Bronchiolitis

When your child gets a cold, it is often nothing more than a bother for a few days. But if your child begins to wheeze, you may become concerned that something more serious is going on. There’s a chance your child has developed bronchiolitis. Bronchiolitis is a viral infection that afflicts the lower lungs of infants and young children, usually under the age of 2 years old. Its peak time is during the cooler fall and winter months in many parts of the country.

What causes it?

Bronchiolitis occurs when a virus infects the bronchioles, which are the smallest of the airways branching off the main breathing tubes (bronchi) within the lungs. The infection causes the bronchioles to swell and become inflamed. The mucus then collects in the airways, making it difficult for air to flow freely in and out of the lungs. RSV is the most common culprit, but many other viruses can cause similar symptoms.

Because it is caused by a virus, bronchiolitis is highly contagious and can be passed from one child to another through contact with infected fluids, such as saliva and mucus.

Symptoms

Initially, you might think your child simply has a cold, since the first symptoms of bronchiolitis include coughing and a runny nose. Your baby might also have a congested nose and a slight fever. However, it then progresses to wheezing and sometimes difficulty breathing. These symptoms can last anywhere from a few days to a couple of weeks.

When to consult the doctor

If your child’s breathing becomes more rapid or labored, it’s time to call the pediatrician. Other signs that call for medical attention include:

• Vomiting
• Fast, labored, or shallow breathing
• Using the small muscles in the ribcage to help to breathe
• Skin turning blue, especially the lips and fingernails
• Increased tiredness
• Refusal to drink enough fluids
• Heavy wheezing

And if your child is under 12 weeks, was born premature, or has breathing/lung issues, consult your pediatrician immediately.

Treatment

Because it is caused by a virus, antibiotics typically are not prescribed to treat bronchiolitis. However, if your child has another illness with bronchiolitis, such as pneumonia or an ear infection, then medication will likely be prescribed.

If it’s a simple case of bronchiolitis, there are steps at home you can take to help your child get better. They include:

• Giving your child plenty of fluids to stay hydrated.
• Using saline nose drops with a bulb syringe to relieve congestion.
• Administering over-the-counter pain/fever reducer (consult your pediatrician first).
• Running a cool-mist humidifier, especially when the baby is sleeping at night.

Sources:

• American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis
• Diagnosis and management of bronchiolitis
• Pediatrics
• 2006 Oct;118(4):1774-93.
  Mayo Clinic
• Bronchiolitis.
  National Institutes of Health
• Bronchiolitis.

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