Bronchiolitis is a chest condition that causes breathing problems in babies. It's very easy to catch, so wash your hands before and after handling your baby. Breastfeeding and a smokefree environment give the best protection against bronchiolitis.
Key points about bronchiolitis
- Bronchiolitis is a common illness in the lungs. It causes breathing problems in babies.
- Bronchiolitis is very easy to catch.
- Breastfeeding and a smokefree environment give the best protection against bronchiolitis.
- Bronchiolitis is usually a mild illness but some sicker babies need to go to hospital.
- There is no medicine that makes bronchiolitis better.
- If your baby with bronchiolitis is under 3 months old, you should always see a doctor.
Bronchiolitis is a common illness usually caused by a virus. The most common are RSV (respiratory syncytial virus) and rhinovirus but there are many viruses that can cause bronchiolitis. Bronchiolitis affects the smallest airways (called bronchioles) throughout the lungs.
Yes, bronchiolitis is very easy to catch – it can spread easily between children or from adults to children. It is most common in winter and spring.
- Bronchiolitis usually affects babies under the age of 1.
- Babies who are around people who smoke are more likely to get bronchiolitis.
- Severe bronchiolitis is more common in premature babies or babies with heart or lung problems.
Bronchiolitis often starts as a cold, with a runny nose.
Babies with bronchiolitis:
- may have a fever
- start to cough
- breathe fast
- put a lot of extra effort into breathing
- have noisy breathing (wheeze)
The second or third day of the chesty part of the illness is usually the worst.
Bronchiolitis can last for several days. The cough often lasts for 10 to 14 days but it may last as long as a month.
When should I seek help for bronchiolitis?
See these signs that a child is struggling to breath.
When do I need to see a doctor?
You should see your family doctor or go to an after-hours medical centre urgently if your baby:
- is under 3 months old
- is breathing fast, has noisy breathing and is having to use extra effort to breathe
- looks pale and unwell
- is taking less than half of their normal feeds
- is vomiting
- has not had a wet nappy for 6 hours.
You should also see a doctor if you are worried about your baby.
|Even if you've already seen your doctor, if your baby's breathing difficulties get worse or if you are worried, take your baby back for checking.|
When should I dial 111?
Dial 111 within New Zealand (use the appropriate emergency number in other countries) and ask for urgent medical help if your child:
- has blue lips and tongue
- has severe difficulty breathing
- is becoming very sleepy and not easy to wake up
- is very pale
- is floppy
- has breathing that is not regular, or pauses in breathing.
Most babies get better by themselves
Most babies with bronchiolitis get better by themselves without any special medical treatment.
- Antibiotics do not help babies with bronchiolitis because it's caused by a virus.
- Asthma puffers or inhalers don't help babies with bronchiolitis.
- Using blue reliever asthma puffers or inhalers in babies less than 6 months of age may make their breathing worse.
- Steroid medicine by mouth or inhaler does not help babies with bronchiolitis.
- In babies over 12 months of age, it may be hard to tell if the problem is bronchiolitis or viral wheeze – your doctor may try asthma puffers or inhalers.
Babies with more serious illness may need to go to hospital
Babies with more serious bronchiolitis may need to go to hospital. Sometimes babies need help with their breathing. This might include extra oxygen through nasal prongs (small soft plastic tubes) that fit into your child's nose.
If your baby is not drinking enough, they may need feeding through a nasogastric tube (a tube through the nose or mouth into the stomach) or fluid through an intravenous drip (into a vein).
Babies who can stay at home are those who:
- are feeding well
- do not look sick
- are not working too hard with their breathing.
Suggestions for looking after your baby
Remember to sleep baby on their back in their own bed and don't prop them up with pillows or blankets.
- Babies with bronchiolitis may not be able to feed for as long as usual – offer smaller feeds more often.
- Give your baby as much rest as possible.
- Don't smoke in the house or around your baby.
- Keep your baby's nose clear – if it is blocked or crusty you can use saline nose drops (from a pharmacy).
- Keep your baby away from other children to stop bronchiolitis spreading.
- If your baby is miserable and upset, you can give paracetamol. You must follow the dosage instructions on the bottle – it is dangerous to give more than the recommended dose.
Babies who are breastfed and those who live in smoke-free environments are less likely to get bronchiolitis.
Breastfeeding your baby protects them from getting bronchiolitis by boosting their infection-fighting (immune) system. Breastfeeding beyond 4 months of age offers the best protection.
Make sure your child's environment is smokefree. If you want to give up smoking:
- call the Quitline on 0800 778 778
- check out the website Quitline
- ask your health professional.
A warm house
Keeping the house warm and well-insulated will also decrease your baby's risk of developing bronchiolitis. Read more about keeping your home warm and dry.
Stay away from people with coughs and colds
It is sensible to keep young babies away from people who have colds and coughs.
Make sure everyone in your family washes their hands regularly and thoroughly and dries them well, including (but not only) before preparing food and eating. This can reduce the spread of infection.
Bronchiolitis is not the same as asthma. Most babies with bronchiolitis do not go on to have asthma. Asthma is more likely in children if there are other family members with asthma.
- Starship Children's Health Clinicians. Starship Children's Health clinical guideline: Bronchiolitis Starship Children's Health, NZ, 2019
- Paediatric Society of New Zealand. Best practice evidence-based guideline: Wheeze and chest infection in infants under 1 year Paediatric Society of New Zealand, 2005
- PREDICT: Paediatric Research in Emergency Departments International Collaborative. Australasian bronchiolitis guideline 2017