Bronchiolitis-RSV

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Symptoms of Bronchiolitis

• Wheezing is the main symptom that helps with diagnosis. Wheezing is a high-pitched purring or whistling sound.
• You can hear it best when your child is breathing out.
• Rapid breathing at a rate of over 40 breaths per minute.
• Tight breathing (having to work hard to push air out).
• Coughing (may cough up very sticky mucus).
• Fever and a runny nose often start before the breathing problems.
• The average age for getting bronchiolitis is 6 months (range: birth to 2 years).
• Symptoms are like asthma.
• About 30% of children with bronchiolitis later do develop asthma. This is more likely if they have close family members with asthma. Also likely if they have bronchiolitis more than 2 times.

Cause of Bronchiolitis

• A narrowing of the smallest airways in the lung (bronchioles) causes wheezing. This narrowing results from swelling caused by a virus.
• The respiratory syncytial virus (RSV) causes most bronchiolitis. RSV occurs in epidemics almost every winter.
• People do not develop life-long immunity to the RSV virus. This means they can be infected many times.

Trouble Breathing: How to Tell

Trouble breathing is a reason to see a doctor right away. Respiratory distress is the medical name for trouble breathing. Here are symptoms to worry about:

• Struggling for each breath or short of breath.
• Tight breathing so that your child can barely speak or cry.
• Ribs are pulling in with each breath (called retractions).
• Breathing has become noisy (such as wheezes).
• Breathing is much faster than normal.
• Lips or face turn a blue color.

Diagnosis of Bronchiolitis

• A doctor can diagnose bronchiolitis by listening to the chest with a stethoscope.

Prevention of Spread to Others

• Cover the nose and mouth with a tissue when coughing or sneezing.
• Wash hands often. After coughing or sneezing are important times.

When to Call for Bronchiolitis-RSV

Care Advice for Bronchiolitis

What You Should Know About Bronchiolitis:

• Bronchiolitis is common during the first 2 years of life.
• Most children just have coughing and fast breathing.
• Some develop wheezing. This means the lower airway is getting tight.
• If you were given a follow-up appointment, be sure to keep it.
• Here is some care advice that should help.

Asthma Medicines:

• Some children with bronchiolitis are helped by asthma-type medicines. Most children are not helped by these medicines.
• If one has been prescribed for your child, give it as instructed.
• Keep giving the medicine until your child's wheezing is gone for 24 hours.

Coughing Fits or Spells:

• Any age: breathe warm mist (such as with warm shower running in a closed bathroom).
• Age less than 1 year: give smaller, more frequent feedings with breastmilk or formula.
• Age 1 year and older: give warm fluids to drink, such as apple juice and herbal tea.
• Reason: relax the airway and loosen up any phlegm.

Homemade Cough Medicine:

• Do not give any over-the-counter cough medicine to children with wheezing.
• Age 1 year and older: use honey ½ to 1 teaspoon (2 to 5 mL) as needed. It works as a homemade cough medicine. It can thin the mucus and loosen the cough.

Nasal Saline to Open a Blocked Nose:

• Your baby can't nurse or drink from a bottle if the nose is blocked. Suction alone can't remove dry or sticky mucus.
• Use saline (salt water) nose drops or spray to loosen up the dried mucus. If you don't have saline, you can use a few drops of bottled water or clean tap water. If under 1 year old, use bottled water or boiled tap water.
• Step 1: put 3 drops in each nostril. (If age under 1 year old, use 1 drop).
• Step 2: suction each nostril out while closing off the other nostril. Then, do the other side.
• Step 3: repeat nose drops and suctioning until the discharge is clear.
• How often: do nasal saline when your child can't breathe through the nose. Limit: no more than 4 times per day.
• Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
• Other option: use a warm shower to loosen mucus. Breathe in the moist air, then suction.

Humidifier:

• If the air in your home is dry, use a humidifier. Reason: dry air makes coughs worse.

Smaller Feedings:

• Use small, frequent feedings whenever your child has the energy to drink.
• Reason: children with wheezing don't have enough energy for long feedings.
• Offer enough fluids to prevent dehydration.

Avoid Tobacco Smoke:

• Tobacco smoke makes coughs and wheezing much worse.
• Don't let anyone smoke around your child.

What to Expect:

• Wheezing and rapid breathing most often improve over 2 or 3 days.
• Mild wheezing sounds can last up to 1 week.
• Coughing may last 3 weeks.
• Some children (2%) with bronchiolitis need to be in the hospital. These children need oxygen or fluids given through a vein.

Return to Child Care:

• Your child is contagious for 7 days after the cough first started.
• Your child can return to child care after this time.

Call Your Doctor If:

• Trouble breathing occurs
• Wheezing gets worse (becomes tight)
• Trouble feeding occurs
• Fever lasts more than 3 days
• You think your child needs to be seen
• Your child becomes worse

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.