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Bronchiolitis

Dr Roger Henderson
Reviewed by Dr Roger HendersonReviewed on 13.10.2023 | 3 minutes read
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Bronchiolitis is a very common lung infection that happens in young children, typically those under 2 years old, and is caused by a virus. The bronchioles are small airways in the lungs, branching off the two main bronchi, and the ‘itis’ part of bronchiolitis means inflammation, so bronchiolitis is inflammation and congestion of these small airways. 

Symptoms of bronchiolitis start off similarly to a cold with a blocked and runny nose, cough, and possibly fever. Children can also sound quite wheezy. 

Bronchiolitis is most commonly caused by a virus called RSV (respiratory syncytial virus) during the winter months and often it gets better by itself. In about 20% of cases of all ages, hospital admission may be required and it’s thought that up to 1 in 3 young children get bronchiolitis at some time.

Doctor’s advice

Is my child at risk of bronchiolitis?

Children younger than 12 weeks are most at risk because their immune system is still developing. Other risk factors include babies who are born early or have an underlying condition of the heart or lung. Children who are exposed to smoke are also at risk, but breastfeeding for more than 2 months is protective against bronchiolitis.

How does the infection spread?

Viruses spread through respiratory droplets that can be passed from one person to another through coughing, sneezing, or touching contaminated surfaces. The virus then enters through the mouth or nose and travels into the breathing system causing the bronchioles to become inflamed and overproduce mucus leading to congestion and blockage. Bronchiolitis typically lasts two to three weeks and a child can remain infected up to three weeks later.

What are the symptoms of bronchiolitis?

The usual early symptoms are of a cold, such as a fever, cough and runny nose. Over a day or two, the cough usually worsens, and the breathing may become wheezy or noisy. There may be difficulty in feeding, along with a fast heart rate.

The wheezing typically lasts for up to three days, then starts to settle, and as it does so, the child starts to improve, although the cough may last three or four weeks.

When should I see my doctor?

Contact your doctor straight away if:

  • your child is having difficulty breathing
  • their breathing becomes fast, laboured or very noisy
  • their breathing causes them difficulty with eating or drinking
  • they’re drinking less than half of what they usually drink
  • their temperature isn’t improving with paracetamol or ibuprofen
  • they become drowsy, or you notice a blue tinge around their lips or fingernails (seek immediate medical attention for this).

How is it treated?

Bronchiolitis often gets better on its own without any treatment and typically lasts two to three weeks. Bronchiolitis is often caused by a virus and therefore antibiotics don't help, they only fight off a bacterial infection. 

There are some really simple home treatments that can be done that can be very effective. Ensuring your child drinks plenty of fluid is really essential to ensuring to avoid dehydration - they need more fluids on board when they're fighting an infection, if they have a fever or if it's hot weather.

If your child is quite congested, then using a humidifier will help moisten the airways and improve coughing symptoms. Using saline nasal drops can also be effective and safe. Keeping children upright as much as possible is beneficial.

If symptoms become severe then your child may need to attend the hospital for oxygen and fluid intake support. Oxygen is delivered via a mask and fluid is given through a vein. In extreme cases, they may need artificial help with their breathing. 

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Dr Roger Henderson
Reviewed by Dr Roger Henderson
Reviewed on 13.10.2023
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