09/17/2025
🦠 Let’s Talk About Bronchiolitis! 🦠
The fall and winter months are some of our busiest times with an increase in viral respiratory infections. Children less than 2 years are susceptible to developing a respiratory condition called bronchiolitis.
📍 What is it? - A clinical syndrome of respiratory symptoms that occurs in infants and children less than 2 years of age. It can be caused by various respiratory viruses, with the most common cause being due to respiratory syncytial virus or RSV. These viruses can cause inflammation and mucous collection of the smaller airways in the lungs (the bronchioles).
📍 What does it look like? - Can usually begin with upper respiratory symptoms such as a fever, runny nose, nasal congestion, and cough. The mucous produced may be a lot in relation to your childs tiny nasal passages leading to noisy breathing, the feeling of "rattling" in the chest, and persistent, wet cough. Sometimes children may have mucous-filled vomiting and loose stools. In bronchiolitis, symptoms can progress to the lower, smaller airways and cause symptoms such as wheezing, crackles, and/or retractions of the chest wall. In infants less than 2 months old, RSV bronchiolitis can cause apnea events where the infant has episodes of prolong breath holding along with poor feeding.
📍 What can I do? - Bronchiolitis is a viral process and in most situations can be managed at home with supportive care. Antibiotics are usually not recommended due to the viral nature of the disease. As with many viral respiratory illnesses or "colds", we recommend keeping the child comfortable with ibuprofen (6+ months) and acetaminophen if febrile and fussy. Keep the child hydrated with clear liquids even if they are not wanting solid foods. Monitor urine output for any signs of dehydration, your child needs 3 urinations/diapers in 24 hours. Monitor respiratory effort. Can use nasal saline sprays to break up mucous and make it easier for the child to manage their secretions, in addition to using nasal suction devices such as bulb suction or the Nose Freda. Nasal clearance can be especially beneficial before feeds and bedtime.
📍 When should I worry? - In a small handful of patients, some symptoms can become severe leading to respiratory distress or respiratory failure. Symptoms to be aware of and would require further attention includes breathing too fast or too slow, poor feeding, lethargy/difficult to arouse, urine output less than 3 times per day, head bobbing, nasal flaring, sucking in of the ribs between breaths, or dusky discoloration around the mouth or nose. Additionally, any fevers suspected in an infant less than 2 months old should be taken rectally; a fever above 100.4 F in a newborn less than 2 months old will need to be evaluated by the ER regardless of respiratory status.
⚠️This information is for educational purposes and is not meant to be a substitution for medical advice. Please contact our office to schedule an appointment or speak with one of our nurses if at any time you are concerned about your child and the symptoms they are experiencing.
References: https://www.uptodate.com/contents/bronchiolitis-in-infants-and-children-treatment-outcome-and-prevention
