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Bronchiolitis is a frequent lung infection in newborns and young children. It causes inflammation and congestion in the lung's tiny airways (bronchioles). Bronchiolitis is almost often the result of a virus. The winter months are typically the worst for bronchiolitis.
Bronchiolitis begins with symptoms similar to a regular cold, but progresses to coughing, wheezing, and, in some cases, difficulty breathing. Bronchiolitis symptoms might linger for several days to weeks.
Most children improve with home care. Only a small number of children require hospitalization.
WHAT ARE THE SYMPTOMS OF BRONCHIOLITIS?
The signs and symptoms of bronchiolitis are similar to those of a cold for the first few days:
- Runny nose
- Nose congestion
- Cough
- A mild fever (not always present)
Following this, the child may experience difficulties breathing or a whistling sound while exhaling for a week or more (wheezing).
Many babies also suffer ear infections (otitis media).
WHEN SHOULD YOU SEE A DOCTOR?
If your kid is refusing to eat or drink and his or her breathing becomes more rapid or laborious, contact your child's doctor. This is especially critical if your child is less than 12 weeks old or has other bronchiolitis risk factors, such as premature birth or a heart or lung problem.
The following indications and symptoms should cause you to seek medical attention:
- audible wheezing
- Breathing very quickly — more than 60 breaths per minute (tachypnea) — and shallowly
- Breathing is labored – the ribs appear to suck inward as the infant inhales.
- A sluggish or lethargic demeanor
- Refusing to drink enough water or breathing too quickly to eat or drink
- Blue skin, particularly the lips and fingernails (cyanosis)
WHAT ARE THE CAUSES OF BRONCHIOLITIS?
Bronchiolitis develops when a virus infects the bronchioles, the smallest airways in the lungs. The infection causes swelling and inflammation of the bronchioles. Mucus accumulates in these airways, making it difficult for air to pass easily into and out of the lungs.
The respiratory syncytial virus causes the majority of bronchiolitis cases (RSV). RSV is a common virus that affects nearly every child by the age of two. Every year, outbreaks of RSV infection occur, and individuals can be reinfected because past illness does not appear to provide lasting immunity. Other viruses, such as those that cause the flu or the common cold, can also cause bronchiolitis.
Bronchiolitis viruses are easily transmitted. You can get them through droplets in the air when someone is unwell coughs, sneezes, or speaks. You can also get them by touching common objects like cutlery, towels, or toys and then touching your eyes, nose, or mouth.
WHAT ARE THE RISK FACTORS OF BRONCHIOLITIS?
Bronchiolitis is most common in children under the age of two. Infants under 3 months of age are most vulnerable to bronchiolitis because their lungs and immune systems have not yet fully formed.
Other factors associated with a higher incidence of bronchiolitis in babies and more severe cases include:
- Premature delivery
- underlying heart or lung disease
- Depressed immune system
- Tobacco smoke exposure
- Having never been breast-fed (breast-fed babies receive immune benefits from the mother)
- Contact with a large number of children, such as in a child care environment
- Spending time in crowded places
- Having siblings who go to school or use child care facilities and carry the virus home
WHAT ARE THE COMPLICATIONS OF BRONCHIOLITIS?
Severe bronchiolitis complications may include:
- Blue lips or skin (cyanosis) caused by inadequate oxygen
- Breathing pauses (apnea), which are more common in premature babies and babies within the first two months of life
- Dehydration
- Respiratory failure and low oxygen levels
If this happens, your child may need to be hospitalized. Severe respiratory failure may necessitate the insertion of a tube into the child's windpipe (trachea) to assist breathing until the illness has run its course.
Keep an eye out for early signs of bronchiolitis if your kid was born preterm, has a heart or lung disease, or has a weakened immune system. The infection can soon worsen. In such instances, your child will almost always require hospitalization.
HOW IS BRONCHIOLITIS DIAGNOSED?
Bronchiolitis is frequently diagnosed without the use of tests or X-rays. The doctor can typically figure out what's wrong by studying your child and listening to his or her lungs with a stethoscope.
If your kid is at danger of developing severe bronchiolitis, if symptoms are worsening, or if another disease is suspected, your doctor may request the following tests:
- Chest X-ray: A chest X-ray may be ordered by your doctor to check for signs of pneumonia.
- Testing for viruses: Your doctor may take a sample of your child's mucus to test for the virus that causes bronchiolitis. This is accomplished by gently inserting a swab into the nose.
- Blood tests: Blood tests may be done to check your child's white blood cell count on occasion. An increase in white blood cells is usually indicative of the body's battle against illness. A blood test can also indicate whether the level of oxygen in your child's bloodstream has dropped.
Your doctor may also inquire about indicators of dehydration, particularly if your child has refused to drink or eat or has vomited. Sunken eyes, dry mouth and skin, sluggishness, and little or no urination are all symptoms of dehydration.
WHAT ARE THE TREATMENTS FOR BRONCHIOLITIS?
Bronchiolitis usually lasts between two and three weeks. The majority of children with bronchiolitis can be treated at home with supportive care. It is critical to be on the lookout for changes in breathing problems, such as straining for each breath, being unable to speak or scream due to trouble breathing, or producing grunting noises with each breath.
Antibiotics, which are used to treat infections caused by bacteria, are ineffective against bronchiolitis since it is caused by viruses. Bacterial infections, such as pneumonia or ear infections, can occur in conjunction with bronchiolitis, and your doctor may prescribe antibiotics to treat such infections.
Bronchodilators (drugs that widen the airways) have not been found to be routinely beneficial and are rarely used to treat bronchiolitis. In severe circumstances, your doctor may decide to try nebulized albuterol to see whether it works.
Oral corticosteroid medicines and chest physiotherapy (beating on the chest to remove mucus) have not been demonstrated to be effective therapies for bronchiolitis and are not suggested.
Hospital treatment
A small number of children may require hospitalization to manage their illness. A child in the hospital may get humidified oxygen to maintain enough oxygen levels in the blood, as well as fluids administered through a vein (intravenously) to prevent dehydration. In severe circumstances, a tube may be placed into the child's trachea to assist with breathing.
HOME REMEDIES FOR BRONCHIOLITIS
Home remedies and way of life
Although you may not be able to shorten your child's illness, you may be able to make him or her more comfortable. Here are some ideas to get you started:
- Make the air more humid: If the air in your child's room is dry, a cool-mist humidifier or vaporizer can help relieve congestion and coughing. Keep the humidifier clean to avoid the formation of bacteria and mould.
- Maintain your child's upright position: Being upright usually makes it simpler to breathe.
- Consider over-the-counter pain relievers: Ask your doctor about giving your child over-the-counter fever and pain medications such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) as a safer alternative to aspirin for fever or pain. Because of the risk of Reye's syndrome, a rare but potentially fatal illness, aspirin is not recommended for children. Children and teenagers who are recuperating from chickenpox or flu-like symptoms should never use aspirin because they are more likely to develop Reye's syndrome.
- Keep the environment smoke-free: Smoking can exacerbate the symptoms of respiratory illnesses. If a family member smokes, request that he or she smoke outside the house and in the car.
- Make your child consume liquids: Give your child lots of clear fluids to drink, such as water or juice, to prevent dehydration. Because of the congestion, your youngster may drink more slowly than normal. Offer modest amounts of fluid on a regular basis.
- To relieve congestion, use saline nose drops: These drops are available without a prescription (OTC). They're effective, non-irritating, and even suitable for children. To use them, place several drops in one nostril and immediately bulb suction that nostril (but not too far in). Rep the procedure in the opposite nostril.
Except for fever reducers and pain relievers, do not use over-the-counter medications to treat coughs and colds in children under the age of six. Consider avoiding the use of these medications in children under the age of 12.
HOW CAN BRONCHIOLITIS BE PREVENTED?
Because the viruses that cause bronchiolitis move from person to person, washing your hands frequently is one of the best methods to prevent it – especially before contacting your infant if you have a cold or another respiratory infection. At this time, a face mask is appropriate.
To avoid spreading bronchiolitis to others, keep your child at home until the sickness is over.
Other commonsense methods for preventing infection include:
- Make use of your own drinking glass: Share your glasses with no one, especially if someone in your family is sick.
- Hands should be washed frequently: Wash your hands and your child's hands frequently. When you're not at home, keep an alcohol-based hand sanitizer on hand for yourself and your child.
- Breast-feed: In breast-fed babies, respiratory infections are much less common.
- Avoid contact with anyone who has a fever or a cold: Avoid exposing your newborn, especially a premature newborn, to persons who have colds, especially during the first two months of life.
- Surfaces should be cleaned and disinfected: Surfaces and objects that people commonly touch, such as toys and doorknobs, should be cleaned and disinfected. This is especially vital if a member of the family is ill.
- Coughs and sneezes should be covered: Use a tissue to cover your mouth and nose. Then discard the tissue and wash your hands with soap or an alcohol-based hand sanitizer.
Vaccines and drugs
There are no vaccinations available against the most prevalent causes of bronchiolitis (RSV and rhinovirus). Everyone above the age of six months, however, should have a flu shot every year.
Infants who are at high risk of RSV infection, such as those born prematurely, have a heart or lung problem, or have a weakened immune system, may be administered palivizumab (Synagis) to reduce the likelihood of RSV infections.