Bronchiolitis

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This advice is intended for parents/carers taking their child home after consulting a doctor.  Your doctor may recommend different treatments depending on your child's condition.

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What is bronchiolitis?

Bronchiolitis is when the tiniest air passages in your baby’s lungs become swollen.  This can make it more difficult for your baby to breathe.  Usually, bronchiolitis is caused by a virus called respiratory syncytial virus (known as RSV).

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 usually only causes mild ‘cold-like’ symptoms.  Most children get better on their own.

Some babies, especially very young ones, can have difficulty with breathing or feeding and may need to go to
hospital.

The virus that causes bronchiolitis in babies also causes coughs and colds in older children and adults so it is very difficult to prevent.

What are the symptoms?
  • 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. Your baby’s breathing may be faster
    than normal and it may become noisy. He or she may need to make more effort to breathe
  • Sometimes, in very young babies, bronchiolitis may cause them to have brief pauses in their breathing
  • 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 irritable
How can I help my baby?
  • If feeding is difficult, try breastfeeding more often or offering smaller bottle feeds more often
  • If your baby has a temperature, you can give them paracetamol (such as Calpol).  You must follow the instructions that come with the paracetamol carefully.  If you are not sure, ask your community pharmacist if paracetamol is suitable for your baby, and what dose you should give
  • If your baby is already taking any medicines or inhalers, you should carry on using these.  If you find it difficult to get your baby to take them, ask your doctor for advice
  • Bronchiolitis is caused by a virus so antibiotics won’t help
  • Make sure your baby is not exposed to tobacco smoke. Passive smoking can seriously damage your baby’s health.  It makes breathing problems like bronchiolitis worse

If you would like help to give up smoking you can get information / advice from your local pharmacist, GP surgery or by calling the Quit Your Way Scotland helpline on 0800 84 84 84 Mon-Fri 0800-2200 and Sat-Sun 0900-1700.

How long does bronchiolitis last?
  • Most children with bronchiolitis will seem to worsen during the first 1-3 days of the illness before beginning to improve over the next two weeks. The cough may go on for a few more weeks. Antibiotics are not required
  • Your child can go back to nursery or day care as soon as he or she is well enough (that is feeding normally and with no difficulty in breathing)
  • There is usually no need to see your doctor if your child is recovering well. But if you are worried about your child’s progress discuss this with your doctor or Health Visitor

The chart above show how long bronchiolitis lasts in children. The faces represent 10 children who have bronchiolitis. Green faces are those children who have recovered within that time period.
Diagram taken from www.whenshouldiworry.com

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 - too breathless to feed
  • Becomes pale, mottled and feels abnormally cold to touch
  • Becomes extremely agitated, confused or very lethargic (difficult to wake)
  • Is under 1 month of age with a temperature of 38°C / 100.4°F 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 they are working hard to breath – drawing in of the muscles below their lower ribs, at their neck or between their ribs (recession).
  • Seems dehydrated (sunken eyes, drowsy or not passed urine for more than 12 hours)
  • Is becoming drowsy (excessively sleepy)
  • Is between 1-3 months of age with a temperature of 38°C / 100°F or above; or 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations).
  • Seems to be getting worse or if you are worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

 

If none of the features in the red or amber boxes above are present.

Self care

Continue providing your child’s care at home. If you are still concerned about your child, contact your GP or call NHS 111 – dial 111

Content adapted with permission from the what0-18.nhs.uk resource produced by the Healthier Together initiative