Bronchiolitis

You should bring your child to a doctor if they display any of the following symptoms:

• Wheezing
• Hard or fast breathing with recessions in the ribcage muscles, flaring of the nostrils or bobbing head motions in younger children/in babies
• Irregular breathing or pauses in breathing
• Increased lethargy
• Refusal to drink
• Change in facial colour (pale, blue or turning red on coughing)

Bronchiolitis is often diagnosed on clinical examination by your doctor. Blood tests, nasal swabs and x-rays are usually not required for diagnosis.

Since bronchiolitis is caused by a virus, antibiotics are not indicated. Antibiotics do not treat viruses. Other medications such as nebulised adrenaline, or steroids are also not useful in bronchiolitis.

If your child has mild symptoms, allow them to have sufficient rest for recovery. Feed your child small but frequent fluids to keep them well hydrated. It is normal for your child not to be able to finish a full formula feed at a go. Split feeds into half and shorten the time interval between feeds.

You can use saline drops or nasal sprays to keep the nasal passage clear so that your child will be more comfortable.

If your child is refusing to feed, breathing hard or fast or becoming lethargic, they may need to be admitted for closer monitoring. Your child may require additional treatments such as oxygen, nebulised saline or supplemental fluids through a drip.

Your child may continue to be unwell for 7 – 10 days. As they recover, the cough can continue to persist for up to 4 weeks.

Your child has a higher risk of bronchiolitis if they were born prematurely, has chronic heart or lung disease, or has a weakened immune system due to a recent illness.

Yes. Since there are many viruses which can cause bronchiolitis, your child may develop more than 1 episode.

Viruses are contagious. Your child contracts viruses if they breathe in infected droplets in the air or touch objects with infected droplets from other persons who are unwell. Avoid close contact with persons who are unwell.

Your baby can also get the flu vaccine to protect them from more contagious flu strains from the age of 6 months. This should be repeated on a yearly basis.

Ensure that your home is a smoke-free environment. Infants exposed to cigarette smoke are at increased risk of bronchiolitis.

Some children who have a genetic tendency to develop asthma may present as babies with similar symptoms to bronchiolitis. However, they usually have breathing difficulties earlier on the first or second day of illness.

Such children may continue to exhibit other symptoms of asthma such as bad coughing episodes in the daytime or middle of the night even when they are not unwell. If your child has multiple episodes of bronchiolitis or has any of the above symptoms, they should see a doctor for an evaluation and close follow-ups.