Bronchiolitis

Bronchiolitis is a chest infection that affects babies and young children under 2 years old. It's very common and usually mild, but it can sometimes be serious.

What is bronchiolitis?

Bronchiolitis happens when tiny airways in your child's lungs get swollen and blocked. This makes it harder for your child to breathe. It's different from bronchitis, which is a cough with lots of mucus that can affect people of any age.

What causes it?

A virus causes bronchiolitis. The most common one is called RSV (respiratory syncytial virus). This virus spreads very easily through coughs and sneezes. Nearly all children catch RSV at least once before they turn 2.

What are the symptoms?

At first, bronchiolitis looks like a normal cold:

• Sneezing
• Runny or blocked nose
• Cough
• Slightly high temperature (38°C)

After a few days, your child might develop:

• Faster breathing
• Finding it hard to feed or eat
• Noisy breathing or wheezing
• Being more irritable than usual

The worst symptoms usually happen between days 3 and 5. The cough can last up to 3 weeks.

When to get emergency help

Call 999 or go straight to A&E if your child:

• Has trouble breathing (you might hear grunting sounds or see their tummy sucking in under their ribs)
• Stops breathing for short periods
• Has blue skin, tongue or lips
• Is very floppy and won't wake up or stay awake

Trust your instincts - if you think your child is seriously unwell, get help immediately. Don't drive to A&E yourself - ask someone else to drive or call an ambulance.

When to speak to your GP urgently

Call 111 or ask for an urgent GP appointment if:

• Your child's cold is getting worse
• They're eating or drinking much less than normal
• They haven't had a wet nappy for 12 hours or show other signs of not having enough fluids
• Your baby is under 3 months with a temperature of 38°C, or over 3 months with a temperature of 39°C or higher
• Your child feels unusually hot or sweaty when you touch their back or chest
• Your child seems very tired or irritable

How to help your child at home

Do:

• Give children's paracetamol (for babies over 2 months) or ibuprofen (for babies over 3 months) - never give aspirin to children under 16
• Use salt water drops if their nose is blocked
• Keep your child sitting up when they're awake to help them breathe easier
• Give them plenty of fluids - smaller feeds more often for babies, extra water or diluted fruit juice for older children

Don't:

• Smoke around your child
• Try to cool them down by sponging with cold water or removing all their clothes

Preventing bronchiolitis

You can reduce the risk by:

• Washing hands regularly
• Cleaning toys and surfaces often
• Not sharing cups or cutlery
• Using tissues and throwing them away straight after use
• Keeping newborn babies away from anyone with a cold, especially if they were born early or have health problems

Never smoke around children - this increases their risk of getting bronchiolitis.

RSV vaccination

Pregnant women can get the RSV vaccine from 28 weeks to protect their baby in the first few months of life. Speak to your GP about this.

Most children recover from bronchiolitis at home within a few weeks. However, always seek medical advice if you're worried about your child's symptoms.

Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.