Bronchiolitis and your baby

What is bronchiolitis?

Bronchiolitis is a very common infection that affects the lower respiratory tract and causes the bronchioles (very small airways) to become inflamed in babies and young children. It is estimated that a third of babies in the UK develop bronchiolitis before the age of 12 months and the condition most commonly affects babies between 3 and 6 months old.

Most babies develop bronchiolitis in the winter months and some may develop the infection more than once in one winter season.

What causes bronchiolitis?

Most cases of bronchiolitis are caused by a virus known as the respiratory syncytial virus (RSV). RSV is a very common virus and almost all children will have been infected by RSV by the time they reach the age of 2 years old. RSV usually causes coughs and colds in older children and adults but it tends to cause bronchiolitis in small children.

Other types of virus can also cause bronchiolitis.

These include:

• Influenza virus (more commonly known as flu).
• Parainfluenza virus.
• Rhinovirus.
• Adenovirus.
• Viral infections spread through droplets, which are released when you cough or sneeze.

Droplets can be inhaled or caught by coming into contact with a surface or object, and as RSV can survive for up to 6 hours outside the body, infections can be spread very easily. Bronchiolitis is a very common infection and is usually mild. Any child could develop bronchiolitis but there are some risk factors, which make children more prone to the infection.

These include:

• Being under the age of 12 months.
• Being born prematurely (this is classed as before 37 weeks).
• Congenital heart disease.
• Not being breastfed.
• Chronic lung disease.
• Passive smoking.

Symptoms of bronchiolitis

Initially, the symptoms of bronchiolitis are very similar to the common cold and include:

• A runny nose.
• High temperature.
• Sore throat.
• Mild cough.

As the infection progresses, symptoms become more severe but usually start to improve after 3 days. Advanced symptoms include:

• A dry cough.
• Rapid breathing.
• Pauses between breaths.
• Problems with feeding.
• Vomiting after feeding.
• Being irritable and more clingy than usual.

You should contact your GP if your child has any of the advanced symptoms listed above, especially if your baby has an underlying health condition or they are under the age of 12 weeks. If your child has the early symptoms keep an eye on them and see your GP if they start to get worse. It is rare for bronchiolitis to become a severe condition, however, you should ring 999 if your child has breathing difficulties or a rapid heart rate or they stop breathing for more than 10 seconds and their skin becomes very pale.

How is bronchiolitis diagnosed?

If your child has symptoms of bronchiolitis you should see your GP, who will examine the child and talk to you about their symptoms. The doctor will also listen to the child's chest to check their breathing. Doctors can usually confirm a diagnosis without conducting any further tests, but in some cases, where it is not clear what is causing the symptoms (symptoms are similar to other conditions, including asthma and cystic fibrosis), more tests, including a chest X-ray and a mucus sample may be ordered.

Treatment for bronchiolitis

In most cases, the symptoms clear up without any treatment within two weeks. Viruses cannot be killed by medication so your doctor will not prescribe medicines, however, they will make suggestions to help your child feel more comfortable.

These include:

• Getting plenty of rest.
• Drinking plenty of fluids.
• Take paracetamol or ibuprofen (always stick to dosage guidelines and check with your pharmacist or GP if you have any queries).
• Keep an eye on your child and contact your GP if the symptoms get worse.

In rare cases (around 3%), infants can become very ill with bronchiolitis and must be treated in hospital, which occurs when they are not getting enough oxygen into their blood and cannot feed or drink properly. If your baby is having difficulty feeding they may be fed using a tube.

Preventing bronchiolitis

It is impossible to prevent viral infections but it is possible to try and prevent the spread of infections. However, if your baby has bronchiolitis, keep them at home and keep an eye on them and do not take them back to nursery or playschool until their symptoms have cleared up.

You can also reduce the risk of infection by:

• Using tissues instead of handkerchiefs.
• Throwing away tissues after use.
• Washing your hands regularly.
• Washing toys and surfaces on a regular basis.
• Asking relatives or friends who have colds and coughs to stay away until they are better, which is important with very young babies.