Bronchiolitis

Bronchiolitis is an inflammation of the bronchioles, which are tiny airways in the lungs. It is most common in very young children and can result in severe respiratory problems.

Bronchiolitis is an infection most often caused by the respiratory syncytial virus (RSV). Bronchiolitis:

  • Affects the lungs and respiratory tract
  • Is contagious and is easily spread through contact with contaminated secretions via the hands or objects, or through tiny airborne droplets
  • Usually occurs from late fall until early spring

It usually starts with symptoms similar to those of a common cold. These include nasal congestion, runny nose, cough, sore throat, low-grade fever and otitis. These symptoms typically go away within two weeks.

When the infection worsens and develops into bronchiolitis, the child may experience the following symptoms:

  • Rapid breathing
  • Wheezing when breathing out
  • Rapid heartbeat
  • Dry cough that turns into a cough with secretions
  • Blue-tinged nails and lips
  • Unusual agitation
  • Refusal to feed

Causes and triggers

Viruses other than RSV, such as the flu virus, can also cause bronchiolitis.

Bronchiolitis mostly affects young children, and some have more risk factors for severe bronchiolitis. These are often children who:

  • Were born prematurely
  • Are younger than 3 months of age
  • Have a lung or heart condition (e.g., asthma)
  • Are exposed to secondhand smoke (e.g., cigarette smoke)
  • Come from large families
  • Are in daycare

Treatment

Frequent handwashing is the best way to prevent bronchiolitis. The importance of good hygiene measures is even more important in areas heavily frequented by young children such as daycare centres and preschools. Providing a healthy, smoke-free environment and breastfeeding infants are also great preventive measures.

A child with bronchiolitis should rest for the first 48 to 72 hours and contact with others should be limited to prevent further spread.

Several measures may be used to provide some relief to your child:

  • Clearing the nasal passage with saline solution (Salinex, Sinus Rinse) or a nasal aspirator can provide some relief.
  • If the child has a pet or dust allergy, avoid exposure to the allergen.
  • Treat the fever with acetaminophen (Tylenol).
  • If there is a secondary bacterial infection such as otitis or pneumonia, an antibiotic may be prescribed.
  • To ease breathing, a bronchodilator (inhaled medication that opens the airway) may be prescribed.

In the most severe cases, hospitalization may be required in order to rehydrate the child with intravenous fluids and to administer oxygen.

Cough medicine should never be given to a child without first consulting a healthcare professional.

When should I see a healthcare professional?

See your health provider if your child:

  • Has a medical condition that puts them at higher risk for infection-related complications
  • Is showing signs of dehydration:
    • dry or sunken eyes
    • dry, pasty mouth
    • urinating less
    • difficulty eating or drinking
  • Has trouble breathing or is breathing very rapidly
  • Has pale or blueish-coloured skin
  • Is listless
  • Is unable to nurse or drink (young infant)
For more information:
Canadian Paediatric Society
www.cps.ca
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