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Patient education: Bronchiolitis and RSV in children (The Basics)

Patient education: Bronchiolitis and RSV in children (The Basics)

What is bronchiolitis? — Bronchiolitis is an infection that affects a part of the lungs called the "bronchioles." The bronchioles are the small, branching tubes that carry air in and out of the lungs. When these tubes are infected, they get swollen and full of mucus (figure 1). That makes it hard to breathe.

Bronchiolitis most often affects children younger than 2 years of age. It is usually caused by a virus. In most children, bronchiolitis goes away on its own. But some children with bronchiolitis need to be seen by a doctor.

What is RSV? — RSV stands for "respiratory syncytial virus." It is the most common cause of bronchiolitis.

What are the symptoms of bronchiolitis? — Bronchiolitis usually begins like a regular cold. Children who get bronchiolitis usually have these symptoms at first:

Stuffy or runny nose

Mild cough

Fever (temperature higher than 100.4°F, or 38°C)

Decreased appetite

As bronchiolitis progresses, other symptoms can start, including:

Breathing faster than normal

Pauses between breaths – Sometimes, a pause in breathing can last more than 15 or 20 seconds.

Wheezing – This is a whistling sound when breathing. It usually lasts about 7 days.

Severe cough – The cough can last for 14 days or longer.

Trouble eating and drinking – Other symptoms can make a child less interested in food. In babies, a stuffy nose or fast breathing can make it harder to breastfeed or drink from a bottle.

Should I take my child to see a doctor or nurse? — Many children with bronchiolitis do not need to see a doctor. But you should watch for some important symptoms.

Call for an ambulance (in the US and Canada, call 9-1-1) if your child:

Stops breathing

Has blue or gray lips, gums, or fingernails

Has a very hard time breathing

Starts grunting

Looks like they are getting tired from working so hard to breathe

Call your child's doctor or nurse if:

The skin and muscles between your child's ribs or below your child's ribcage look like they are caving in (figure 2).

Your child's nostrils flare (get bigger) when they take a breath.

Your baby is younger than 3 months and has a fever (temperature greater than 100.4°F, or 38°C).

Your child is older than 3 months and has a fever (temperature greater than 100.4°F, or 38°C) for more than 3 days.

Your baby has fewer wet diapers than normal.

You have other questions or concerns about your child.

Will my child need tests? — It depends. Your child's doctor or nurse will be able to tell if they have bronchiolitis based on their symptoms. In some cases, they might do tests to figure out the cause. This can tell them if your child has RSV or another viral infection like the flu or COVID-19.

How is bronchiolitis treated? — The main treatments for bronchiolitis are aimed at making sure that your child is getting enough oxygen. To do that, the doctor or nurse might need to suction the mucus from your child's nose, or give your child moist air or oxygen to breathe.

The doctor will probably not prescribe antibiotics. That's because bronchiolitis is caused by viruses, and antibiotics do not work on viruses.

Is there anything I can do on my own to help my child feel better? — Yes. Here are some things you can do:

Make sure that your child gets enough fluids. Call the doctor or nurse if your baby has fewer wet diapers than normal.

Use a humidifier in the room where your child sleeps.

If your child is uncomfortable because of fever, you can give them over-the-counter medicines, such as acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin). Read the instructions carefully. Never give aspirin to a child younger than 18 years old.

Remove the mucus from your child's nose with a suction bulb.

If your child is older than 1 year, feed them warm, clear liquids to soothe the throat and to help loosen mucus.

Prop your child's head up on pillows if they are over 1 year old. (Do not use pillows for a child younger than 1 year.)

Sleep in the same room as your child, so you know right away if they start having trouble breathing.

Do not smoke or allow anyone else to smoke near your child.

If your child's symptoms get worse, call their doctor or nurse for advice.

How did my child get bronchiolitis? — Bronchiolitis is caused by viruses, including RSV, that spread easily from person to person. These viruses live in the droplets that go into the air when a sick person coughs or sneezes.

Can bronchiolitis be prevented? — Experts recommend that young babies get a shot to protect against RSV. This lowers the risk of infection and serious illness. If your baby is younger than 8 months old during their first RSV season, talk to their doctor about the shot. In the US, the RSV season is from October to March.

There are also other things you can do to protect your child from viruses that can cause bronchiolitis. These things also help prevent other illnesses, like colds, the flu, and COVID-19.

You can help prevent infections from spreading if you:

Wash your hands and your child's hands often with soap and water (figure 3), or use alcohol-based hand sanitizer (figure 4).

Teach your child to cover their mouth when they cough, or cough into their elbow.

Do not share glasses, cups, or utensils.

Clean things that are touched a lot, such as counters, sinks, faucets, doorknobs, phones, remotes, and light switches.

Stay away from people who are sick.

Make sure that your child gets all of their recommended vaccines, including those for the flu and COVID-19.

More on this topic

Patient education: Cough, runny nose, and the common cold (The Basics)
Patient education: Fever in children (The Basics)
Patient education: Flu (The Basics)
Patient education: What you should know about vaccines (The Basics)
Patient education: Sore throat in children (The Basics)
Patient education: Cough in children (The Basics)

Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics)

This topic retrieved from UpToDate on: Jun 02, 2024.
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