Bronchiolitis is an infection of the small air passages in the lungs. It results in narrowing of the airways as a result of inflammation caused by any of a number of viruses, usually the respiratory syncytial virus (RSV). RSV occurs in epidemics almost every winter. Bronchiolitis is a common illness in babies and young children. It usually occurs during winter and early spring. Children over age 2 and adults will usually only develop cold symptoms from RSV while children under 2 years old may develop bronchiolitis.

Good prevention steps…

Signs/Symptoms of Bronchiolitis

Treatment
Since bronchiolitis is caused by a virus, babies usually get better without treatment. In severe cases, babies may be admitted to the hospital for close monitoring of oxygen saturation, supplemental oxygen, intravenous fluids, and/or possible suctioning. The main course of treatment is to treat the signs/symptoms and make the baby as comfortable as possible. 

This includes:

• Warm fluids for coughing spasms.Encourage an increase in oral fluids and consider smaller more frequent feedings.
• Keep the baby’s nose clear by using saline nasal spray and bulb suction. If a baby has a nose that is blocked with sticky mucus, it will make nursing or drinking a bottle more difficult.
• Humidify the air with a cool or warm mist humidifier.  Make sure to keep the filters clean as to not allow bacteria growth in the humidifier.
• It has been proven that antibiotics are not beneficial in the treatment of bronchiolitis since it is cause by a virus.
• Tylenol as needed for fever or discomfort.  Ibuprofen may be used in babies greater than 6 months old.  Contact your pediatric office for proper dosing.
• Medicines that a baby breathes into the lungs are sometimes tried in the office and sometimes given at home.  Medications such as albuterol and steroids are seldom used because they have shown to have little benefit. 

When to call your pediatrician

• If you have any questions/concerns about caring for your baby.
• If signs/symptoms worsen after 4 days.
• If baby is not drinking enough (less than 2 wet diapers per day or less than half or normal intake)
• If your baby is in the high risk category (ex: premature, heart or lung disease, nervous system disease)
• Suggestion of an ear infection (common complication of bronchiolitis that occurs in about 20% of bronchiolitis cases)

When to go to the Emergency Department

• Baby has a bluish color
• Baby is very sleepy or acting very sick (unable to be consoled,  listless, unresponsive)
• Baby’s breathing is fast and shallow (greater than 60 breaths per minute)
• Baby is using his/her
  stomach muscles
  to breath.  When he/she breathes, its ribs suck in and its nose flares.

Resources: AAP and Instructions for Pediatric Patients, 2nd ed.