Bronchiolitis

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 tends to affect young children (under 2 years of age) is caused by a number of different viral infections. One of the most common viruses that causes bronchiolitis is Respiratory Syncytial Virus (RSV).
  • Rates of RSV usually peak in winter (November and December). However, due to the social restrictions put in place last year, there were almost no cases of last year. This year, cases have been rising in Wessex since August and are likely to continue rising over the Autumn and winter.
  • Bronchiolitis usually only causes cold like symptoms and mild breathing difficulty - breathing may be faster than normal as well as noisy and they may not be able to take their usual amount of milk by breast or bottle. Your child may get a little worse each day until the 3rd or 4th day of their illness after which they are likely to start improving. However, most children get better on their own; there are no specific medical treatments that speed up recovery from bronchiolitis and many children will continue to cough for a few weeks afterwards.

Some children, especially those under 6 weeks of age or young children with heart or lung problems, can develop significant breathing difficulty and may need to go to hospital for help supporting their breathing and feeding.

When should you worry?

If your child has any of the following:

  • Is pale, mottled and feels abnormally cold to touch
  • Has pauses in their breathing lasting more than 10 seconds, makes a grunting noise every time they breathe out or has blue lips
  • Is stiff or rigid or makes repeated, jerky movements of arms or legs that doesn't stop when you hold them (a fit or seizure)
  • Is extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
  • Has a rash that does not disappear with pressure (the ‘Glass Test’)
  • 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:

  • Difficulty breathing, including breathing fast all of the time; widening their nostrils or pulling in of the muscles below the ribs when breathing
  • Not interested in feeding and/or looks dehydrated (dry mouth, sunken eyes, no tears, drowsy, no wet nappies in the last 8 hours or sunken fontanelle (soft spot on the head)
  • Is drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
  • 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) or continues to have a fever of 38.0°C or above for more than 5 days
  • Is 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

  • None of the above features are present
  • It is normal for a baby to take slight pauses in their breathing for a few seconds, or to breath rapidly for a short period. By 6 weeks of age they should have a more regular breathing pattern.
  • Addition information is available about infant crying and how to cope – click here

Self care

Continue providing your child’s care at home. If you are still concerned about your baby, speak to your health visitor, local pharmacist or call NHS 111– dial 111

For parents from ethnic minority groups, you can contact the Barnado's Boloh advisors who can provide practical advice and support in many different languages. Call 0800 151 2605 or click here for the web chat function.

What can you do to help your child?

  • 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.
  • Although you should continue to place your baby on their back to sleep, you can tilt the head of their cot upwards to help their breathing. You can do this by raising the cot legs on blocks or putting a pillow under the mattress, although remember never put a pillow or cushion under your baby's head as this is unsafe.
  • 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.

Where should you seek help?

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance