Bronchiolitis

Bronchiolitis

Bronchiolitis is a chest condition that causes breathing problems in babies. It's catching so wash your hands before and after handling baby.

Key points to remember

  • bronchiolitis is a common illness affecting the lungs that causes breathing problems in babies
  • bronchiolitis is catching (contagious) so wash your hands before and after handling baby
  • breastfeeding and a smoke-free environment give the best protection against bronchiolitis
  • bronchiolitis is usually a mild illness
  • babies with bronchiolitis can usually stay at home
  • some sicker babies need to go to hospital
  • there is no specific medicine for bronchiolitis
  • if your baby with bronchiolitis is under 3 months old, you should always see a doctor

What is it?

Bronchiolitis is a common illness. A virus is usually the cause. There are many types of viruses that can cause the illness. The most common are RSV (respiratory syncytial virus) and rhinovirus.

Bronchiolitis affects the smallest airways (called bronchioles) throughout the lungs.

Is it catching?

Yes, bronchiolitis is very easy to catch - it can spread easily between children or from adults to children. 

It is most common in winter and spring.

What puts my child at risk of getting it?

  • bronchiolitis usually affects babies in their first year of life
  • it commonly occurs between 3 and 6 months of age
  • babies who were born prematurely are more at risk of severe bronchiolitis
  • babies who already have heart or lung disease are at high risk of severe bronchiolitis
  • babies who are around people who smoke are more likely to get bronchiolitis

What are the signs and symptoms?

Bronchiolitis can start as a cold, with a runny nose.

Babies with bronchiolitis:

  • may have a fever
  • start to cough
  • breathe fast
  • put a lot of extra effort into breathing
  • have noisy breathing (wheeze)

The second or third day of the chesty part of the illness is usually the worst.

Bronchiolitis can last for several days. The cough often lasts for 10 to 14 days but it may last as long as a month.

When should I seek help?

When do I need to see a doctor?

You should see your family doctor or go to an after hours medical centre urgently if your baby:

  • is under 3 months old
  • is breathing fast, has noisy breathing and is having to use extra effort to breathe
  • looks pale and unwell
  • is taking less than half of their normal feeds
  • is vomiting
  • has not wet a nappy for 6 hours

You should also see a doctor if you are worried about your baby.

Even if you've already seen your doctor, if your baby's breathing gets worse or you are worried, take your baby back for checking.

Even if you've already seen your doctor, if your baby's breathing difficulties get worse or you are worried, take your baby back for checking.

When should I dial 111?

Dial 111 within New Zealand (use the appropriate emergency number in other countries) and ask for urgent medical help if your child:

  • has blue lips and tongue
  • has severe difficulty breathing
  • is becoming very sleepy and not easy to wake up
  • is very pale
  • is floppy
  • has periods of irregular breathing or pauses in breathing

What is the treatment?

Most babies get better by themselves

Most babies with bronchiolitis get better by themselves without any special medical treatment.

  • a virus causes bronchiolitis so antibiotics do not help or cure it
  • asthma puffers or inhalers don't help babies with bronchiolitis
  • using blue reliever asthma puffers or inhalers in babies less than 6 months of age may make their breathing worse
  • steroid medicine by mouth or inhaler does not help babies with bronchiolitis 
  • in babies over 12 months of age, it may be hard to tell if the problem is bronchiolitis or asthma - your doctor may try asthma puffers or inhalers

Babies with more serious illness may need to go to hospital

Babies with more serious bronchiolitis may need to go to hospital. Sometimes babies need help with their breathing. This might include extra oxygen through nasal prongs (small soft plastic tubes) that fit into your child's nose.

If your baby is not drinking enough, they may need feeding through a nasogastric tube (a tube through the nose or mouth into the stomach) or fluid through an intravenous drip (into a vein)

Can I care for my child at home?

Babies who can stay at home

  • babies who are feeding well
  • babies who do not look sick
  • babies are not working too hard with their breathing

Suggestions for looking after your baby

Remember to sleep baby on their back in their own bed and don't prop them up with pillows or blankets.

  • babies with bronchiolitis may not be able to feed for as long as usual - offer smaller amounts of breast milk or infant formula more frequently
  • keep your baby warm but not too hot
  • give your baby as much rest as possible
  • don't smoke in the house or around your baby
  • keep your baby's nose clear - if it is blocked or crusty you can use saline nose drops (from a pharmacy)
  • keep your baby away from other children to stop bronchiolitis spreading
  • if your baby is miserable and upset, you can give paracetamol. (You must follow the dosage instructions on the bottle. It is dangerous to give more than the recommended dose)​

How can I prevent my child getting bronchiolitis?

Babies who are breast fed and those who live in smoke-free environments are less likely to get bronchiolitis.

Breastfeeding

Breastfeeding your baby protects them from getting bronchiolitis by boosting their infection-fighting (immune) system. Breastfeeding beyond 4 months of age offers the best protection.

Smoke-free environment

Make sure your child's environment is smoke free. If you want to give up smoking:

  • call the Quitline on 0800 778 778
  • check out the website Quitline
  • ask your health professional

A warm house

Keeping the house warm and well insulated will also decrease your baby's risk of developing bronchiolitis.

Stay away from people with coughs and colds

It is sensible to keep young babies away from people who have colds and coughs.

Clean hands

Make sure everyone in your family washes their hands regularly and thoroughly and dries them well, including (but not only) before preparing food and eating. This can reduce the spread of infection.

Will my child get asthma?

It is difficult to diagnose asthma with certainty until a child is over 1 year of age. Most babies who start wheezing in the first 2 years of life do not go on to have asthma.

  1. Starship Children's Health clinicians. June 2010. Starship Children's Health clinical guideline: Bronchiolitis. Auckland: Starship Children's Health. https://www.starship.org.nz/for-health-professionals/starship-clinical-guidelines/b/bronchiolitis/ [Accessed 19/1/2017]
  2. Paediatric Society of New Zealand. 2005. Best practice evidence based guideline: Wheeze and chest infection in infants under 1 year. Paediatric Society of New Zealand. http://www.paediatrics.org.nz/files/guidelines/Wheezeendorsed.pdf [Accessed 19/1/2017]
  3. PREDICT: Paediatric Research in Emergency Departments International Collaborative. 2016. Australasian bronchiolitis guideline. http://www.predict.org.au/publications/2016-pubs/ [Accessed 11/04/2017]

This page last reviewed 11 April 2017.
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