some possible drug treatments include an antiviral drug for RSV and also bronchodilator drugs (which increase size of airways) for some older children
• Babies born prematurely or with heart conditions showing signs of bronchiolitis should be seen by a doctor urgently
• Ensure you see your doctor if you child is not getting better within 3 – 5 days

You particularly need quick medical attention if your baby is:

• Breathing very fast
• You see the ribs and abdomen pulling very hard in and out when your child is breathing
• Your baby can’t keep fluids down
• Your baby is tired, pale, sweaty
• Your baby has a blue colour around the lips on in the fingertips

Risks & complications of bronchiolitis

• Respiratory distress – your baby is having difficulty breathing and needs emergency medical care. Untreated, this can cause death
• Cyanosis – your child is turning blue from lack of oxygen. This is a medical emergency: call an ambulance immediately
• Pneumonia (for further information, see the link below)
• Dehydration
• Fatigue
• Reoccurrence over several years

What can I do for my baby?

• Give your baby small amounts of fluid frequently
• Use a humidifier in your baby’s room to help keep the air moist – or take your child into a bathroom where you’ve run hot water from a shower or bath to create a moist, misty environment
• Keep your child upright to help them breathe
• Some health professionals recommend tilting your babies mattress up slightly to aid breathing
• Keep your baby away from people with colds, fevers and flues to prevent contracting the illness
• Be meticulous about hygiene for yourself and your baby
• Don’t smoke around your baby

This is an essential family health reference, covering over 100 common, important, potentially serious and often worrying symptoms and emergencies, such as headaches, chest pain, dizziness, fever, bleeding, tiredness or stress. This classic bestseller has now been completely revised and updated to include the latest information on how to care for your sick child.

Helpful articles:

For further information on Pneumonia, visit our Kiwi Families article in this Winter Ailments Section.

For information on Asthma visit our Allergies section.