Patients, parents and carers
Bronchiolitis: A guide for parents
What is it?
- Bronchiolitis is a viral infection of the lungs and airways. The tiniest air passages become swollen and produce a lot of mucus. This can make it more difficult for your baby to breathe
- It mainly affects babies and young children
- It happens mostly in winter, but can happen at any time of the year
- It is caused by a number of different viruses, the most common being respiratory syncytial virus (RSV)
- Most children don’t need any medical help, but some need to come to hospital for assessment or treatment
How did my child get it?
RSV and other viruses that cause bronchiolitis often cause mild coughs and colds in older children and adults who can easily pass the virus on to infants in tiny droplets that travel in the air. Almost all children will have had an infection caused by RSV by the time they are two years old. It is most common in the winter months and many infants only get mild ‘cold-like symptoms’ for a few days. Most infants get better on their own but some, especially very young ones or infants with other health problems, can have difficulty with breathing or feeding and may need to go to hospital.
What symptoms will you see?
- Bronchiolitis starts like a simple cold. Your baby may have a runny nose and sometimes a temperature and a cough
- After a few days your baby’s cough may become worse. This may be dry initially, but becomes wet as the symptoms develop. Your baby’s breathing may be faster than normal and they may become wheezy. They may need to make more effort to breathe
- As breathing becomes more difficult, your baby may not be able to take the usual amount of milk by breast or bottle. You may notice fewer wet nappies than usual
- Your baby may be sick after feeding and become clingy, unsettled and cry more
- Sometimes, in very young babies, bronchiolitis may cause them to have brief pauses in their breathing
How is it diagnosed?
Bronchiolitis is diagnosed by a healthcare professional based on the story of the illness and what is found when examining the child. A throat swab can be done to confirm the virus causing the illness.
What is the treatment?
There is no cure for bronchiolitis. It will get better in time but some children need help with their breathing and feeding until they improve. Bronchiolitis is caused by a virus so antibiotics won’t help.
How can I help my baby at home?
- If feeding is difficult, try breastfeeding more often or offering smaller bottle feeds more often (every two hours for example)
- If your baby has a temperature, you can give them liquid paracetamol. You must follow the instructions that come with the paracetamol carefully.
- If your baby is already taking any medicines, you should carry on using these. If you find it difficult to get your baby to take them, ask your doctor or health visitor for advice.
- Try to make sure your baby is not exposed to smoking or vaping. Passive smoking can seriously damage your baby’s health. It makes breathing problems like bronchiolitis worse and the cough will last longer. Smoke exposure is also a significant risk factor for developing childhood asthma later.
How long does bronchiolitis last?
- Most children with bronchiolitis will seem to worsen during the first 3-5 days of the illness before beginning to improve over the next two weeks. The cough may go on for a few more weeks as the swelling in the tiny air passages takes time to heal.
- Your child can go back to nursery or daycare as soon as they are well enough (feeding normally and with no difficulty in breathing)
- If you are worried about your child’s progress discuss this with your GP or Health Visitor
When should I get help?
If your child has any of the following:
- Has blue lips
- Has pauses in their breathing or has an irregular breathing pattern or starts grunting
- Severe difficulty in breathing e.g. too breathless to feed
- Becomes pale, mottled (blotchy appearance to skin) or feels abnormally cold to touch
- Becomes extremely agitated, confused or very difficult to wake
- Is under 1 month of age with a temperature of 38°C or above
You need urgent help. Go to the nearest Hospital Emergency Department or phone 999
If your child has any of the following:
- Has laboured/rapid breathing or are working hard to breathe e.g. sucking in of the muscles below their ribs or between their ribs
- Seems dehydrated
You need to contact a doctor or nurse today. Please call your GP surgery or NHS 111.
If none of the features in red or amber are present, continue to provide care at home as described above. If you have any concerns about your child, call your GP or NHS 111.
