Bronchiectasis (Bx) information for schools

Bronchiectasis (Bx) information for schools

School is an important part of life for a child with bronchiectasis.

Key points to remember

  • school is an important part of life for a child with bronchiectasis (Bx)
  • don't discourage coughing - it is vital to get rid of the mucus
  • encourage involvement in sports

What is bronchiectasis?

Bx is not contagious - a child with Bx can't pass it on to other children.

Bx is a chest disease - the airways in the lungs have become damaged and scarred.

The airways (or breathing tubes) become widened and mucus can be trapped in pockets within the airway. Having extra mucus in the airways means bacteria and viruses can grow quickly and cause new or long-lasting (chronic) infection.

These infections cause damage and more scarring to the airways and lungs. Once this has happened, the scarring is usually lifelong. However, with good treatment, there can be some improvement and further damage prevented. Good treatment is expecially important in young children because their lungs are still growing. 

What causes bronchiectasis?

Common causes

Most children get Bx after having a very bad chest infection or repeated chest infections. Bx usually develops after:

  • a severe bronchiolitis or pneumonia requiring hospitalisation
  • chest infections which need repeated antibiotic treatment at home
  • a wet sounding cough which lasts for weeks or recurs frequently

Less common causes

Problems with fighting off infection. Some children cannot fight infection very well because they are born with a problem in their infection-fighting (immune) system.

Medications. Some medications (such as oral steroids) cause difficulty in fighting off infection.

Objects stuck in the airway. If a child breathes in a nut or a piece of a toy and this gets stuck in the airway, it can cause a blockage that can lead to scarring.

Food or liquid going into the lungs (aspiration). Children who sometiumes cough or choke when feeding have problems controlling their swallow. Food can end up in their lungs. This can also happen if food refluxes from the stomach and ends up going into the lungs. Over time this can cause Bx.

Primary ciliary dyskinesia. In this condition, the tiny mucus-clearing hairs (cilia) in the lungs are not working properly. 

What are the signs and symptoms?

Children with Bx feel well most of the time.

Wet-sounding cough

A wet-sounding cough is the main symptom. This usually lasts for weeks. Extra mucus (phlegm or sputum) in the airways is the cause.

This cough can get worse during infections, first thing in the morning and during exercise. Remember though that playing sport is helpful for keeping well.

How do children with bronchiectasis keep well?

Things that will help a child with Bx stay well:

  • doing their physiotherapy regularly to keep their lungs clear
  • exercising regularly
  • eating a healthy balanced diet
  • avoiding tobacco smoke, especially in a house or car
  • never smoking themselves
  • having their flu vaccine each year
  • visiting their family doctor as soon as they are sick
  • regular hospital clinic reviews for assessment and update of their treatment

How to tell if a child with bronchiectasis is sick

They may:

  • cough more
  • have a cough which becomes more more mucousy or wet sounding
  • have more mucus (phlegm or sputum) which may be a different colour than normal
  • have a temperature
  • breathe fast
  • look unwell
  • be unable to take part in sport

If a child has any combination of the above signs or symptoms then they do need to see their own family doctor for assessment and/or treatment.

Dial 111 within New Zealand (use the appropriate emergency number in other countries) and ask for urgent medical help if a child with Bx becomes suddenly unwell, and is having difficulty talking because they are short of breath or they have blue lips or tongue.

School and bronchiectasis

Exercise will help a child with Bx - it doesn't matter if they cough.

School is an important part of life for a child with Bx. Teachers can make a significant difference. 

  • don't discourage coughing –  it is vital to get rid of the mucus –  let them leave the room for this if they want
  • be aware of the child's need to take medication
  • encourage involvement in sports

Remember:

  • a child with Bx can attend school camps and trips
  • the regional hospital schools have visiting teachers who can help if a child is in hospital

Communication and privacy

Some children, especially teenagers, do not want their friends to know they are unwell. It can help to have clear communication with the student and family - so you are aware of any changing needs and can provide work in absences.

The Paediatric Society of New Zealand acknowledges the cooperation of the Starship Respiratory Service at Starship Children's Health and the Paediatric Department, University of Auckland in making this content available to patients and families.

This page last reviewed 22 May 2017.
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