Key points to remember

• bronchiolitis is a chest condition that causes breathing problems in babies
• bronchiolitis is contagious (catching) so wash your hands before and after handling baby
• breast feeding and a smoke-free environment give the best protection against bronchiolitis
• keep baby warm and comfortable and offer small and frequent feeds
• bronchiolitis is usually a mild illness that can be treated at home
• some sicker babies need to be admitted to hospital
• there is no specific medicine for uncomplicated bronchiolitis

See a doctor urgently if your child:

• has difficulty breathing
• is taking less than half of normal feeds
• is getting worse

Dial 111 and ask for urgent medical help if your baby:

• looks very pale
• is very sleepy or floppy
• has periods of stopping breathing
• is blue in the tongue and lips

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What is it?

Bronchiolitis is a common illness caused by a respiratory infection. It affects the smallest airways or breathing tubes (called bronchioles) throughout the lungs.

• it usually occurs in babies in their first year of life
• it most commonly occurs between three and six months of age
• it is usually a mild illness but some babies are sicker and need to be admitted to hospital
• babies who were born prematurely are more at risk of severe bronchiolitis than full-term babies
• babies with heart or lung disease are at high risk of severe bronchiolitis

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What causes it?

Bronchiolitis is usually caused by a viral infection. Many viruses can cause the illness. The most common is RSV (respiratory syncytial virus). 

 

Bronchiolitis is very contagious. It is most common in winter and spring.

 

Spread of infection can be reduced by careful washing and drying of hands.

 

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

 

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

 

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What are the signs and symptoms?

Bronchiolitis can start as a cold, with a runny nose. The baby may have a fever for two to three days and then begin to cough, breathe fast and 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. Cough often continues for ten to 14 days but it may last as long as a month.

 

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When should I seek help?

You should see your GP (general practitioner) or go to an after-hours medical centre urgently if your baby:

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

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

 

Dial 111 and ask for urgent medical help if your child:

• has blue lips and tongue
• has severe difficulty breathing
• is becoming less responsive
• is pale
• is floppy
• has periods of stopping breathing

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What will my doctor do?

Your doctor will:

• ask you about baby’s symptoms
• listen to your baby’s breathing
• check that your baby is drinking enough
• may ask you to bring your baby back again in 24 hours as the symptoms may get worse over the first few days
• may refer you to hospital if your baby needs to be given oxygen or fluids

In very young babies, less than two months old, it can be hard to tell the difference between bronchiolitis and pneumonia so your doctor may refer your baby to hospital.

 

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How is it diagnosed?

Bronchiolitis is usually diagnosed from the description of symptoms that you give the doctor. An examination of your baby is important too.

 

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What treatment is required?

You can look after your baby at home if they:

• are feeding well
• do not look sick
• are not having problems with breathing

Most babies with bronchiolitis can be managed well at home. However, some children do need to be admitted to hospital. 

 

Babies with moderate to severe illness may require supportive treatment. Bronchiolitis affects your baby’s breathing. Sometimes this makes it hard for them to get enough oxygen. Signs of not getting enough oxygen may include any of the following:

• looking very pale
• going blue in the tongue and lips
• becoming very sleepy and not easy to rouse

If your child has any of these signs, they will need to be given extra oxygen in hospital. This is usually given through nasal prongs (small soft plastic tubes) that fit into your child’s nose and carry a flow of oxygen.

 

If your baby is not drinking enough they may need to be given fluid by an intravenous drip (into a vein) or by nasogastric feeding (feeding via a tube that is passed through the nose or mouth into the stomach).

 

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

• bronchiolitis is caused by a virus – so antibiotics do not help or cure it
• asthma medicines are not effective in bronchiolitis – using these medicines in babies less than six months of age may make their breathing worse

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How can I care for my child at home?

• offer small feeds of breast milk or infant formula regularly
• 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 so as not to spread the disease

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Will my child get asthma?

It is difficult to diagnose asthma with certainty until a child is over one year of age. Eight out of every ten babies who start wheezing in the first two years of life do not go on to have asthma.

 

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Endorsement

This fact sheet was endorsed by PSNZ - 30/08/2007

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Fact sheets are subject to copyright. In the interests of information sharing they may be copied but acknowledgement must be given to PSNZ and Starship Foundation.
© The Paediatric Society of New Zealand and Starship Foundation 2005 - 2010

The Paediatric Society of New Zealand http://www.paediatrics.org.nz

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