Bronchiolitis in Children
What is bronchiolitis in children?
Bronchiolitis is an infection of
the lungs. It’s when your child has swelling in the smaller airways (bronchioles) of the
lung. This swelling blocks air in the smaller airways.
Bronchiolitis usually happens in the winter and early spring. It most often affects children younger than 2 years old.
What causes bronchiolitis in a child?
The most common cause of bronchiolitis is a virus. At first, the virus causes an infection in the upper respiratory tract. This includes the nose, mouth, and throat. It then spreads downward into the windpipe (trachea) and lungs (lower respiratory tract). The virus causes inflammation and even death of the cells inside the respiratory tract. This blocks airflow in and out of the child’s lungs.
Bronchiolitis is most often caused by the respiratory syncytial virus (RSV). But these other viruses can also cause it:
- Parainfluenza virus
- Human metapneumovirus
In rare cases, bronchiolitis may be
caused by bacteria.
Which children are at risk for bronchiolitis?
All young children are at risk for bronchiolitis. The illness can spread easily through droplets in the air from coughing, sneezing, and talking. But some children have a higher chance of developing it. These are children who:
- Were born too early (premature)
- Have been exposed to tobacco
- Go to daycare
- Have other serious health conditions
- Have older children in the home
- Are not breastfed
What are the symptoms of bronchiolitis in a child?
Bronchiolitis may at first be mistaken for a common cold. It starts out with many of the same symptoms. But your child may have a cough and other breathing problems that get worse over time. Below are the most common symptoms of bronchiolitis:
- Runny nose
- Fast or hard breathing
- Loss of appetite
These symptoms often last about a
week. They may look like other health problems. Make sure your child sees his or her
healthcare provider for a diagnosis.
How is bronchiolitis diagnosed in a child?
Your child’s healthcare provider can diagnose bronchiolitis with a health history and physical exam of your child. In some cases, your child may need tests to rule out other diseases, such as pneumonia or asthma. These tests include:
- Chest X-rays. This test makes images of internal tissues, bones, and organs.
- Blood tests or blood gases. A blood test may help see if the infection is caused by a virus or bacteria.
- Pulse oximetry. An oximeter is a small machine that measures the amount of oxygen in the blood. To get this measurement, the healthcare provider puts a small sensor (like a bandage) on your child's finger or toe. When the machine is on, a small red light can be seen in the sensor. The sensor is painless and the red light does not get hot.
- Swab of the nose and throat (nasopharyngeal swab). This test can quickly spot RSV and other viruses.
How is bronchiolitis treated in a child?
Treatment will depend on your
child’s symptoms, age, and general health. It will also depend on how severe the
Most cases are mild and can be
treated at home. There is no cure for the illness. So the goal of treatment is to ease
symptoms. Antibiotics are not used unless your child has a bacterial infection.
Some babies with severe breathing
problems are treated in the hospital. While they are in the hospital, treatment may
- IV (intravenous) fluids if your child
can't drink well
- Extra oxygen and a breathing machine
(ventilator) to help with breathing
- Frequent suctioning of your child’s
nose and mouth to help get rid of thick mucus
- Breathing treatments, as ordered by
your child’s healthcare provider
If your child is at home, the
following treatment may be helpful:
- Drinking lots of fluids
- Suctioning your child’s nose and mouth
with a bulb syringe to help get rid of thick mucus, especially before feedings
- Raising your child’s head while
sleeping. Don’t use pillows with babies.
- Giving acetaminophen for fever, if
- Use a cool-mist vaporizer in your
child's room at night
Don’t give aspirin or medicine that contains aspirin to a child
younger than age 19 unless directed by your child’s provider. Taking aspirin can put
your child at risk for Reye syndrome. This is a rare but very serious disorder. It most
often affects the brain and the liver.
What are possible complications of bronchiolitis?
Most children who have bronchiolitis will get well without any problems. But those born early or who have other health problems are more likely to have complications from the condition. These may include:
- Pauses in breathing (apnea)
- Breathing failure
How can I help prevent bronchiolitis in my child?
You can help prevent the spread of bronchiolitis. Wash your hands or use an alcohol-based hand cleaner before and after touching your child. While your child has symptoms, keep him or her away from other children.
Your child may also need a
palivizumab shot. During RSV season, these shots are recommended for high-risk babies.
High-risk babies include those born early or those with lung, heart, or immune system
diseases. Talk with your child’s healthcare provider to see if the shot is right for
When should I call my child’s healthcare provider?
Call if your child:
- Has trouble breathing
- Turns blue in color, especially the lips and fingertips
- Is breathing very fast
Call your child’s healthcare
provider right away if your child’s symptoms get worse, or if he or she:
- Can't keep liquids down
- Is not eating or drinking
Key points about bronchiolitis in children
- Bronchiolitis is an infection of the airways in the lungs.
- It’s often caused by a virus, often
the respiratory syncytial virus (RSV).
- The first symptoms may look like a common cold. But a child develops a cough, wheezing, and breathing problems.
- Most cases are mild and can be treated at home. Children with severe breathing problems are often treated in the hospital.
- Bronchiolitis can be prevented with
proper handwashing. Your child may get a palivizumab shot if he or she is at high
risk for an RSV infection.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.