Bronchiolitis

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Dr Dan Bunstone

Medically reviewed by:

Dr Dan Bunstone - Medical Officer

Updated: Aug 18, 2021
Next review: Aug 18, 2022
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Bronchiolitis affects babies and young children under 2 years old, but it’s most often seen in babies who are between 3 and 9 months. It’s a common lung infection that can cause them to have cold-like symptoms, along with a cough and difficulty breathing.

It is caused by the respiratory syncytial virus (RSV), which can just cause cold like symptoms, but sometimes the infection can affect the lower respiratory system too, leading to bronchiolitis.

The condition will clear up on its own, but sometimes medical attention is needed to support babies whilst they recover.

Let’s take a look at the condition in more detail.

The initial symptoms of bronchiolitis are very similar to the ones caused by a common cold:

  • A runny nose
  • A blocked nose
  • A cough
  • A slightly high temperature

Then, other symptoms may start to develop:

  • Wheezing
  • Fast breathing or irregular breathing
  • Flaring nostrils
  • Difficulty eating and drinking, or being sick after eating or drinking
  • Being irritable and not settling

Some cases of bronchiolitis can cause severe symptoms and may require urgent medical attention. You should call for an ambulance if your baby:

  • has severe difficulty breathing - they may be struggling to catch a breath, or be exhausted from trying to breathe
  • looks like they’re breathing through their tummy - they may also be making grunting noises and you may be able to see the muscles under their rib cage sucking in
  • is breathing at more than 60 breaths a minute
  • is pausing between breaths for 5 to 10 seconds or more, or if they stop breathing from more than 10 seconds at a time
  • is pale, clammy or sweaty
  • has blue lips (look inside their mouth too), under their tongue, or if their fingernails or skin are blue
  • won’t wake up, are very drowsy or won’t stay awake

Bronchiolitis can also lead to dehydration as it makes feeding more difficult.

If it’s a child or baby who you think could be dehydrated, take them to A&E, or see a GP urgently if they are showing any of the following signs:

 A rapid heartbeat or breathing

  • Have no tears when they cry (or very few)
  • Drowsiness
  • Floppiness
  • Irritability
  • If they have a sunken fontanelle (the soft spot on their head)
  • Their mouth is dry
  • Their urine is dark yellow in colour
  • Reduced wet nappies
  • Their hands and feet are cold and mottled
  • Drinking less than 50% of their normal intake

You can read more about dehydration.

Bronchiolitis is caused by the respiratory syncytial virus (RSV), which can also be give cold-like symptoms but sometimes the infection can lead to bronchiolitis in young children and babies.

There are some factors that may put children and babies more at risk of developing bronchiolitis, which include:

  • if they were/are bottle fed, rather that breastfed
  • being born prematurely
  • being born with a lung or heart condition
  • being in environments where there is cigarette smoke
  • having a weakened immune system
  • being around other children or adults who have the virus, such as school aged children, or if the child or baby goes to nursery school

There is no specific medication used to treat bronchiolitis - because it is a virus, antibiotics will not be of any use, as they only treat bacterial infections.

In most cases, the condition should improve on its own as your baby or child's immune system works to kill the virus. They should be fully recovered after 2 to 3 weeks. Make sure they get plenty of rest and you can use paracetamol or ibuprofen to help bring a temperature down (always make sure the medicine is suitable for their age - speak to a pharmacist or read the information sheet that comes with it).

Make sure you give your child or baby fluids to keep them from becoming dehydrated. You can also use a humidifier to moisten the air, which may help with the symptoms.

To help with the blocked nose, you may want to raise one side of their cot so their head is slightly elevated. You may also want to use saline nasal drops, which can help a congested nose, and it may help with feeding. Also make sure your child isn’t exposed to any fumes, such as cigarette smoke.

If your child’s symptoms do not improve or if they get worse, see a GP. See above about when more urgent medical attention may be needed.

Occasionally a child needs hospital attention, often because they struggle to eat and drink and are at risk of dehydration. They may also need oxygen to help them breath whilst they recover.

The virus that causes the condition is contagious, so make sure anyone that comes into contact with the child washes their hands. Clean their toys and any surfaces they come into contact with to avoid risk of spreading the virus to others.