Bronchiolitis is a common respiratory tract infection involving the smallest breathing tubes in the lungs called the bronchioles. It is usually caused by a virus; a respiratory syncytial virus (RSV) is most common but parainfluenza virus and adenovirus can also cause the infection. The viruses spread from person to person through sneezing and coughing and direct hand-to-hand contact. Exposure to cigarette smoke and being around many children in an enclosed environment (such as a day care center) can also increase the risk of infection and illness.
Babies who are born prematurely are at increased risk and children under 2 are especially prone to bronchiolitis. It is most common in boys between 2 to 6 months old and in children who have not been breastfed. Bronchiolitis is most common in winter and early spring, and it may occur in minor epidemics.
The disease starts out as an upper respiratory infection (URI) such as a common cold. Initially, the child will sneeze and have a runny, stuffy nose, but after a few days, she'll develop a fever and a harsh cough. The child will then develop rapid breathing and have difficulty exhaling. She may need to use extra breathing muscles, especially in the neck, between the ribs, and below the rib cage, and may begin to wheeze. Very young children who develop bronchiolitis may have problems sleeping and eating. Large amounts of thick secretions in the airway may lead to vomiting or mucus in the stool.
Breathing difficulty is one of the most worrisome complications of bronchiolitis. The breathing of children under 6 months may be severely affected; contact a doctor if there is any sign of labored breathing. Food and liquid intake tends to decrease due to breathing difficulty and vomiting, both of which frequently occurs in connection with coughing attacks. Increased mucus formation in the airways may plug up areas of the lungs, leading to lung tissue collapse and inflammation and even bacterial infection (pneumonia).
It is difficult to keep your child away from viruses that cause bronchiolitis. Fortunately, not all children with bronchiolitis will require medical attention. If your child has bronchiolitis, avoid contact with other infants until any fever is gone and your child's condition improves. Frequent hand washing, avoiding people with colds, and avoiding exposure to cigarette smoke will reduce the risk of infection and sickness.
Children with a high risk for developing bronchiolitis, such as those born prematurely or those with known lung or heart diseases, will be given a medication that protects against RSV. It is given in the form of monthly injections, only to selected groups of high-risk children. If you think your child is a candidate for this medicine, discuss this with your doctor.
It is important to act calmly with your child so that he does not become more anxious, which will make breathing even more difficult.
There are some treatment measures you can take at home:
However, contact 911 or your doctor immediately if:
In some cases, hospitalization is necessary so that extra oxygen can be given to make breathing easier or intravenous fluids given to treat dehydration. Antibiotics may be administered in serious cases where a bacterial infection is suspected. Smaller children with severe breathing problems may also need an inhaler to provide medication that will open the airways.