Bronchiolitis is a viral infection of the lower respiratory tract, which causes inflammation and mucous blockage of the smallest airways in the lungs. It is often caused by Respiratory Syncytial Virus (RSV) and other ‘flu’ like viruses and is spread by droplet infection. Bronchiolitis can make your baby cough and have breathing difficulties. It commonly affects babies and children under 2 years, but is more prevalent between age 3 and 6 months.
Bronchiolitis starts with symptoms similar to a common cold including cough, runny nose and slight fever. Symptoms usually improve after 3 days and are generally mild. But in some cases it can cause more severe symptoms, which can worsen by the 3rd day, these include difficulty in breathing, problems feeding and vomiting after feeds, which can lead to dehydration.
Is it common?
Bronchiolitis is most common in babies aged 3 to 6 months. By age 2, nearly all infants would have had at least 1 infection, often only suffering mild symptoms. It normally occurs over the winter months, in temperate countries, but in Singapore it can occur at any time of the year.
As bronchiolitis is a viral infection there is no specific treatment, but there are some medicines that you can give your baby to help relieve their symptoms, including normal saline nose drops to help improve the congestion. Paracetamol can also be administered for management of fever.
It is important that your child be given regular fluids so that he or she does not become dehydrated. If your child has any breathing difficulties, giving fluids often and in little amounts is advised. Checking that your child is passing a good amount of urine as a mark of their hydration status.
Try to position your baby upright by propping up the mattress. For an older child, giving an extra pillow can make the breathing easier as the upright position helps to open up the airways.
Keeping your child away from irritating fumes such as cigarette smoke will prevent further breathing difficulties. Approximately 3% of babies need admission to hospital if their breathing difficulties are severe, not taking enough feed or they are not getting enough oxygen in their blood.
When to seek advice
Contact your doctor if you are concerned your child:
- Is struggling to breathe, coughing, wheezing
- Is having difficulty feeding, or is becoming dehydrated
- Is more sleepy / lethargic than usual
- Is pale or sweaty
- Has a change in skin colour, (example; looks blue or mottled) particularly the lips and the fingernails
- Has no wet nappy for over 12 hours, or passing small amounts of concentrated (dark yellow) urine
- Is breathing very rapidly
Long term effects
Bronchiolitis is a virus so symptoms should start to improve after day 3 and fully resolve after 2 weeks if mild. Bronchiolitis can cause inflammatory damage to the airways, which may last several weeks. 20% of babies remain wheezy for a prolonged period or have a cough lasting for a few weeks. There is no evidence to show a link to developing asthma when older.
Further reading: www.nhsdirect.nhs.uk www.rch.org.au www.mayoclinic.com