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Your Questions Answered

Dr Su LaurentYour frequently asked questions on bronchiolitis are answered by consultant paediatrician Dr. Su Laurent.

Dr. Laurent has been a consultant paediatrician at Barnet Hospital, (Royal Free Hospital NHS Trust) for over 20 years and writes books on parenting and child health.

What is bronchiolitis?

Bronchiolitis is an inflammation of the small airways in the lungs called the bronchioles. It is a common condition affecting babies and young children.

What are the symptoms of bronchiolitis?

The early symptoms can be very like a common cold.  The first symptom is often a blocked or runny nose, which is sometimes accompanied by a cough or slightly high temperature.

However babies who may be developing more severe bronchiolitis exhibit these symptoms, the most significant of which is a distinctive rasping cough:

  • Fast breathing: shallow, quick breaths not taking in much air
  • Appetite: not feeding and no interest in food
  • Cough: a distinctive rasping cough
  • Temperature: a high temperature and fever will usually accompany cold-like symptoms of a runny nose
  • Tired and listless or very irritable

If your baby has some or all of these symptoms, seek medical attention from a healthcare professional.

In a small number of severe cases, a baby's tongue and lips may turn 'blue' in colour.  If this happens then take your baby to A&E or call for an ambulance immediately.

How common is bronchiolitis?

Bronchiolitis is a common lower-lung chest infection in infants. One in three babies in the UK can develop bronchiolitis before their first birthday and it most commonly occurs in babies aged three to six months.

What causes bronchiolitis?

The Respiratory Syncytial Virus (RSV) causes around 80% of bronchiolitis cases while other viruses are sometimes the cause, such as human Adenovirus and Rhinovirus.

Is there a time when babies are more likely to contract bronchiolitis?

Yes, in the winter months. The bronchiolitis season in the UK varies slightly each year, but it usually runs from October to March.

Are some babies at a higher risk of developing bronchiolitis than others?

Yes, newborn babies born during the bronchiolitis season and babies born prematurely, so their lungs are not fully developed, also those with underlying heart and lung conditions.

Why are premature babies more at risk?

The airways of a premature baby will have to work harder than normal. Meanwhile the immune systems of premature babies are not fully developed making them pre-disposed to infection.

Are there any additional risk factors?

Yes, risk factors for infection include; low birth weight, number and age of siblings, smoking in the home and not breast feeding.

Are babies who have bronchiolitis always hospitalised?

No, it is not always a serious illness, around 3% of babies with bronchiolitis are admitted to hospital but most babies will have relatively mild symptoms and can be cared for at home.  If you are worried about your baby then do contact your GP. 

What home treatment is recommended?

If the symptoms are not severe you can care for your baby at home as you would with a cold. Breathing may be easier for the baby if he or she sleeps with their head slightly raised. It is not recommended that babies use pillows but parents could try putting a pillow or cushion under one end of the mattress.

Monitor baby's condition and go to your GP if you have any concerns. 

Sometimes symptoms can get worse after your GP has checked your baby.   Young babies can get worse or better quite quickly so if you’re worried, go back to your healthcare professional In particular if baby:

  • Is not feeding or drinking well
  • Appears to be struggling to breathe – you might notice sucking in under their ribcage
  • Is breathing rapidly – check how many breaths baby is taking each minute.  If it’s more than 50-60 contact your GP
  • Loses a good healthy colour and becomes pale or blue

If a baby is hospitalised what treatment might they receive?

If a baby is admitted to hospital with bronchiolitis they may need to stay in for several days. There is no specific treatment for the virus but at hospital, staff can provide supportive care for your baby such as oxygen if your baby’s oxygen levels are low and fluids via a nasogastric tube or a drip if she is having difficulty feeding. The average stay for a baby with moderate to severe bronchiolitis in hospital is about five days but they can stay for up to a week. The pattern of illness is that the baby will get worse over three or four days and then plateaus for a couple of days before getting better.

  • Don't ask for antibiotics as they will not work for bronchiolitis
  • Chest x-rays are very rarely done unless it is seen as a complicated case

How are the viruses which cause bronchiolitis spread?

The virus is airborne and transmitted by close personal contact with people or through hand to mouth contact. It can also be spread through sharing items such as toys, clothes, cups and bottles. 

Are there long-term health risks associated with bronchiolitis?

If a baby has developed severe bronchiolitis it can cause recurrent wheezing during childhood, a reduced quality of life, disturbed sleeping, digestive and lung capability. Some of these conditions last into the early teenage years, for example recurrent wheezing and a cough.

What can I do to help protect my baby from bronchiolitis?

It's difficult to prevent bronchiolitis completely but there are ways to reduce the risk of your baby getting the infection. View the how to reduce the risk section on this website for more information on how to protect your baby. If you are still concerned, contact your healthcare professional.

 

Please note: The views and opinions expressed are those of Dr. Su Laurent.