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Bronchiolitis
and Your Young Child
Guidelines for
Parents
Adapted from
Caring for Your Baby and Young Child: Birth to Age 5 |
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Respiratory illnesses caused by
viruses are some of the most common health problems in infancy. The common
cold is the one we see most often. Bronchiolitis is another. Because of its
symptoms, bronchiolitis can be scary for parents as well as children. This
brochure explains what bronchiolitis is, as well as its causes, symptoms,
and treatments.
What is
bronchiolitis?
Bronchiolitis is an infection of
the small breathing tubes (bronchioles) of the lungs. It occurs most often
in infants.
Bronchiolitis is sometimes
confused with bronchitis, which is an infection of the larger, more
central airways.
Bronchiolitis is almost always
caused by a virus. The infection causes the small airways in the lungs to
swell. This blocks the flow of air through the lungs and makes it hard for
your baby to breathe. From October through March, bronchiolitis is often
caused by respiratory syncytial virus (RSV) infection. During the
other months, the illness is usually caused by other viruses.
Most adults and many children
with RSV infections get only a cold. In infants the infection is more likely
to lead to bronchiolitis. This is because their airways are smaller and are
more easily blocked. Infants who develop bronchiolitis may develop asthma
later in life. It is possible that RSV infection is the first trigger for
the asthma. RSV is spread by contact with an infected person’s mucus or
saliva. It often spreads through families, child-care centers, and hospital
wards. Careful hand washing can help prevent the spread of this infection.
Signs and
symptoms
A baby who develops bronchiolitis
often starts off with signs of a cold, such as a runny nose, a mild cough,
and a fever. After a day or two his cough may get worse. He will begin to
breathe faster. The following signs may mean that he is having trouble
breathing:
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He may widen his nostrils and
squeeze the muscles under his rib cage to try to get more air in and out
of his lungs. |
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When he breathes he may grunt
and tighten his stomach muscles. |
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He will make a high-pitched
whistling sound, called a wheeze, each time he breathes out. |
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He may not take fluids well
because he is working so hard to breathe that he has trouble sucking and
swallowing. |
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If it gets very hard for him to
breathe, you may notice a bluish tint around his lips and fingertips. This
tells you that his airways are so blocked that there is not enough oxygen
getting into the blood. |
If your baby shows any of these
signs of trouble breathing, or if his fever lasts more than 24 hours (or is
present at all in an infant under 3 months of age), call your pediatrician.
Also call your pediatrician if
your baby develops any of the following signs or symptoms of dehydration:
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Taking less than her normal
amount of fluids |
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Dry mouth |
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Crying without tears |
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Urinating less often than
normal |
If you think your child has
bronchiolitis and your child has any of the following conditions, call your
pediatrician.
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Cystic fibrosis |
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Congenital heart disease |
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Bronchopulmonary dysplasia
(seen in some infants who have been on a respirator as newborns) |
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Immune deficiency disease (like
AIDS) |
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Organ transplant |
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A cancer for which she is
receiving chemotherapy |
Home Treatment
There are no medications you can
use to treat RSV infections at home.
Antibiotics, which treat
bacteria, are not helpful for bronchiolitis because it is almost always
caused by a virus. However, you can ease your child’s cold symptoms. Try the
following suggestions:
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To
relieve stuffy nose and fever:
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Thin the mucus using mild
salt-solution (saline) nose drops recommended by your pediatrician.
Never use nonprescription nose drops that contain any medication. Only
use salt-solution nose drops.
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Clear your baby’s nose with a
suction bulb. Squeeze the bulb part of the device first. Gently put the
rubber tip into one nostril, and slowly release the bulb. This slight
amount of suction will draw the clogged mucus out of the nose. This
works best when your baby is under 6 months old.
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Place a cool-mist humidifier
(vaporizer) in your baby’s room. Set it close to her. Be sure to clean
and dry the humidifier each day to keep bacteria or mold from growing.
Do not use hot water vaporizers since they can cause serious scalds
or burns.
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If your baby has a fever,
give her acetaminophen. (Be sure to follow the recommended dosage for
your child’s age.) Do not give aspirin to your child. Aspirin has been
associated with Reye syndrome, a disease that affects the liver and the
brain. Never give her any other kind of cold medicine without first
checking with your pediatrician.
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To
prevent dehydration:
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Make sure your baby drinks lots
of fluid so he does not become dehydrated. He may prefer clear liquids
rather than milk or formula. He may feed more slowly and may not tolerate
solid foods very well because he is having trouble breathing.
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Professional Treatment
If your baby is having mild to
moderate trouble breathing, your pediatrician may try using a drug that
opens up the breathing tubes, which seems to help some infants.
Some children with bronchiolitis
need to be hospitalized, either for breathing problems or dehydration. Your
pediatrician will treat your baby’s breathing problems with oxygen and
medication. The dehydration will be treated with a special liquid diet or
with fluids given intravenously (directly into the blood stream)..
Very rarely an infant will not
respond to any of these treatments. She might have to be put on a breathing
machine (respirator). This usually is only a temporary measure to help her
until her body is able to overcome the infection.
Prevention
The best way to protect your baby
from bronchiolitis is to keep him away from the viruses that cause it. When
possible, avoid close contact with children or adults who have colds. If
your baby is in a child-care center where other children might have RSV,
make sure that those who care for him wash their hands well and often.
When your baby has a cold, he
needs a bit more attention to detect early signs of bronchiolitis or another
serious infection. Be sure to call your pediatrician if you think your baby
might have such a problem.
The information contained in this
publication should not be used as a substitute for the medical care and
advice of your pediatrician. There may be variations in treatment that your
pediatrician may recommend based on individual facts and circumstances.
From your doctor
Jon Jantz MD
Ericca Berry ARNP,CPNP
Cottonwood Pediatrics
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