We're still in flu season, and one common illness for infants and children this time of year is bronchiolitis.

No, bronchiolitis isn't the same as bronchitis, which is a respiratory infection that typically affects older children and adults. Bronchiolitis most often affects infants and young children, as their noses and small airways are more likely to block. The infection typically hits within the first two years, most commonly between 3 and 6 months old.

Bronchiolitis is an infection of the respiratory tract that affects the bronchioles — small airways that lead to the lungs. As these airways become inflamed, they swell and fill with mucus, which can make breathing difficult. Bronchiolitis is typically caused by a viral infection — most often Respiratory Syncytial Virus — but can also develop from the common cold, influenza, metapneumovirus or adenovirus.

Risk factors for bronchiolitis include exposure to cigarette smoke or attending childcare facilities, where illnesses spread more rapidly due to exposure to high numbers of children.

Additional risk factors for young children include being male, born prematurely, bottle-fed or formula-fed instead of breastfed, in a crowded home environment, diagnosed with heart or lung disease, or diagnosed with a weakened immune system due to medicines or illness.

What are the signs and symptoms of bronchiolitis?

Your child will often show signs of a cold, such a runny nose, mild cough and fever. After a couple of days, the cough will worsen and breathing will quicken. Your child may show the following signs if he or she is having trouble breathing:

• Widened nostrils, retracted or squeezed muscles in and around the rib cage as he/she tries to get enough air

• Grunting or high-pitched whistling (wheezing) while exhaling

• Drinking trouble, due to difficulty sucking or swallowing

• In severe cases, a bluish tint around the mouth and fingertips

Contact your doctor immediately if you think your child is having trouble breathing.

Additional symptoms of bronchiolitis include rapid heartbeat, irritability, difficulty sleeping, fatigue/lethargy, vomiting after coughing, poor appetite or not feeding well, which can lead to decreased urination and fewer dirty diapers.

Your child may also become dehydrated, which is evident by drinking less than normal, a dry mouth, crying without tears and urinating less than normal or having dark yellow urine. 

Cases of bronchiolitis typically last about seven to 12 days, but more severe cases can result in a cough and wheeze that lasts for weeks. The illness is often at its worst on the second or third day after coughing begins.

How is bronchiolitis treated?

There is currently no vaccine for bronchiolitis, and medication to ease severity is typically only recommended for infants at high risk for developing a severe infection, which includes those born prematurely. This medication is given as a monthly injection during peak RSV months. However, there are several home treatments that can help ease your child’s discomfort throughout the duration of his or her illness.

• Offer small amounts of fluid often to combat dehydration. Your child may not want to drink due to discomfort, so frequent small offerings are more effective than large offerings throughout the day.

• Use a cool-mist vaporizer or humidifier in the house and your child’s room, as this can help loosen mucus and relieve the cough and congestion.

• Clear nasal congestion with a bulb syringe and saline nose drops. This can be particularly beneficial right before feeding and sleeping. You can also put your child in a slightly upright position to ease labored breathing.

• Give your child acetaminophen to help ease fever and make your child more comfortable.

• Make sure you and your family wash your hands regularly during cold and flu season. It is the best prevention of illness.

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Kevin R. Murphy, M.D., is board certified in pediatrics. Learn more about Kevin on the Boys Town Pediatrics website. Read more advice from Boys Town pediatricians on Momaha's expert advice page.

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