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Sometimes a cold or flu turns into something more serious for children, especially younger kids. Pediatric bronchiolitis happens when a common virus infects the small airways in the lungs.

It can cause difficulty breathing and dehydration. (Babies may not want to drink when severely congested).

If your child has cold or flu symptoms that are worsening, causing them to struggle to breathe, you should take them to see a doctor promptly.

What Is Pediatric Bronchiolitis?

The airway inflammation in pediatric bronchiolitis results from infection with a virus. Respiratory syncytial virus (RSV) is the culprit 80% of the time. But other viruses, like the flu and rhinovirus (a cold-causing virus), can also lead to bronchiolitis.

Pediatric bronchiolitis usually gets better in a few days, but cough and congestion may persist for longer. Young babies are especially at risk of pediatric bronchiolitis.

What Are the Symptoms of Pediatric Bronchiolitis?

Before you see signs of bronchiolitis, your child will have cold/flu symptoms, including congestion, coughing, fatigue, and fever. If any of the following symptoms of pediatric bronchiolitis emerge, you should call your doctor:

  • Wheezing (a whistling sound on your child’s exhale).
  • Fever.
  • Fast breathing (more than 60 breaths a minute).
  • Gaps in breathing (also called apnea).
  • Concerns about dehydration (sunken eyes and cheeks, dry mouth, lack of tears).
  • Lethargy/fatigue, even after a nap.
  • Difficulty breathing, with the breath sucking in skin at the neck or between the ribs.
  • Blue-tinged skin, which may be more obvious on the lips and fingernails.

Depending on the symptoms, your doctor may recommend you care for your child at home with fluids and rest. If your child is struggling to breathe or drink adequate amounts, you should take them to the nearest emergency department.

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What Are the Risk Factors for Pediatric Bronchiolitis?

Bronchiolitis is most common in children under 2. Within this age group, children who were born preterm and have other medical conditions are more at risk.

Risk factors for pediatric bronchiolitis include:

  • Young age (children 3 months or younger are more likely to need hospital care).
  • Preterm birth (especially babies born before 29 weeks).
  • Lower immune system responses due to an underlying condition.
  • Some heart and lung conditions.
  • Neuromuscular conditions that can affect breathing (such as muscular dystrophy).
  • Exposure to tobacco smoke in utero.

Doctors may suggest medication ahead of winter’s RSV season to prevent bronchiolitis for premature infants who are under one year old. This drug, Palivizumab, is a prophylactic medication because doctors give it to prevent, rather than treat, disease. Doctors also recommend Palivizumab for some infants with underlying conditions that put them at risk of bronchiolitis.

If you think your baby is at high risk of bronchiolitis, ask your doctor about this medication. A health provider gives Palivizumab by injection once a month for a period of 5 months.

How Do You Treat Pediatric Bronchiolitis at Home?

If your child has mild symptoms, your doctor may recommend you care for your child at home with fluids and rest. However, if your child is struggling to breathe or drink adequate amounts, you should take them to the nearest emergency department.

Likewise, you need to go to the emergency department if your infant under 3 months develops a fever. This is because fever-causing infections can be more dangerous at this age. (A fever is an oral temperature of 99 °F or a rectal temperature of 100.4 °F.)

You can treat a fever in a child in a child over 3 months with acetaminophen. For a child 6 months or older, you can use either acetaminophen or ibuprofen.

Since some babies don’t like to drink when they feel congested, it may help to suction your child’s nose before feeding. You can do this with a bulb syringe or nasal aspirator, which you can buy from a pharmacy.

How Is Pediatric Bronchiolitis Treated in the Hospital?

If your child needs hospital care, nurses will monitor your child and provide oral fluids or intravenous fluids. They will check your child’s oxygen levels and, if necessary, provide oxygen through a face mask. In some cases, the doctor will need to temporarily insert a breathing tube, attached to a machine, to help your child breathe.

It’s always scary to have a child in the hospital. It helps to know that hospital staff are well-equipped and very experienced in treating bronchiolitis in children. Bronchiolitis is one of the most common reasons for hospitalization in children.

Children hospitalized with bronchiolitis typically stay for 3 to 4 days. A caregiver will be able to stay with the child throughout their time in the hospital.

Sources

American Academy of Pediatrics. Fever and your baby. Link

Dr. Evelyn Erikson et al. Pediatric Bronchiolitis. StatPearls. Link

Dr. Luis Garegnani. Palivizumab for preventing severe respiratory syncytial virus (RSV) infection in children. Cochrane Database of Systematic Reviews. Link

Dr. Nizar Maraqa. What are the risk factors for the development of bronchiolitis? Medscape. Link

Dr. Pedro Piedra and Dr. Ann Stark. Patient education: Bronchiolitis and RSV in infants and children. UpToDate. Link

Dr. Alyssa Silver. Bronchiolitis. Pediatrics in Review. Link

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.