Bronchiolitis
Your child has been diagnosed with bronchiolitis.
We know this can be a stressful time with lots of information from healthcare providers. It can be difficult to absorb everything.
We hope the following pages will be helpful in providing you with the education and resources you need to support your child from home.
What is Bronchiolitis?
Bronchiolitis is an acute respiratory illness which typically affects infants and young children. It tends to be more severe at younger ages and in children born prematurely or with underlying health conditions such as asthma or a weakened immune system.
It is due to inflammation of the bronchioles (small airways of the lungs) caused by a viral infection, most commonly RSV (respiratory syncytial virus). This inflammation leads to mucous production and narrowing of the small airways of the lungs leading to the typical symptoms of bronchiolitis.
Click continue to learn more!
Other Resources: Nemours KidsHealth - Bronchiolitis
Symptoms of Bronchiolitis
The symptoms of bronchiolitis can include:
- fever
- runny nose
- congestion
- cough
- wheeze (high pitched sound when the child breathes out)
- difficulty breathing
- decreased intake
- dehydration
Hospital Care
Medical therapy for bronchiolitis is focused on "supportive care". This refers to helping the infant or child stay well hydrated, managing fever or discomfort and ensuring breathing is comfortable. Click below to learn more.
A. Saline and Suction
As you might do at home, your medical team may use saline and suction to help clear your child's nasal passages. This can ease breathing and help facilitate feeding or sleep.
B. Inhaled Medications
The medical team may have tried using inhaled medications
such as epinephrine or salbutamol (common brand name:
Ventolin, most commonly a blue puffer). The goal of trying
these medications is to help improve symptoms such as cough,
wheeze, and shortness of breath.
Inhaled medications are given with a puffer or with a
nebulizer (a machine that turns liquid medicine into a fine
mist that can be inhaled). In some children with
bronchiolitis, these medicines can be helpful, while in
others it may not make much of a difference. Your healthcare
provider will do their best to see if the medication has
helped.
Generally, these medications are not prescribed for
treatment of bronchiolitis at home. However, if your child
was prescribed a puffer, please follow the instructions from
the doctor and if you have any questions, speak to your
doctor or pharmacist.
C. Oxygen
If your child is having difficulty breathing or low oxygen levels, your medical team may give them supplemental oxygen. Oxygen is usually delivered by face mask or nasal prongs. Generally, if a child requires oxygen, then they may need to be admitted to hospital for further care.
What to do at home
Click below for information on ways to help at home.
Track your child's symptoms
Keep track of your child's symptoms, such as fever and cough, and document details you feel are important. You may also want to keep track of any medications given and whether this helped.
Help your child stay hydrated
As with other viral illnesses, it is important to ensure your child remains well hydrated by offering fluids containing not only water but sugar and electrolytes (e.g., breastmilk or formula in infants, electrolyte drinks in older children) WebMD - Treating Dehydration in Children
Help with fever and discomfort
To help reduce fever and alleviate discomfort, you can give
your child acetaminophen (Tylenol) or, if they are over 3
months old, ibuprofen (Advil), so long as your child does
not have allergies or other reasons not to take these
medications.
Note: fever in infants under 4 weeks of age is a
medical emergency and these children should be seen in their
local emergency department.
Caring for Kids - Fever and temperature taking
Safe Acetaminophen Dosing for Infants and Children
Mount Sinai - Ibuprofen Dosing for Infants and
Children
Help with cough and congestion
Saline and suction can be used to help clear your child's
nasal passages. Start by applying saline (salt water) to the
nasal passages. Afterwards, you can use a bulb suction to
remove excess mucous. This can help with feeding in infants
and with sleep, so consider saline and suctioning prior to
feeding or sleeping.
The following resource is a link to a video with instruction
on how to use saline and suction in an infant
Boys Town Pediatrics - Nasal Saline & Suction
Does my child need antibiotics?
Antibiotics are not used to treat viral infections, like bronchiolitis.
Viruses and bacteria can both cause infection but are different bugs. Bacteria can be killed using antibiotics. Viruses cannot be killed by antibiotics.
Although antibiotics are not used to treat bronchiolitis, some children may have other infections requiring antibiotics such as an ear infection or bladder infection. Please follow the advice of your physician and if you have any questions, speak to your doctor or pharmacist.
When to seek medical attention
Here are some signs that, if present, should lead you to seek immediate medical attention:
- fever in a child under 3 months of age
- fever lasting more than 48-72 hours since your child was last seen for fever
- fast or laboured breathing
- cyanosis (blue lips or tongue)
- lethargy
- poor intake leading to dehydration (dry mouth, sunken eyes, no tears, dark urine, no urine for more than 8-12 hours)
Follow Up
Please follow up with your primary care provider unless instructed otherwise. Of course, if you feel your child needs immediate medical attention, please do not hesitate to call 911 or bring them to your closest emergency department.
We hope this has been useful. Thank you for using Paediatrics@home!