Bronchiolitis

What is Bronchiolitis?

It is an illness that causes respiratory distress (breathing problems) in infants, particularly those under 6 months.

Signs you may see of respiratory distress in your baby include:

• grunting noise as your baby breathes out
• flaring of the nostrils
• ribs become prominent with each breath
• abdomen moving out with breathing

What causes Bronchiolitis?

It is usually caused by a virus called RSV, or Respiratory Syncitial Virus. Occasionally, other viruses may cause a similar illness. Bronchiolitic epidemics occur in the winter months.

What symptoms do babies have?

A baby will often have a mild fever and a runny nose for a couple of days. Then he will develop cough and difficulty in breathing, (you will see some signs of respiratory distress as he breathes). Sometimes babies are unable to feed properly because they are having so much breathing difficulty.

What is the treatment for Bronchiolitis?

In most cases, no specific treatment is necessary. Occasionally, babies need help with feeding (for example, a tube placed through the nose into the stomach), and some babies need extra oxygen. These babies are generally admitted to hospital. In a few babies, medicines to stop wheezing help. A few babies will need help with breathing, (CPAP is a type of artificial ventilation that helps babies).

Do all babies need to be admitted to hospital?

No. Most babies will have minor symptoms and will get better by themselves. Only babies who have a lot of difficulty breathing or feeding will need to be admitted.

What symptoms should make me worried enough to bring my baby to hospital?

Your baby may need hospital care if:

• he is having difficulty feeding
• he is struggling with his breathing
• he changes colour (especially if he goes blue)
• he has short periods when he stops breathing
• he already has lung disease and is having breathing problems
• he already has heart disease and is having breathing problems
• he already has a problem with his immunity and is having breathing problems

Are there treatments to prevent Bronchiolitis?

There are some treatments that in some cases prevent RSV Bronchiolitis hospital admissions, (for example, Palivizumab). However, these medicines are not straightforward to give, and decisions regarding their use need to be made by the pediatric specialist.

They are best reserved for infants who have been born prematurely and who have chronic lung disease.

Can babies get the RSV infection again?

Yes. However, as we get older, the infection generally causes less severe symptoms. Older children who get RSV often get symptoms of the common cold.

Does Bronchiolitis cause any long-term effects?

Yes. It can cause wheezing (asthma). If there is not a history of asthma in the family, most children will 'grow out' of their wheezing (asthma) by the age of 13 years.

What can I do help my baby after an episode of Bronchiolitis?

Make sure your baby avoids passive smoking.

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References

• Meates-Dennis M. Chapter in Evidence-based Pediatrics and Child Health. 2nd ed. BMJ Publishing Group. 2004.pp 319 - 329
• Lozano JM. Bronchiolitis. Clinical Evidence. BMJ Publishing Group. 2006

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Last reviewed 5 August 2007

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