Bronchiolitis is an infection of the small airways in the lungs, called bronchioles, and it is most common in children under 2 years of age. It makes it hard for young children to breathe and can be serious if not recognised early. Understanding bronchiolitis is important because timely care can prevent complications and help your child recover more quickly.
If your child shows signs of bronchiolitis, Hope Plus can connect you to a licensed healthcare provider for a consultation within minutes. Through Hope Plus, a provider can assess your child’s breathing, suggest any necessary tests, and guide you on supportive care at home or in hospital if needed. You can access this service here: Hope Plus.
Key Takeaways
- Bronchiolitis is most common in children under 2 years and is usually caused by viruses like RSV.
- Early symptoms include runny nose and dry cough, which may later progress to fast breathing and wheezing.
- Most cases are mild and can be managed at home with supportive care.
- Severe cases need hospital care, oxygen, and careful monitoring.
- Antibiotics and steroids are usually not needed because bronchiolitis is viral.
Causes of Bronchiolitis
The most common cause is viral infection, particularly respiratory syncytial virus (RSV). Other less common causes include Mycoplasma infection.
Children are more vulnerable due to their small airways, which can easily become blocked by mucus during infections.
Symptoms to Watch For
Bronchiolitis usually develops in stages:
- First 1–3 days: Runny nose, mild dry cough, and irritability.
- Later: Fast breathing (tachypnoea), difficulty breathing, wheezing, frothy cough, and mucus in the nose.
- Fever is often mild or absent.
Severe signs that need urgent attention include:
- Child younger than 3 months
- Trouble breathing, blue lips or face (cyanosis)
- Very fast breathing (>60 breaths per minute)
- Difficulty feeding
- Low oxygen levels (SpO2 < 92%)
- General weakness or confusion
How Healthcare Providers Diagnose Bronchiolitis
Diagnosis is mainly clinical, based on symptoms and age. Providers may also:
- Take a chest X-ray to rule out pneumonia
- Do a blood test (haemogram) if needed
Managing Bronchiolitis
Treatment depends on severity.
Mild to Moderate Bronchiolitis
If the child is wheezing but able to feed, with no signs of cyanosis:
- Clean the nose with normal saline drops or irrigation.
- Offer small, frequent meals and plenty of fluids.
- Treat fever with paracetamol if needed.
- Usually managed at home under supervision.
Severe Bronchiolitis
If the child has fast breathing (>60 breaths per minute), wheezing, or cyanosis:
- Hospital admission is required.
- Humidified nasal oxygen (1–2 litres per minute) may be given.
- Salbutamol inhaler (100 micrograms/puff, 2 puffs every 30 minutes) or nebulised salbutamol (2.5 mg in 4 ml saline).
- If symptoms improve, salbutamol may continue every 6 hours. If not, it may be stopped.
- Nebulised adrenaline (1:1000, 1 ml in 2–4 ml saline) may be given every 2–4 hours.
- Provide oral fluids liberally; if the child cannot drink, fluids are given through a tube (NGT) or intravenously.
- Fluid requirement: about 150 ml per kg in 24 hours, plus extra for losses from illness.
Important notes:
- Antibiotics are usually not needed because bronchiolitis is viral.
- Steroids are not recommended.
Preventing Bronchiolitis
- Limit exposure to cold environments and people with viral infections.
- Wash hands properly after contact with sick children.
- Avoid crowded places during RSV season if possible.
FAQ: Common Parent Questions About Bronchiolitis
1. Can bronchiolitis be cured?
Yes, most children recover fully with supportive care, though recovery may take 1–2 weeks.
2. Does my child need antibiotics?
No, antibiotics are not effective for viral bronchiolitis.
3. How can I make my child more comfortable at home?
Use saline nose drops, keep the child well-hydrated, and feed small, frequent meals.
4. When should I take my child to the hospital?
If the child has very fast breathing, difficulty feeding, blue lips or face, or seems very weak, seek urgent care.
5. Can bronchiolitis come back?
It can, especially during RSV season, but most children recover completely each time.
6. Can older children get bronchiolitis?
It is rare in children over 2 years because their airways are larger and more developed.
7. Can I prevent bronchiolitis at home?
Handwashing, avoiding sick contacts, and keeping the child away from smoke and cold drafts can help reduce risk.
