Bronchiolitis in Babies and Young Children

What is Bronchiolitis?

Bronchiolitis is when the tiniest air passages in your baby's lungs become swollen. This can make it more difficult for your baby to breathe. Usually, Bronchiolitis is caused by a virus called respiratory syncytial virus (known as RSV).

Almost all children will have had an infection caused by RSV by the time they are two. It is most common in the winter months and usually only causes mild 'cold-like' symptoms. Most children get better on their own.

Some babies, especially very young ones, can have difficulty with breathing or feeding and may need to go to hospital.

Can I prevent Bronchiolitis?

No. The virus that causes Bronchiolitis in babies also causes coughs and colds in older children and adults so it is very difficult to prevent.

What are the symptoms?

• Bronchiolitis starts like a simple cold. Your baby may have a runny nose and sometimes a temperature and a cough.
• After a few days your baby's cough may become worse.
• Your baby's breathing may be faster than normal and it may take more effort to breathe.
• Sometimes in very young babies, Bronchiolitis may cause them to have brief pauses in their breathing.
• As breathing becomes more difficult your baby may not be able to take the usual amount of milk by breast or bottle. You may notice fewer wet nappies than usual.
• Your baby may be sick after feeding and become irritable.

How can I help my baby?

• If feeding is difficult, try breastfeeding more often or offering smaller bottle feeds more often.
• If your baby has a high temperature, you can give him or her paracetamol (for example Calpol or Disprol). You must follow the instructions that come with the paracetamol carefully. If you are not sure, ask your community pharmacist what is suitable for your baby, and what dose you should give. Please note, a 'normal' temperature is between 36°c and 36.8°c. If your child's temperature exceeds 38°c, seek medical advice. 
• If your baby is already taking any medicines or inhalers, you should carry on using these. If you find it difficult to get your baby to take them, ask your doctor for advice.
• Bronchiolitis is caused by a virus so antibiotics won't help.

Make sure your baby is not exposed to tobacco smoke. Passive smoking can seriously damage your baby's health. It makes breathing problems like Bronchiolitis worse.

Green flag - Monitor and self care

Babies and children often get coughs and colds and will recover without parents needing to seek medical help.

Amber flag - Seek medical advice

e.g. GP, NHS Direct

1. Temperature over 38°c (ear thermometer)
2. Noisiness with breathing, bubbly
3. Pale (mottled)
4. Cold hands and feet
5. More sleepy than usual
6. Not responding as normal
7. Not feeding adequately

Red flag - Call an ambulance

1. Baby going blue
2. Increased breathing rate more than 1 per second
3. Pauses in breathing (apnoea)
4. Sucking ribs in when breathing
5. Head bobbing with breathing
6. Struggling to feed on two occasions, breathlessness
7. Non responsive
8. Grunting (at the end of each break)

Alert: Children who already have chest or heart problems could become unwell quicker and more seriously – take them to hospital.

When should I get advice?

Contact your GP if:

• You are worried about your baby.
• Your baby is having difficulty breathing.
• Your baby is taking less than half his or her usual feeds over two to three feeds, or has no wet nappy for 12 hours.
• Your baby has a high temperature.
• Your baby seems very tired or irritable.

Dial 999 for an ambulance if:

• Your baby is having a lot of difficulty breathing and is pale and sweat
• Your baby's tongue and lips are turning blue.
• There are long pauses in your baby's breathing.

Contact NHS Direct for health advice or information on 0845 4647 or visit their website at www.nhsdirect.nhs.uk