Bronchiolitis

Symptoms

If your child is under 2 years old and:

• Has a cough accompanied by wheezing, rapid breathing, or tightness near the ribs (their ribs contract and their chest sinks in when they inhale)
• Has cold symptoms
• Has a mild fever

• Is under 6 months old
• Is 6 months or older and their condition worsens
• Shows signs of respiratory distress: severe/laboured/rapid wheezing; more than 40 breaths per minute; grunting on exhalation
• Chokes when drinking and is unable to feed
• Has a persistent cough

• Lethargy
• A blue tinge to their lips
• Pauses in breathing (stops breathing for about 20 seconds)

What is bronchiolitis?

Bronchiolitis is an inflammation of the small airways (bronchioles) that allow air to circulate through the lungs. It is most often caused by the respiratory syncytial virus (RSV) and occasionally cold viruses.

Bronchiolitis is generally a mild illness, but can lead to complications in premature infants, children with heart, lung, or neurological disorders, and children with a weakened immune system due to illness or medication.

Bronchiolitis is the leading cause of hospitalization in children under age 1.

Does bronchiolitis lead to asthma?

Many asthmatic children had bronchiolitis during infancy. Several studies have shown that bronchiolitis during infancy is a risk factor for the development of asthma. In fact, children who had bronchiolitis in infancy are twice as likely to develop asthma.

However, not all babies who have bronchiolitis will become asthmatic as they grow older. There are also children who develop asthma without ever having had bronchiolitis.

If your child has recurring bronchiolitis, they likely have asthma. Talk to their doctor about it. Asthma generally appears between the ages of 12 and 15 months. To learn more, read our fact sheet on asthma.

Treatment

The treatment for bronchiolitis focuses on relieving nasal congestion (which is often present) and making your child feel better.

If their breathing problems are more serious (e.g., trouble breathing, unable to feed or drink, feeling very tired or lethargic, pauses in breathing), they may need to be hospitalized. They will be given oxygen, fluids, and help with feeding.

Care and practical advice

• Give your child fluids as often as possible. Give them small amounts at a time. Keep breastfeeding or giving them formula, or try an electrolyte drink like Pedialyte^®.
• Help clear your child’s nose, since a stuffy nose makes it harder to breathe. Use a saline solution (from the pharmacy or homemade) to loosen the mucus—especially before feedings—to help them drink more easily. For more details, see our article on cleaning and blowing a stuffy nose.
• To relieve pain and fever, give them acetaminophen (Tylenol^® or Tempra^®) or ibuprofen (Advil^®, Motrin^®, etc.) as indicated and in the doses recommended for your child’s weight. Don’t give ibuprofen to babies under 6 months, and never give aspirin (acetylsalicylic acid, or ASA) to a child or teen.
• Prop up the head of your child’s bed to about 30 degrees (semi-seated position) to make it easier for them to breathe. To do this, place pillows or cushions under the mattress. Hold your baby in a semi-upright position when breastfeeding or bottle-feeding.
• Try to keep the room temperature at 19°C or 20°C.
• Don’t smoke inside your home. If possible, avoid using a wood-burning stove to heat your home.
• Do not give your child cough syrup. Health Canada recommends not giving any cold or cough medicine (syrup, suppository, or other) to children under age 6. These medicines don’t work well for young children and may even be harmful.

Prevention

The virus that causes bronchiolitis is highly contagious. Being around infected people is a major risk factor. Children who go to daycare or have older siblings are more likely to catch it. However, breastfeeding is a protective factor.

Here are some ways to help prevent bronchiolitis:

• Wash your hands with soap and water before feeding or caring for your baby.
• Cough into the crook of your elbow, and teach your child to do the same as soon as they’re able to.
• Keep your child away from tobacco smoke, wood stove smoke, and vapour from e-cigarettes.
• Avoid taking your baby to crowded places (public transportation, shopping malls, hospitals, etc.), where they could be exposed to with people with colds.
• Don’t let your baby share pacifiers, bottles, or utensils with other children.
• Clean shared toys often.
• Avoid kissing your child on the face if you have a cold or cold symptoms.
• If you’re sick, wear a protective mask (sold in pharmacies) before caring for your baby.

Scientific review: Dr. Anne-Claude Bernard-Bonnin, pediatrician Research and copywriting:The Naître et grandir team Updated: January 2024

Photo: iStock.com/lostinbids