Bronchiolitis (Wheezing in Infants)
 
 

Bronchiolitis is an infection of the breathing tract.  The infection is usually caused by a virus (such as Respiratory Syncytial Virus, AKA "RSV").  It cannot be cured with antibiotics.  The virus must run its course and can last as long as six weeks.

Symptoms of bronchiolitis include:

  • Rapid heavy breathing
  • Wheezing (tight breathing)
  • Fever
  • Cough (which can occasionally cause vomiting)
  • Lots of mucus from the nose and mouth

Things to do at home:

  • You can give acetaminophen (Tylenol) every 4 to 6 hours for fever greater than 101° F. (38.3° C.).  Click here if you need medication dosing.  Do not give more than five doses in 24 hours.
  • Even better than a bulb suction: use Nosefrida to suction your infant's nose before feeding and before putting him down to sleep.  This helps clear the mucus from the airway and makes breathing easier.  You can purchase saline to irrigate the nose or make it at home.
  • DO NOT let anyone smoke around your child or in your home.  Smoke can make the wheezing and coughing worse.
  • Good handwashing can help decrease the spread of viruses causing bronchiolitis.
  • Viruses causing bronchiolitis are contagious.  Germs can live on objects, like toys, for 2 or 3 hours or longer.  It is a good idea not to share toys.  Clean your child's toys often with soap and water.  When running a fever children should be kept at home.
  • Encourage your child to rest often.  He may not eat as much as usual because he is sick and tires easily.
  • Elevate the head of the bed to help with drainage of mucus.
  • Encourage your child to drink fluids in small amounts.  Give liquids often and at room temperature to relax his throat and lessen his cough.
  • A cool mist vaporizer or humidifier can help your child breathe easier.  Change the water every day.  Clean the machine per the manufacturer recommendations.
  • Never use menthol products (such as Vicks VapoRub).  They have been shown to increase mucus production and worsen symptoms, especially in children under 2 years. 

When to bring your child in for an evaluation:

Your infant should be seen immediately if:

  • Breathing becomes more difficult, with a respiratory rate over 60 breaths/minute consistently.
  • Infant is unable to drink enough fluids to stay hydrated.  Signs of dehydration include no tears, thick/pasty or no saliva, or fewer than 3 wet diapers in 24 hours.
  • The color of the child's lips or skin looks blue.
  • The infant looks uncomfortable or is inconsolable.

If your child simply isn't getting better after several days, or if earache develops, make an appointment during regular office hours.

This page adapted from Children's Mercy Care Cards.