Bronchiolitis is a lower respiratory tract infection that commonly affects babies and young children under 2 years old. Around 1 in 3 children in the UK will develop the condition during their first year of life[1].

Bronchiolitis is almost always caused by a viral infection. In most cases, the respiratory syncytial virus (RSV) is responsible, although not all babies infected with RSV will go on to develop bronchiolitis. It can also be caused by the common cold or flu.

The infection causes the smallest airways in the lungs (the bronchioles) to become infected and inflamed. This reduces the amount of air entering the lungs, making it difficult to breathe.

For the majority of babies and children, symptoms of bronchiolitis will be mild. As it is a virus, antibiotics cannot help but it will typically clear up within two to three weeks without the need for treatment. However, some children experience more serious symptoms and require medical treatment.

Who is most at risk of bronchiolitis?

Some babies and children are at greater risk of developing severe bronchiolitis, including premature babies, babies with existing heart or lung conditions, and babies who have problems with their immune system from birth.

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What are the main symptoms of bronchiolitis?

Most children will experience cold-like symptoms, such as a cough and runny nose. The main symptoms include:

  • A dry and persistent cough
  • High temperature
  • Difficulty feeding in babies and decreased appetite in older children / toddlers
  • Wheezy chest and breathing

When you should seek medical advice:

The vast majority of cases are not serious. However, it is important that parents look out for the following signs, and if their child is presenting these, parents should ring their GP or 111:

  • If the child or baby has eaten / consumed less milk than normal
  • If they are having fewer wet nappies
  • If they have a persistent high temperature of 38C or above
  • If they seem very tired or irritable, and generally not themselves for a prolonged period

It is essential to dial 999 for an ambulance if:

  • The child is having difficulty breathing
  • The child’s tongue or lips are blue
  • There are long pauses in the child’s breathing

How is bronchiolitis diagnosed?

If parents suspect their child has bronchiolitis and their symptoms have not improved after one week or parents are concerned about the symptoms, they should speak to their GP or paediatrician.  Based on the child’s symptoms, they will be able to diagnose the condition and provide their advice on how to best manage symptoms.

How to treat bronchiolitis?

There is no specific medication that kills the RSV virus which causes bronchiolitis, but treatment focused on easing symptoms will help whilst the child’s body naturally fights the illness.

Parents should make sure their child gets plenty of rest, is well-hydrated and can give Ibuprofen or Calpol in the appropriate dose for an infant if needed.

A very small number of children will contract a severe case of bronchiolitis and might need to be admitted to hospital due to problematic symptoms. This is more common in premature babies.

How can bronchiolitis be prevented?

RSV, the virus responsible for bronchiolitis is spread through droplets of liquid from coughs or sneezes of someone who is infected. As with any bacterial or viral infection, it is difficult to prevent bronchiolitis. However, there are ways to help reduce the risk of children catching it – largely related to hygiene – as these germs can remain on hands, toys, doorknobs, tissues, and other surfaces for a long time.

The following measures could help to limit the risk of children catching the virus:

  • Keep small babies away from anyone who has cold or flu-like symptoms
  • Ensure children wash their hands regularly
  • Make sure surfaces, floors, toys, and other common touchpoints around children are cleaned frequently

For more information, visit www.hcahealthcare.co.uk/facilities/the-portland-hospital

Article by Dr Ranjan Suri, Paediatric Respiratory Consultant at The Portland Hospital, part of HCA Healthcare UK

About The Portland Hospital

The only private hospital in the UK dedicated to healthcare for women and children, The Portland offers world-class personalised care in maternity, gynaecology and paediatrics.

Each year we diagnose and treat more than 40,000 children and deliver more than 1,200 babies. Our experienced team of over 600 consultants are supported by the latest in diagnostic technology including MRI, CT and interventional radiology scanners.

[1] Source: NHS Website (https://www.nhs.uk/conditions/bronchiolitis/)

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