Bronchiolitis in Babies: Symptoms, Treatment, and Prevention

Causes and Symptoms of Bronchiolitis

Bronchiolitis is one of those illnesses that scares both parents and doctors every winter season. We are starting to see bronchiolitis extend into what seems like a year-round illness in the last few years. So what is bronchiolitis, and why is it so worrisome?

Bronchiolitis is basically a viral illness that affects the tiny airways of our smallest patients, those under age 2. It used to be mainly RSV that caused bronchiolitis, and RSV still accounts for the majority of bronchiolitis cases and often the more severe cases. But other viruses, such as rhinovirus and parainfluenza virus are now causing similar symptoms.

Bronchiolitis normally starts off like a mild cold for a day or two, and then on days three through seven, that's the scary time because the virus will create a lot of mucus, so much mucus that little kids who can't blow their nose have breathing issues. Babies who only breathe out of their noses until they're about 9 months old have a hard time breathing, they also have a hard time eating and they are at risk for dehydration.

Treating Bronchiolitis

Parents need to be vigilant with using nasal saline and suctioning the mucus out of their child's nose. Some children need to be seen by suction clinics run by respiratory therapists for deeper suctioning, and your child's pediatrician can refer to these clinics if they're available in your area.

The mucus is really thick. So using humidity can thin the mucus, making it easier to get out of both little noses and little lungs. Kids have a very crackly, raspy cough and sometimes will cough so hard they vomit, and the vomit is full of mucus. Babies especially will have difficulty breathing, and they'll have retractions, which is where it looks like their ribs are sucking in with each breath. You may hear them wheeze, but it's not like asthma. The thick mucus can also cause a child's oxygen to drop pretty low.

Treatment for bronchiolitis has changed a little over the last 10 years. At one point, albuterol nebulizer treatments were used. But research shows that albuterol doesn't help as much as we thought. Treatment is mainly supportive care, nose sucking, nasal saline, a humidifier or a steamy shower, and fluids. If a child's oxygen is low, then they may also be started on oxygen and even admitted to the hospital for close monitoring.

Bronchiolitis is worst the first week, but symptoms can often take two or more weeks before kids start to feel better and their symptoms start improving.

Preventing Bronchiolitis

The best way to prevent bronchiolitis is to keep your child away from other sick individuals as much as possible, especially if you know that certain viruses are going around in your area. Pretty much every child will have multiple colds in their first few years as their immune systems are developing. Be sure to have saline, nasal suction devices, and humidifiers on hand to help them through all their symptoms. And if your child looks like they're having a hard time breathing, see your child's doctor, or take them to the closest pediatric emergency room right away.