Bronchiolitis

Bronchiolitis is a chest infection caused by a virus. It affects the small breathing tubes in the lungs. It is common in babies under six months of age, although it can occur in babies up to 12 months. Bronchiolitis in babies can be confused with asthma, as the symptoms are often the same. However, it is a different condition and requires different treatment.

Smoking in the household increases the risk of babies getting bronchiolitis or any other respiratory illness.

Bronchiolitis usually starts as a cold

Bronchiolitis usually starts as a winter cold. After a day or so, the baby begins to cough and their breathing gets rapid and wheezy. Babies are usually sick for three to five days and the cough may last two to three weeks. Premature babies (especially those who have had breathing problems) and babies with heart disease or major birth defects are more at risk of severe bronchiolitis.

Symptoms of bronchiolitis

The symptoms include:

• Cough
• Wheeziness
• Rapid breathing
• Flaring of the nostrils
• Difficulty breathing.

Bronchiolitis can appear to be like asthma but it is a different condition. Because the airways in young babies are immature and floppy, they do not constrict as they would in a child with asthma.

Beware of dehydration

Your baby may be coughing so much and having such difficulty breathing that it is hard for them to drink. Children can quickly become dehydrated if they do not get enough to drink. Offer small amounts of fluids regularly so that your child does not get too tired when feeding and is less likely to become dehydrated.

Treatment for bronchiolitis

Medicines such as antibiotics don’t help because bronchiolitis is a viral infection. It is best treated like any other viral infection. Suggestions include:

• Make sure your baby rests as much as possible.
• Offer small amounts of fluids regularly – for example, breastfeed or give formula or water more often than usual.
• Baby paracetamol can be given if required. Make sure you follow instructions carefully as baby doses may be different to adult doses.
• Avoid smoking around your baby – in the car or house – as this will make the symptoms worse.
• If your baby is very distressed and having trouble feeding, they may need to be admitted to hospital where they can be closely observed, given oxygen and possibly fluid through a drip into the vein (intravenous therapy).

Vaporisers, humidifiers or other methods of putting steam into the air have not been shown to be helpful for babies with bronchiolitis. Treatments that work for older children with asthma usually do not help with bronchiolitis.

When to seek medical help

Bronchiolitis can make babies sick for three to five days, but the cough can last for weeks. Often the illness is mild and does not need any special treatment. You should seek medical advice if you are worried or if your baby:

• Is breathing rapidly or irregularly, or both
• Refuses food and drink
• Turns blue
• Seems tired, pale and sweaty and is very irritable.

Bronchiolitis can be passed on to others

Bronchiolitis is an infectious disease. Avoid contact with other babies in the first few days. Keep your child home from child care or other places where there may be young children. Older children and adults can catch the virus that causes bronchiolitis, but it is most common in young children and babies.

Bronchiolitis does not mean a child will develop asthma

Wheezing or bronchiolitis in babies does not mean that a baby will progress to more persistent symptoms and develop asthma in childhood.

Where to get help

• In an emergency, call triple zero (000)
• Emergency department of your nearest hospital
• Your doctor
• Maternal and Child Health Line Tel. 13 22 29 (24 hours)
• Parentline (24 hours) Tel. 13 22 89
• NURSE-ON-CALL Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
• The Royal Children’s Hospital Tel. (03) 9345 5522

Things to remember

• Bronchiolitis is a common chest infection in babies under six months of age. Symptoms include coughing and wheezing.
• Seek medical advice if symptoms are persistent or you are worried about your baby.
• Bronchiolitis is infectious, so keep your baby home from child care or other places where there may be young children.
• Having bronchiolitis or another lung condition as a baby does not necessarily mean the baby will develop asthma as a child.