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Bronchiolitis

Advice for professionals

Bronchiolitis is an infection that causes the tiniest airways in your child’s lungs to become swollen. This can make it more difficult for your child to breathe:

  • Bronchiolitis is caused by virus infections
  • It is common in winter months and usually only causes mild cold like symptoms
  • Most children get better on their own
  • Some children, especially very young ones, can have difficulty with breathing or feeding and may need to go to hospital

pdf.pngBronchiolitis Guideline 

pdf.pngCough and breathlessness clinical pathway Under 1s 

pdf.pngCough and breathlessness clinical pathway Over 1s 

pdf.pngBronchiolitis paediatric pathway 

pdf.pngAcute asthma / wheeze paediatric pathway

​​​​​​​Asthma Attack Parent information 

When should you worry?

If your child has any of the following:

  • Has blue lips
  • Has pauses in their breathing (apnoeas) or has an irregular breathing pattern or starts grunting
  • Severe difficulty in breathing - too breathless to feed
  • Becomes pale, mottled and feels abnormally cold to touch
  • Becomes extremely agitated, confused or very lethargic (difficult to wake)
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features)

You need urgent help

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Has laboured/rapid breathing or they are working hard to breathe – drawing in of the muscles below their lower ribs, at their neck or between their ribs (recession)
  • Seems dehydrated (sunken eyes, drowsy or not had very many wet nappies)
  • Is becoming drowsy (excessively sleepy)
  • Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
  • Is between 3-6 months of age with a temperature over 39°C
  • Continues to have a fever of 38.0°C or above for more than 5 days
  • Seems to be getting worse or if you are worried

You need to contact a doctor or nurse today

Please ring your GP surgery or call NHS 111 - dial 111

We recognise that at peak times, access to a health care professional may be delayed. If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest Emergency Department

If none of the features in the red or amber boxes above are present

Self care

Using the advice below you can look after your child at home

 

  • If your child is not feeding as normal offer smaller feeds but more frequently
  • Children with bronchiolitis may have some signs of distress and discomfort. You may wish to give either Paracetamol or liquid Ibuprofen to give some relief of symptoms (Paracetamol can be given from 2 months of age). Please read and follow the instructions on the medicine container
  • If your child is already taking medicines or inhalers, you should carry on using these. If you find it difficult to get your child to take them, ask your Pharmacist, Health Visitor or GP. Bronchiolitis is caused by a virus so antibiotics will not help
  • Make sure your child is not exposed to tobacco smoke. Passive smoking can seriously damage your child’s health. It makes breathing problems like bronchiolitis worse
  • Remember smoke remains on your clothes even if you smoke outside

If you would like help to give up smoking you can get information / advice from your local GP surgery or by calling the National Stop Smoking Helpline Tel: 0800 169 0 169 from 7am to 11pm every day.

  • Your child may have a runny nose and sometimes a temperature and a cough
  • After a few days your child’s cough may become worse
  • Your child’s breathing may be faster than normal and it may become noisy
  • He or she may need to make more effort to breathe
  • As breathing becomes more difficult, your baby may not be able to take their usual amount of milk by breast or bottle
  • You may notice fewer wet nappies than usual
  • Your child may vomit after feeding and become miserable

  • Most children with bronchiolitis will seem to worsen during the first 1-3 days of the illness before beginning to improve over the next two weeks. The cough may go on for a few more weeks. Antibiotics are not required
  • Your child can go back to nursery or day care as soon as he or she is well enough (that is feeding normally and with no difficulty in breathing)
  • There is usually no need to see your doctor if your child is recovering well. But if you are worried about your child’s progress discuss this with your Health Visitor, Practice Nurse or GP or contact NHS 111
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