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Bronchiolitis

Bronchiolitis affects one in three babies under one year old so it’s best to know about it. Here we talk about the symptoms, treatment and what you need to know about bronchiolitis.

What is bronchiolitis and what causes it?

Bronchiolitis is a common type of chest infection that tends to affect babies and children who are under one year old (NHS GOSH, 2016). It’s almost always caused by a viral infection (NHS Choices, 2015). Bronchiolitis causes inflammation of the small airways in the lungs that are called the bronchioles. This makes it more difficult to breathe (Morethanacold, 2016).

What are the symptoms of bronchiolitis?

Children will usually have a dry and persistent raspy cough, a blocked or runny nose, rapid or noisy breathing and a mildly raised temperature. They might find it difficult to feed. The tricky thing about bronchiolitis is that the symptoms can be confused with a cold and there are no specific tests for bronchiolitis.

Doctors will usually take a medical history of what symptoms are present and when they started. They will also be able to hear a wheeze or crackles that can tell them it’s bronchiolitis (NICE, 2015).

What is the treatment for bronchiolitis?

Most cases of bronchiolitis are mild and clear up in two to three weeks without needing any treatment. Some children have severe symptoms and need hospital treatment (NICE, 2015).

What can I do to help a child with bronchiolitis?

  • Give paracetamol or ibuprofen made for babies. As bronchiolitis is caused by a virus, antibiotics won’t help.
  • Keep your child upright as much as possible – this will make breathing and feeding easier.
  • Try vapour rubs or humidifiers. You can also get saline (salt water) drops to put inside the nostrils and help keep the nose clear.
  • Try giving babies smaller bottle- or breastfeeds more frequently. Some additional water may also stop them becoming dehydrated.

How common is bronchiolitis in babies?

People in the UK usually get bronchiolitis between October and March. Around one in three babies will develop clinical bronchiolitis in the first year of their lives. They’re most likely to get it between three and six months old and 2% to 3% of all babies will need to go to hospital for it.  

Why do some babies need a hospital stay?

Children are more likely to require hospital or intensive care treatment for bronchiolitis if they:

  • are younger than three months old
  • were born with a heart defect
  • have a lung disease
  • were born prematurely
  • have a weakened immune system – either because of a problem they were born with (congenital) or because of medicine they are taking for another problem. (NHS GOSH, 2016)

Contact your GP if you're worried about your child, or if they develop any of the following symptoms:

  • Struggling to breathe.
  • Poor feeding, which is taking less than half their usual amount during the last two or three feeds.
  • No wet nappies for 12 hours or more.
  • Breathing rate of 50 to 60 breaths per minute.
  • High temperature of 38°C or above.
  • Seeming very tired or irritable.
  • Pauses in their breathing of 10 seconds or more.
  • Skin inside the lips or under the tongue is turning blue. (NHS Choices, 2015; BLF, 2016)

It's particularly important to get medical advice if your baby is younger than 12 weeks old, or they have an underlying health condition. An underlying health condition might be something like a heart or lung condition that’s been present from birth.

Bronchitis or bronchiolitis: What’s the difference?

Bronchitis is a condition that affects adults and children. Most cases of bronchitis develop when an infection irritates and inflames the bronchi – the airways that deliver air into the lungs. This makes them produce more mucus than usual, which your body tries to shift by coughing (NHS GOSH, 2016).

How can bronchiolitis be prevented?

The virus that causes bronchiolitis is very common and easily spread, so it's impossible to completely prevent it. A few tips and tricks could help reduce the likelihood of your child developing or spreading the infection:

  • Cover their nose and mouth when they cough or sneeze.
  • Throw tissues away as soon as they've used them.
  • Wash your hands and theirs frequently, particularly after touching their nose or mouth, or after feeding.
  • Wash or wipe toys and surfaces regularly.
  • Keep children at home until their symptoms have improved.
  • Keep newborn babies away from people with colds or flu, particularly during the first two months of life or if they were born prematurely.
  • Do not smoke or let others smoke around your baby.
  • Ask your GP about short-term immunisations that can be given to babies at high risk during bronchiolitis season. (NHS Choices, 2015; BLF, 2016)

Further information

NCT's support line offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.