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Bronchiolitis
Bronchiolitis is an infection of the small airways of the lungs known as bronchioles. It;
- Usually affects babies
- Is usually caused by respiratory syncytial virus
- Most get better within about two weeks
- The cough can persist for up to 6 weeks
What is Respiratory Syncytial Virus (RSV)?
Respiratory syncytial virus, known as RSV, is the most common cause of bronchiolitis. Almost all children will have had an infection caused by RSV by the time they are two years old. It is most common in the winter months. Usually it only causes mild ‘cold-like’ symptoms. Some children, especially very young ones, can have more severe symptoms and may need treatment in hospital. Sometimes other viruses can cause bronchiolitis.
Symptoms of Bronchiolitis
- Runny nose
- Coughing
- Fever
- Wheezing
- Difficulty breathing
- Difficulty feeding
How long does bronchiolitis last?
Most children with bronchiolitis will seem to worsen during the first 1 to 3 days of illness before beginning to improve over the next few weeks. There is no specific treatment for bronchiolitis, and most children manage with supportive care. The cough may go on for a few weeks or more; this is usually longer than most common coughs and colds. Your child can go back to nursery as soon as they are well enough (feeding normally and with no breathing difficulties). There is usually no need to see your doctor if your child is recovering well. If you are worried about your child’s progress, seek medical advice.
If your child
- has blue lips
- or is unresponsive or very irritable
- is struggling to breathe, such as;
- pulling in of the chest or neck muscles
- using tummy muscles
- or has unusually long pauses in breathing
- or has an irregular breathing pattern
- or is unable to swallow or is drooling
- is too breathless to feed or speak
- is unable to take fluids
- is pale, drowsy, weak or quiet
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any one of these features
- Appears to be getting worse or you are worried
- Restless or irritable
- Increased difficulty in breathing such as;
- Rapid breathing
- Taking more effort to breathe
- Flaring of nostrils
- Becoming unusually pale
- Temperature of 39°C despite paracetamol and/or ibuprofen
- Reduced fluid intake by half usual amount
- Passed urine less than twice in 12 hours
- Vomiting
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If none of the features in the red or amber boxes above are present
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
Caring for your child at home
If your child does not have any red or amber symptoms in the traffic light advice then you can care for your child at home. If your child is already taking medicines or inhalers, you should carry on using these. Bronchiolitis is caused by a virus, antibiotics will not help.
Pain or distress
If your child is in pain or distressed and over 3 months old, you can give them liquid paracetamol or ibuprofen. At home, we do not recommend giving paracetamol and ibuprofen at the same time.If your child has not improved after two to three hours you may want to give them the other medicine. Never exceed the dose on the packaging.
Hydration
If your child is not feeding as normal, offer smaller feeds more frequently. If your child is breastfed, continue to feed on demand.
Make sure your child is never exposed to tobacco smoke.
Passive smoking can seriously damage children’s health. It can make breathing problems like bronchiolitis worse. Remember, smoke remains on your clothes when you smoke anywhere, including outside. More information is available to help you stop smoking.
Key points to remember
- Most babies and children get better within about two weeks.
- The cough can persist for up to 6 weeks
- Bronchiolitis is caused by a virus, so antibiotics will not help
- Your child may need to take smaller feeds more often
- Speak to your doctor if your child has difficulty with breathing or feeding
Tips to prevent RSV
Since there is no treatment specific for RSV disease, prevention is critical.
All parents should:
- Avoid close contact with unwell people
- Keep your baby’s toys, clothes and bedding clean
- Wash your hands
For wear and tear, minor trips and everything in between.
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.