What is bronchiolitis?
Bronchiolitis is an infection of the bronchioles, the small air passages in the lungs. It is common in infants and is the leading cause of serious lower respiratory illness.
What causes bronchiolitis?
Bronchiolitis is caused by a virus, especially respiratory syncytial virus (RSV), and frequently occurs in the late fall to early spring.
What are the symptoms?
Symptoms of bronchiolitis include runny nose, cough, and fever. After a few days, your child may experience shortness of breath and/or breathing that is rapid and laboured with wheezing.
A severe infection in infants may cause a noticeably increased breathing rate. For information on what to do if your child has trouble breathing, see the topic Respiratory Problems, Age 11 and Younger.
If your child has heart disease or was born prematurely, call your doctor at the first sign of bronchiolitis.
Symptoms of bronchiolitis are the worst in the first 5 days. Most children get better in 1 to 2 weeks.
How is bronchiolitis diagnosed?
A doctor may diagnose bronchiolitis based on a medical history, your child's symptoms, and a physical examination. Testing is usually not needed if your doctor suspects the bronchiolitis is caused by RSV.
How is it treated?
Home treatment to manage the symptoms of bronchiolitis is usually all that is needed. Have your child drink plenty of liquids to avoid dehydration. If your baby has a stuffy nose, use a suction bulb to remove mucus. Fever medicine (such as acetaminophen or ibuprofen) may help reduce fever discomfort. Do not give aspirin to anyone younger than 18 because of the risk of Reye syndrome, a serious illness. Over-the-counter cough and cold medicines are not recommended. Be safe with medicines. Read and follow all instructions on the label.
The doctor may suggest bronchodilator medicine if your child has shown the tendency to have allergic reactions (atopy). In severe cases, your child may need to stay in the hospital or get extra oxygen.
How can you prevent bronchiolitis?
It is common for children to get respiratory problems (such as bronchiolitis caused by a viral infection), because they are often exposed to people who have infections to which they have not built up immunity. Bronchiolitis is spread just like a cold. To prevent bronchiolitis:
- Avoid contact with other children who have bronchiolitis or upper respiratory infections. If there is an ill child in the home, separate him or her from other children, if possible. Put the child in a room alone to sleep. If your child has bronchiolitis, keep him or her home from school or daycare until he or she gets better.
- Wash your hands often to prevent spreading the disease. Handwashing removes the germs on your hands and helps stop the spread of germs to your child when you touch your child or touch an object he or she might touch.
- Do not smoke or use other tobacco products around your child. Second-hand smoke irritates the mucous membranes in your child's nose, sinuses, and lungs and increases his or her risk for respiratory infections.
If your child was born early (prematurely), has heart or lung disease, or has other conditions that make it more likely to have problems from RSV, ask the doctor if palivizumab (Synagis) might help. This medicine helps prevent bronchiolitis and other problems from RSV in children most likely to have problems (susceptible).
Other Works Consulted
- Bourke T, Shields M (2011). Bronchiolitis, search date July 2010. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
- Federico MJ, et al. (2011). Respiratory tract and mediastinum. In WW Hay et al., eds., Current Diagnosis and Treatment: Pediatrics, 20th ed., pp. 487–535. New York: McGraw-Hill.
- Gadomski AM, Brower M (2010). Bronchodilators for bronchiolitis. Cochrane Database of Systematic Reviews (12).
- Ralston S, et al. (2014). Clinical practice guideline: The diagnosis, management, and prevention of bronchiolitis. Pediatrics, 134(5): e1474–e1502. DOI: 10.1542/peds.2014-2742. Accessed October 28, 2014.
- Seiden JA (2009). Bronchiolitis: An evidence-based approach to management. Clinical Pediatric Emergency Medicine, 10(2): 75–81.
- Welliver RC (2009). Bronchiolitis and infectious asthma. In RD Feigin et al., eds., Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 6th ed., vol. 1, pp. 277–288. Philadelphia: Saunders Elsevier.
- Zore JJ, Hall CB (2010). Bronchiolitis: Recent evidence on diagnosis and management. Pediatrics, 125(2): 342–349.
Current as of: May 27, 2020
Author: Healthwise Staff
Susan C. Kim MD - Pediatrics
Brian D. O'Brien MD - Internal Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine
John Pope MD - Pediatrics