Bronchiolitis

Bronchiolitis is a common chest infection in young children. It usually occurs in babies under 6 months, but sometimes up to 12 months of age.

It is caused by a virus in the lungs which causes your child to have more difficulty with breathing. Medicines do not usually help babies with bronchiolitis. They need to rest and have small feeds more often, so they don’t get too tired when feeding and do not get dehydrated.

Signs and symptoms

The illness begins as a cold. After a day or so, your baby begins to cough, and the breathing becomes fast and sounds wheezy. This fast, wheezy breathing can make it difficult for your baby to eat or drink. Some children may need to be admitted to hospital because of these problems.

The first symptoms your child may have are the same as a common cold. These symptoms last 1-2 days:

Runny nose
Mild cough
Stuffiness.

They are followed by an increase in problems related to breathing, such as:

Very fast breathing
Poor feeding
Noisy breathing (wheezing)
Drawing in of the chest with each breath
Fever.

Babies with bronchiolitis are usually worst on the 2^nd or 3^rd day and are often sick for 7-10 days. Their cough may continue for 2-4 weeks.

Treatment

Always try not to smoke in the home or around your baby. This is especially important around babies with any respiratory illness.

Medicines do not usually help babies with bronchiolitis. Antibiotics are not given because bronchiolitis is caused by a virus. Antibiotics don't not cure viruses.
Babies need to rest, and to take small amounts of fluid more often, so they don't get too tired when feeding.
Give more frequent breastfeeds or smaller amounts of formula or water more often. If children do not get enough drinks they can get dehydrated.
You can give paracetamol (eg. Panadol, Dymadon, Tempra) if your child is irritable.

If your baby is distressed and having trouble feeding, they may need to be admitted to hospital. Staff may need to:

Watch them closely that they do not get more sick.
Give them some extra oxygen.
Give them extra fluids through a drip into a vein (intravenous/IV therapy).

Care at home

Encourage rest.
Give shorter breast feeds/formula/water more often. This way your child does not get too tired when feeding.
Avoid contact with other babies in the first few days, as bronchiolitis is an infectious disease.
Ensure a smoke free environment.

Follow-up

Go to the nearest doctor or hospital if your child:

Has difficulty breathing (very fast or not regular breaths).
Cannot feed normally because of coughing or wheezing.
Is changing colour in the face when they cough.
Turns blue or has skin that is pale and sweaty.

Make an appointment for your child to see a doctor if:

They have a cough that is getting worse
They have less than half their normal feeds or are refusing food or drinks.
They seem very tired or are more sleepy than usual.
You are worried in any way.

Key points to remember

Babies need to rest and drink small amounts more often.
Bronchiolitis is an infectious disease in the first few days of illness.
It is more common in babies under six months old.
Babies are usually sick for 3-5 days, and then recover over the next 7-10 days. The cough may continue for 2-4 weeks.
Smoking in the home increases the chance of babies having bronchiolitis and makes it worse.

For more information

Your local doctor
Your local hospital emergency or casualty department
Royal Children's Hospital Emergency Department (03) 9345 6153
Royal Children's Hospital General Medical Ward - 5th floor (03) 9345 5559

Individual instructions

Developed by RCH departments: General Medicine, Centre for Community Child Health, Thoracic Medicine. First published August 2003 Update: June 2007.