Symptoms

Bronchiolitis usually begins with symptoms that are very like a normal cold, such as cough and runny nose. Over the next few days, these symptoms develop. Bronchiolitis typically causes a slight fever along with a persistent, dry cough. Your child's breathing may become faster than normal and you might be able to hear a wheezing sound. Young babies can also have difficulty breathing and trouble feeding when they have bronchiolitis. In most cases the symptoms are fairly mild and improve in about two to three weeks.

Complications

In some cases, the symptoms can be more serious. A small number of babies who develop bronchiolitis will experience severe breathing difficulties, which may require treatment in hospital. Other potential complications include dehydration and in rare cases, secondary infections such as pneumonia. Serious symptoms are more common when the infection occurs in very young babies, in babies who were born prematurely with underdeveloped lungs, and in young children who have a heart or lung condition.

Causes

Bronchiolitis is caused by a number of different respiratory viruses. The commonest is called respiratory syncytial virus (RSV) that most of us are exposed to in early childhood. Like other viruses, RSV spreads in coughs and sneezes and is most easily caught in the winter months. When a child who lacks immunity to the virus is infected, it can cause inflammation in the smallest airways that supply the lungs. Since these tubes are called bronchioles, the infection is known as bronchiolitis. The inflamed bronchioles swell up, which makes them narrower, preventing air from moving as easily in and out of the lungs. This causes the coughing and breathing difficulties that are characteristic of bronchiolitis. Unfortunately, as with the common cold, there are different strains of RSV. This means that a child can be infected by RSV more than once and other viruses can also cause bronchiolitis. However, older children and adults rarely develop bronchiolitis even when they are exposed to RSV, because their lungs and immune systems are more mature.

When to See a Doctor

Although bronchiolitis is usually a mild condition, it can sometimes cause more serious symptoms. If your child has a very severe cough, a high fever, and breathing difficulty, or the symptoms have lasted longer than a few weeks, you should seek medical advice. You should definitely see a doctor if your child is having difficulty breathing or is showing signs of dehydration, such as infrequent urination. If your baby is finding it difficult to breathe, if their breathing stops occasionally, or if you notice a blue colour around the lips or tongue, you should seek urgent medical care.

Diagnosis & Treatment

It is usually possible to diagnose bronchiolitis based on your child's symptoms and a physical examination. If the cause of the infection is confirmed as bronchiolitis, your doctor will usually be able to give you some advice on managing the symptoms at home.

Bronchiolitis can usually be treated in the same way as the flu. You should make sure that your child is drinking plenty of fluids. You might want to use infant paracetamol or ibuprofen to relieve the symptoms and bring the fever down if your child is distressed. Keeping your child in an upright position can help, but be careful not to leave a very young baby alone or in an upright position for too long. Using an air humidifier can also help to soothe the symptoms of bronchiolitis, as air that is too dry can be more irritating to the airways.

If your child has bronchiolitis, it is important to take precautions to prevent the infection from spreading further, particularly to other young children or babies who are at risk of developing this condition if they catch RSV. You should make sure that you are washing your own hands and your child's hands frequently. Toys and surfaces also need to be washed often to get rid of any germs. It is also best to keep infected children at home until the symptoms clear up.

In some cases, bronchiolitis will need to be treated in hospital. If your child is experiencing breathing problems or other severe symptoms, your doctor may want to admit them for treatment. Your baby may need a face mask or nasal tube to ensure that he or she is getting enough oxygen. The hospital will also be able to provide nutrition through a feeding tube or IV if your baby is having trouble feeding. Most children who are admitted into hospital with bronchiolitis will be able to go home in a few days, once their condition has improved.

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