Bronchiolitis: what you need to know

Lead Nurse in Paediatrics at Bupa Cromwell Hospital
17 August 2016
A little girl asleep on her mum's shoulder

Babies are prone to catching colds. Usually their symptoms are mild and last for just a few days. But if your baby is struggling to breathe and has a wheezy cough, they could have bronchiolitis – a common winter viral infection. So how can you tell when it’s time to see your GP?

What is bronchiolitis?

Bronchiolitis mainly affects babies between three and six months, but any child under two years can develop the infection. One in every three babies will have bronchiolitis before they reach the age of one year.

Most infections strike between November and March, but this varies from year to year. The viruses that cause bronchiolitis are spread by coughs and sneezes. You can prevent the infection with common hygiene measures, such as washing your hands regularly. 

How do I spot the signs?

Bronchiolitis causes similar symptoms to a cold at first, with a blocked or runny nose and slight cough. But after three days, your baby may have:

  • a persistent cough
  • wheezing
  • difficulty breathing
  • slight fever 

They may also seem generally unwell and irritable.

What should I do?

Bronchiolitis symptoms are usually mild and only last for a few days. The infection is caused by a virus, not bacteria, so it can’t be treated with antibiotics. Managing mild bronchiolitis involves easing your baby’s symptoms. 

Most babies with bronchiolitis can be treated at home. Make sure your baby gets enough fluids from milk and water. A build-up of mucus in your baby’s nose may mean they find it difficult to feed. Use saline nose drops to clear their nose so they can breathe, and feed, more easily. Keep them as comfortable as possible. If they have a fever, you can give them baby paracetamol or ibuprofen liquid (in a dose suitable for their age).

Most babies recover from bronchiolitis after three to five days. But their wheezing and coughing may last for up to four weeks. 

When should I see my GP?

Sometimes bronchiolitis symptoms can be more severe. The main worry is that your baby will get dehydrated if they don’t get enough milk or other fluids. If your baby isn’t feeding properly, see your GP as soon as possible. You should also see your GP if your baby’s nappies are drier than usual or if they have no wet nappies for 12 hours. This could be a sign that your baby is dehydrated, and your baby may need to go to hospital. 

Only around three in every 100 babies with bronchiolitis need hospital treatment. The hospital doctors will concentrate on helping your baby feed and relieving their symptoms. They may put a tube down your baby’s nose into their stomach if they can’t feed normally by mouth. Occasionally, your baby may need oxygen. Once your baby is feeding and sleeping properly, they’ll be able to go home.

When should I seek urgent help?

Very occasionally, bronchiolitis symptoms can suddenly get worse and your baby will need urgent medical care. You’ll need to look out for warning signs that there’s something wrong. You should call for an ambulance if your baby:

  • is struggling to breathe
  • has flared nostrils when they breathe
  • makes grunting noises when they breathe
  • is blue around their lips
  • is vomiting
  • sucks in their chest or stomach as they breathe
  • is unusually sleepy, irritable, floppy or hard to wake up

Dieter Aretz
Lead Nurse in Paediatrics at Bupa Cromwell Hospital

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