When it comes to parenting, facing childhood illnesses is a rite of passage. One of the most common concerns new parents may face but might not hear of is bronchiolitis.
Bronchiolitis is very common, especially during the fall and winter, and mainly affects children under 2. While many babies and young children who get it do fine, some can get very sick. It’s one of the top reasons babies and young toddlers are treated in urgent care and emergency rooms.
Keep reading to learn more about bronchiolitis, how it differs from other illnesses like bronchitis and pneumonia, and helpful tips to prevent infections.
What is bronchiolitis?
“Bronchiolitis is an infection that targets the small airways (breathing tubes) in a child’s lungs, called the bronchioles,” said Lee Rusakow, MD, a pediatric pulmonologist with Banner Children’s. The insides of the small airways become inflamed (irritated) and swell, which can make breathing difficult.
Many viruses (including influenza) can cause bronchiolitis. However, RSV (respiratory syncytial virus) is the most common virus and tends to cause the most serious illnesses.
“Almost all kids in the first few years of life will eventually get an RSV infection, but infants in the first six months of life are most likely to become seriously ill when they become infected,” Dr. Rusakow said.
Children at greatest risk for serious illness are those with underlying lung or heart problems, such as premature babies with chronic lung disease and those with congenital heart disease.
How is bronchiolitis different from bronchitis?
Bronchiolitis and bronchitis may sound similar because they both are infections of the lungs, but they affect different parts.
“Bronchitis affects the bronchi, or large airways in the lung, whereas bronchiolitis affects the smaller airways (or bronchioles) below the bronchi,” Dr. Rusakow said.
Both illnesses cause cough, but bronchiolitis is more likely to cause wheezing, difficulty breathing and serious symptoms, especially in babies and smaller children. Young children can get bronchitis, but it is more often diagnosed in older children and adults.
How is bronchitis different from pneumonia?
Where bronchiolitis affects the small airways, pneumonia is a lung infection that affects the air sacs called alveoli. “The alveoli are the deepest parts of the lung that help bring oxygen into the blood and remove carbon dioxide from the body,” Dr. Rusakow said.
Bronchiolitis is typically caused by a virus, while serious pneumonia is more often caused by bacteria and may include higher fevers. Bacterial pneumonia doesn’t usually cause wheezing like bronchiolitis.
What are the symptoms of bronchiolitis?
Bronchiolitis usually starts like the common cold, with a runny nose, cough and low-grade fever. Your child may also be tired and fussier. After a day or two, the cough may get worse. You may notice your child starts to breathe faster and harder.
Contact your child’s health care provider or take them to the nearest urgent care if you notice the following signs your child is having problems breathing:
- Nasal flaring: Their nostrils get bigger during breathing.
- Retractions: They suck in the muscles of their rib cage to try to get more air in and out of their lungs.
- Grunting: When they breathe out, they make a “grunting” sound like they are trying to have a bowel movement.
- Wheezing: You hear a high-pitched whistling sound when they breathe out.
- Dehydration: They have dry mouths, drink less than usual and have no wet diapers or crying without tears.
- Blue coloring: Their lips, fingers or toes have a blueish tint.
How is bronchiolitis treated?
There are no antibiotics or anti-virus medications used to treat bronchiolitis. “Treatment for bronchiolitis is usually just supportive, meaning we do things to help the symptoms,” Dr. Rusakow said.
He offered the following tips to try and ease your child’s symptoms:
- Keep your child hydrated: Make sure your child drinks plenty of fluids. This helps loosen mucus in the chest, making it easier to breathe.
- Clear the nose: Use nose drops or a nasal aspirator to gently suction or draw out clogged mucus in the nose. Here are some tips and tricks for cleaning a baby and toddler’s nose.
- Control fever: Over-the-counter (OTC) fever medications can help keep your child comfortable. Ask your provider which medicines are best.
- Rest: Allow your child to get the rest they need to recover.
- Use a humidifier: Adding moisture to the air may help loosen mucus and make it easier for them to breathe.
With more serious illnesses, your child’s provider may prescribe medications to treat wheezing and thin out mucus in the lungs. Steroids may also be given to treat inflammation in the lungs.
“Repeated episodes of bronchiolitis or bronchitis, or a cough that seems to take forever to go away, could suggest that your child might have asthma or go on to develop it later on,” Dr. Rusakow said.
Steps you can take to prevent bronchiolitis
While it’s not always possible to prevent respiratory infections, you can take steps to reduce the risk:
- Practice good handwashing. Make sure everyone washes their hands before touching your baby.
- Avoid coming in contact with others who are sick.
- Do not share cups, forks or spoons.
- Get immunized. The usual childhood immunizations don’t prevent bronchiolitis, but two vaccines may lower your child’s risk:
- Flu shots: The influenza vaccine is given to infants at least 6 months old and may prevent bronchiolitis caused by “the flu” or at least prevent it from becoming a severe case.
- RSV immunization: In July 2023, Beyfortus was approved as part of the routine childhood immunization schedule. Beyfortus is a medication that can be given as a one-time injection to all babies starting at birth up until 8 months to try and prevent infections caused by RSV (including bronchiolitis) or at least prevent them from becoming severe.
If your baby or young child has certain medical conditions, such as being born prematurely or with a chronic lung disease, they may be eligible to receive monthly injections of a drug similar to Beyfortus called Synagis. This drug is also used to try and prevent serious infections with RSV.
Takeaway
While bronchiolitis can be concerning, most cases can be treated at home. If you have concerns about your child’s health or symptoms, call their health care provider or a Banner Health specialist. They are here to support you every step of the way.
