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Bronchiolitis is a common chest infection in young children, caused by a viral infection of the lungs. The infection causes inflammation and mucus to build up in the airways, making it more difficult to breathe.
Bronchiolitis is most common in babies under six months, but sometimes occurs in babies up to 12 months old.
Medicines do not usually help treat bronchiolitis. Babies need to rest and have small feeds more often, so they don't get too tired when feeding and do not get dehydrated.
If your baby has bronchiolitis, you should avoid contact with other people in the first few days, as the virus that causes bronchiolitis is contagious.
Signs and symptoms of bronchiolitis
The illness begins as a cold, and the first symptoms your baby may have include a mild cough, and a runny or blocked nose. After one or two days, your baby’s cough may get worse, and they will begin to have some breathing problems. Their symptoms may include:
- fast breathing
- noisy breathing that sounds wheezy
- breathing that is hard work – you may see the ribs or skin under the neck sucking in or nostrils flaring when they are breathing; younger babies may bob their heads when breathing
- irritability and fever
- difficulties eating or drinking.
Symptoms are usually worst on the second or third day, and your baby may be sick for up to 10 days. Their cough may continue for up to four weeks.
When to see a doctor
You should see your GP if you think your baby has bronchiolitis. Most of the time, tests such as chest X-ray, nose swabs or blood tests are not necessary for diagnosing bronchiolitis.
If your baby is having breathing difficulties or having trouble feeding, they may need to be admitted to hospital. In hospital, staff may need to:
- observe your baby
- give extra oxygen
- give extra fluids through a tube from the nose into the stomach (nasogastric tube), or directly into a vein through a drip (intravenous or IV therapy).
Antibiotics are not given because bronchiolitis is caused by a virus. Antibiotics do not cure viruses. Medicines like steroids, adrenaline and asthma medication are also not helpful in treating bronchiolitis.
Some babies who get bronchiolitis are at more at risk of getting worse quickly. Take your baby to the nearest hospital emergency department if they develop symptoms of bronchiolitis and they:
- were born prematurely
- are younger than 10 weeks old
- have chronic lung disease, congenital heart disease, chronic neurological conditions or they are immunocompromised (have a weakened immune system)
- are an Aboriginal or Torres Strait Islander.
Care at home
Most babies with bronchiolitis can be treated at home after seeing a doctor. You can care for your baby as follows:
- Let your baby have plenty of rest.
- Give them more frequent breastfeeds, or smaller amounts of formula more often. This will keep them from becoming too tired when feeding, and will make sure they do not become dehydrated.
- Saline nasal drops or nasal sprays can help to clear the nasal passages of mucus, which will allow your baby to feed more comfortably.
- Do not allow anyone to smoke in the home or around your baby. This is especially important around babies with any respiratory illness.
You should go back to see your GP if your baby has bronchiolitis and:
- they have a cough that is getting worse
- they have less than half their normal feeds or are refusing drinks
- they seem very tired or are more sleepy than usual
- you are worried for any reason.
Go to the nearest GP or hospital emergency department if your baby:
- has difficulty breathing, irregular breaths or fast breathing at rest
- cannot feed normally because of coughing or wheezing
- is changing colour in the face when they cough
- has skin that is pale and sweaty.
Call an ambulance immediately if your baby is struggling to breathe or if their lips start to turn blue.
Key points to remember
- Bronchiolitis is a common chest infection, caused by a virus, that affects babies up to 12 months old.
- Babies are usually sick for seven to 10 days. They are infectious in the first few days of illness.
- Seek medical attention if your baby is having trouble breathing, feeding or drinking.
- Medicine is not usually used to treat bronchiolitis. Babies need to rest and drink small amounts more often.
- Ensure your baby is in a smoke-free environment.
For more information
Common questions our doctors are asked
What is the difference between bronchiolitis and
bronchitis?
Bronchi and bronchioles are tubes in the lungs – the
bronchi are larger tubes, and the bronchioles are smaller tubes. Bronchitis
is an illness that affects the bronchi, and it is more common in older children
and adults. Bronchiolitis affects the bronchioles, and is more common in
children under two years old.
Can I give my baby pain relief if she has bronchiolitis?
Yes, many babies get a fever with bronchiolitis and may feel miserable. You may give your baby paracetamol, or ibuprofen if they are older than three months old and not dehydrated. See our fact sheet: Pain relief for children.
If my baby gets bronchiolitis, is he more likely to get asthma?
Some studies have shown a correlation between some types of bronchiolitis and the later development of asthma. However, there are many potential explanations for this, including a genetic tendency for sensitive airways, or exposure to triggers like cigarette smoke. This is a question that researchers are still trying to find answers to.
Developed by The Royal Children's Hospital General Medicine and Respiratory and Sleep Medicine departments. We acknowledge the input of RCH consumers and carers.
Reviewed February 2018.
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.