Understanding Bronchiolitis, A Common Infection in Children

Bronchiolitis is an infection of the respiratory tract. It affects the small tubes or airways in the lungs. It can cause mucus to build up and can cause swelling in the lungs. It is an infection that causes symptoms similar to a cold, but can cause difficulty breathing or feeding in some cases.

Nearly a third of all children will have bronchiolitis before the age of two and is the most common cause of infant hospitalizations.

Understanding what bronchiolitis is and its symptoms can help parents feel prepared when their little one gets sick. Here are some facts to know about this common infection.

What causes it bronchiolitis?

Bronchiolitis is most often caused by a virus. The most common cause is the respiratory syncytial virus, or RSV, but other viruses can cause it also. Some other viruses that may cause it include rhinovirus, parainfluenza, adenovirus or human metapneumovirus.

Is it contagious?

Most viruses that cause bronchiolitis are contagious and can spread easily through the air when someone sneezes or coughs and germs can stay on hard surfaces such as hands, toys, door knobs, tissues and other surfaces for some time.

Who is at risk?

Bronchiolitis often affects infants and children under the age of two because their airways are smaller and can more easily be blocked by the congestion and mucus. Children who were born prematurely, exposed to tobacco smoke, have a serious heart or lung condition, or have weakened immune systems have a higher risk for bronchiolitis.

What are the symptoms?

Many times bronchiolitis will start out looking like a cold. Your child may have a cough, runny nose, nasal congestion or a fever over 100.4F. These symptoms usually get better on their own. It is possible that symptoms could get worse and your child may have fast breathing, noisy breathing or have wheezing.

How will my doctor know it is bronchiolitis?

Usually no tests are needed. It is diagnosed based on the history of illness and physical exam. Your doctor may get a chest X-ray or take a sample of mucous from the nose to help with identifying the virus causing the illness or make sure nothing more serious is going on.

How is it treated?

Most cases don’t need any specific medicine or treatment. There is no cure – the illness needs to run its course. Antibiotics are not needed for a simple case of bronchiolitis caused by a virus since antibiotics only work against bacterial infections.

Easing your child’s symptoms is the focus of treatment. When your child has bronchiolitis, they need time to recover. Symptoms may last for a week or two, but sometimes it may take several weeks for symptoms to go away. Here are four things you can do at home to ease symptoms:

1. Keep your child hydrated.

Offer small amounts of fluids more frequently to keep your child hydrated.

2. Use a cool mist vaporizer or humidifier.

This can help loosen mucous to help relieve cough and congestion. Be sure to clean it as recommended to prevent buildup of mold or bacteria.

3. Ease nasal congestion.

You can try a non-medicated saline nose spray or drops and bulb suction or NoseFrida to clear secretions. This can be particularly helpful before feeding or sleeping.

4. Reduce the fever as needed.

If your child is over 6 months old, you may use Tylenol or Motrin to reduce a fever. Be sure to follow the bottle instructions on how much and how often to give it to your child. Talk with your child’s provider if you have questions about using Tylenol or Motrin.

When should you call a doctor?

Often bronchiolitis is a mild illness that can be treated at home. However, there can be severe symptoms that require further treatments.

Seek medical care right away if your child has:

  • Fast or shallow breathing or you can see the belly moving up and down quickly,
  • Labored breathing with the muscles pulling at area below the ribs, between the ribs and/or the neck when the child is breathing in.
  • Flared nostrils.
  • Irritability they cannot be comforted.
  • A poor appetite, not feeding well or won’t wake up for feeds.
  • Fewer wet diapers than usual.
  • A blue color to the lips, tongue, or nails.

How can bronchiolitis be prevented?

Washing hands is the best way to prevent spread of illness. Keep infants or children away from those who are sick with a cough or cold. Keep toys and surfaces clean, and avoid secondhand smoke exposure. Also be sure to maintain regular visits with your pediatrician for wellness checks.

Hannah Henry, APRN-CPNP, is a provider at ProMedica Urgent Care for Kids in Perrysburg.

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