This is a respiratory illness that effects the bronchioles (the smallest airways) of infants and young toddlers. It is caused by several viruses, most frequently Respiratory Syncytial Virus (RSV), which also causes more mild colds and flu like illnesses in older children and adults.
RSV is spread through close contact with other’s mucous and saliva and by infected people coughing into another’s close space. It may reside on tabletops, door handles, phones, or toys. A child can get infected when he or she touches these surfaces and then their eyes or nose. Illness begins about 3-7 days later.
Bronchiolitis usually begins like a regular cold with fever and nasal congestion, but within 2-4 days the virus spreads down to the small airways and causes irritation and inflammation. When this happens the child coughs and has a whistling sound (wheeze) when exhaling. It may look like the child is having an asthma attack and their breathing may become labored and fast. Sometimes the fever is gone at this point. Like most sick children, their appetite and sleep is decreased. The wheezing can last up to 5-7 days but the congestion and cough may persist for 1-2 weeks more.
Home care is mostly supportive of the symptoms. A humidifier in the room keeps nasal secretions moist and the use of saline drops into the nose and suctioning with a rubber bulb syringe- especially before feeds and sleep helps your child. Drying the mucous or preventing coughing with strong cough meds can make the child worse. Antibiotics are not helpful for viruses. Encourage warm, sweet, clear liquids. Shorter feeds that are more frequent can be useful. The recipe for nasal drops is ¼ tsp. of salt to 1 cup of warm water. Use one drop at a time, allow 2-3 minutes and suction the nose if you see or hear the mucous. Sleep within hearing range of your child with respiratory illnesses.
Most children do well at home and don’t need medications, but a few develop enough respiratory distress that they require hospitalization, supplemental oxygen, and additional support. Infants, particularly newborns and premature babies, are at increased risk of more severe disease.
Call the doctor if you feel frightened or worried about your child’s’ breathing, you see a pulling in at the ribs or flaring of the nostrils, your child is breathing faster than 60 times a minute, looks very pale, is bluish around the lips, is feeding poorly, or looks very tired.
COPA Ask a Nurse is always available, 24/7, for our patients and we encourage moms and dads to call at any time.