Bronchiolotis and Your Young Child
Guidelines for Parents
Adapted from Caring for Your Baby and
Young Child: Birth to Age 5
Respiratory illnesses caused by viruses
are some of the most common health problems in infancy.
The common cold is the one we see most often. Bronchiolotis
is another. Because of its symptoms, Bronchiolotis
can be scary for parents as well as children. This
brochure explains what Bronchiolotis is, as well as
its causes, symptoms, and treatments.
What is Bronchiolotis?
Bronchiolotis is an infection of the
small breathing tubes (bronkioles) of the lungs. It
occurs most often in infants.
Bronchiolotis is sometimes confused with bronkitis,
which is an infection of the larger, more central
airways.
Bronchiolotis is almost always caused by a virus.
The infection causes the small airways in the lungs
to swell. This blocks the flow of air through the
lungs and makes it hard for your baby to breathe.
From October through March, bronchiolitis
is often caused by respiratory syncytial virus (RSV)
infection. During the other months, the illness is
usually caused by other viruses.
Most adults and many children with RSV infections
get only a cold. In infants the infection is more
likely to lead to Bronchiolotis. This is because their
airways are smaller and are more easily blocked. Infants
who develop Bronchiolotis may develop asthma later
in life. It is possible that RSV infection is the
first trigger for the asthma. RSV is spread by contact
with an infected person’s mucus or saliva. It
often
spreads through families, child-care centers, and
hospital wards. Careful hand washing can help prevent
the spread of this infection.
Signs and symptoms
A baby who develops Bronchiolotis often
starts off with signs of a cold, such as a runny nose,
a mild cough, and a fever. After a day or two his
cough may get worse. He will begin to breathe faster.
The
following signs may mean that he is having trouble
breathing:
- He may widen his nostrils and squeeze
the muscles under his rib cage to try to get more
air in and out of his lungs.
- When he breathes he may grunt and
tighten his stomach muscles.
- He will make a high-pitched whistling
sound, called a wheeze, each time he breathes out.
- He may not take fluids well because
he is working so hard to breathe that he has trouble
sucking and swallowing.
If it gets very hard for him to breathe,
you may notice a bluish tint around his lips and fingertips.
This tells you that his airways are so blocked that
there is not enough oxygen getting into the blood.
If your baby shows any of these signs
of trouble breathing, or if his fever lasts more than
24 hours (or is present at all in an infant under
3 months of age), call your pediatrician.
Also call your pediatrician
if your baby develops any of the following signs or
symptoms of dehydration:
- Taking less than her normal amount
of fluids.
- Dry mouth.
- Crying without tears.
- Urinating less often than normal.
If you think your child has
Bronchiolotis and your child has any of the following
conditions, call your pediatrician.
- Cystic fibrosis.
- Congenital heart disease.
- Bronchopulmonary dysplasia (seen
in some infants who have been on a respirator as
newborns).
- Immune deficiency disease (like
AIDS).
- Organ transplant.
- A cancer for which she is receiving
chemotherapy.
Home Treatment
There are no medications you can use
to treat RSV infections at home.
Antibiotics, which treat bacteria, are not helpful
for Bronchiolotis because it is almost always caused
by a virus. However, you can ease your child’s
cold symptoms. Try the following suggestions:
To relieve stuffy nose and fever:
Thin the mucus using mild salt-solution
(saline) nose drops recommended by your pediatrician.
Never use nonprescription nose drops that contain
any medication. Only use salt-solution nose drops.
Clear your baby’s nose with a suction bulb.
Squeeze the bulb part of the device first. Gently
put the rubber tip into one nostril, and slowly release
the bulb. This slight amount of suction will draw
the clogged
mucus out of the nose. This works best when your baby
is under 6 months old.
Place a cool-mist humidifier (vaporizer) in your baby’s
room. Set it close to her. Be sure to clean and dry
the humidifier each day to keep bacteria or mold from
growing. Do not use hot water vaporizers since
they can cause serious scalds or burns.
If your baby has a fever, give her acetaminophen.
(Be sure to follow the recommended dosage for your
child’s age.) Do not give aspirin to your child.
Aspirin has been associated with Reye syndrome, a
disease that affects the liver and the brain. Never
give her any other kind of cold medicine without first
checking with your pediatrician.
To prevent dehydration:
Make sure your baby drinks lots of
fluid so he does not become dehydrated. He may prefer
clear liquids rather than milk or formula. He may
feed more slowly and may not tolerate solid foods
very well
because he is having trouble breathing.
Professional Treatment
If your baby is having mild to moderate
trouble breathing, your pediatrician may try using
a drug that opens up the breathing tubes, which seems
to help some infants.
Some children with Bronchiolotis need to be hospitalized,
either for breathing problems or dehydration. Your
pediatrician will treat your baby’s breathing
problems with oxygen and medication. The dehydration
will be treated with a special liquid diet or with
fluids given intravenously (directly into the blood
stream)..
Very rarely an infant will not respond
to any of these treatments. She might have to be put
on a breathing machine (respirator). This usually
is only a temporary measure to help her until her
body is able to
overcome the infection.
Prevention.
The best way to protect your
baby from Bronchiolotis is to keep him away from the
viruses that cause it. When possible, avoid close
contact with children or adults who have colds. If
your baby is in a child-
care center where other children might have RSV, make
sure that those who care for him wash their hands
well and often.
When your baby has a cold, he needs a bit more attention
to detect early signs of Bronchiolotis or another
serious infection. Be sure to call your pediatrician
if you think your baby might have such a problem.
