Bronchiolitis

This is for anyone looking after a baby or child with bronchiolitis.

What is bronchiolitis?

Bronchiolitis is an infection of the smallest breathing airways (bronchioles) in the lungs.

It is caused by an infection (a virus) which causes the airways to become swollen and full of mucous. This can lead to breathing difficulties. As with many infections, it can easily spread from child to child.

Who gets bronchiolitis?

Bronchiolitis affects babies and children aged 0 to 2 years. It affects about 1 in 3 babies less than 1 year old.

It is usually mild and gets better without treatment, but some babies develop more serious symptoms. About 3 in 100 cases need admission to hospital.

Babies at risk of developing more serious symptoms include

• newborn babies and premature babies
• infants who already have heart, lung or immune conditions
• children with Down’s Syndrome.

What are the symptoms?

Symptoms vary but they can include one or more of the following:

• cold symptoms: runny nose, cough, mild fever
• rasping and persistent dry cough
• noisy breathing (wheezing)
• fast breathing, difficulty breathing
• your baby may feed less, vomit after feeding and have fewer wet nappies.

Bronchiolitis usually starts as a cold. Breathing problems and a cough develop 2 to 3 days later (although your baby may not experience breathing or feeding difficulties).

How long does bronchiolitis last?

Bronchiolitis usually lasts for 1 to 2 weeks, but the cough can last for 3 weeks. Symptoms tend to be worse between 3 to 5 days from the start of the illness and then gradually improve.

What treatment is available?

Bronchiolitis is self-limiting. This means the body’s immune system fights the infection and it gets better on its own. There is no medicine to kill the virus and antibiotics are not effective.

In more serious cases your baby may be admitted to hospital for the following treatments:

• oxygen
• nasogastric tube feeds. This means a tube is passed into your baby’s nostril and down into their stomach so they can be given milk feeds without their having to make an effort.
• a small number of babies need to be transferred to Paediatric Intensive Care where specialist machines can help with their breathing.

What can I do if I think my baby has bronchiolitis?

Contact your GP or call NHS 111 if you are worried or your baby is experiencing any of the following:

• they are not feeding normally (they have taken less than half their usual amount during the last 2 or 3 feeds)
• they are less than 3 months old and have a temperature of 38 degrees C or above
• they have not had a wet nappy for 12 hours or more
• they are breathing faster than usual
• they have a persistent temperature of 38 degrees C or above (regardless of their age)
• they seem tired or irritable (difficult to comfort).

Call 999 immediately if you notice any of the following

• your baby is struggling to breathe. They may grunt or pull in their chest muscles when they breathe (breath with their tummies or use a seesaw pattern of breathing).
• your baby is having regular short pauses in their breathing
• your baby’s skin on the inside of their lips or under their tongue turns blue
• you are unable to wake your baby, or if woken they do not stay awake.

What can I do to help my baby if they are well enough to stay at home?

If your baby is well enough to be looked after at home you can do the following.

How can I reduce the spread of bronchiolitis?

Bronchiolitis is highly infectious, so avoid contact with other babies, especially those who are at risk of becoming seriously unwell. You can also do the following.

More information

NHS information on bronchiolitis www.nhs.uk/conditions/Bronchiolitis/

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Contacts

Your GP or NHS111
Paediatric Emergency Department (part of your nearest A&E)