Watch: caring for your child with bronchiolitis
Sejal, Respiratory Paediatric Consultant, explains things you can do to care for your baby with bronchiolitis at home. She also explains the sort of treatment babies might have if they need to be admitted to hospital.
Most babies have very mild bronchiolitis and this can be managed really safely at home.
The types of things you can do is make sure your child is having enough fluids, and to help them because they may be having a little bit of difficulty in breathing, they may not take their usual volume all in one go, it’s quite good to try and give them smaller amounts but more frequently.
But ensure they’re getting at least half to three quarters of their normal intake, and it’s really important to ensure they’re having wet nappies.
The other thing you can do to perhaps help their breathing, especially if they’re breathing a little bit fast is maybe hold them a little bit more upright when you’re feeding them, that might help them a little bit.
The third thing is to ensure you’re keeping their temperature down – we don’t want their temperature above 38 degrees.
The way you can do that is by giving Calpol or any other treatments that might help to bring their temperature down.
A few babies, maybe about three in 100 will develop bronchiolitis that’s severe enough that requires treatment in hospital.
The thing to remember is bronchiolitis is caused by a virus infection, so there’s no specific treatment for the actual infection.
But what we do is treat the babies and support them while their body fights the infection naturally. The two main things we consider are: have they got enough oxygen in their blood stream, and if they haven’t then they may need oxygen which is delivered either by a face mask or some small tubes in the nostril.
Oxygen therapy is one reason a baby may need to be admitted and the other is if they’re not taking enough fluids. We don’t want the babies to become dehydrated.
So, if they’re not managing enough fluids at home, they may to be admitted to either have fluids by a tube which goes into the nose and sits in the tummy, a feeding tube.
If they’re not tolerating that because their breathing is a bit fast and difficult and laboured, then they may need fluids into their vein to stop them from becoming dehydrated.
They’re the main sort of measures we use to manage babies in hospital. It can be very scary and overwhelming and daunting if your child is admitted to hospital with bronchiolitis, especially when they’re having difficulty in breathing and you’re not
quite sure what’s going on.
The thing to remember is the doctors, the nurses, all the healthcare team are there to look after your baby but also to answer your questions.
Please remember no question is too stupid and don’t be afraid to ask questions.
Managing bronchiolitis at home
Bronchiolitis usually gets better by itself, and most children can be looked after at home. There are simple ways you can help your child:
Do
- Take paracetamol or ibuprofen to lower your temperature or give children’s paracetamol or children’s ibuprofen to your child. Check if ibuprofen is suitable for you before taking it.
- Use a salt water (saline) nasal spray or solution to rinse the inside of your child’s nose. This helps to treat a blocked nose.
- Stay upright as much as possible while awake, this will make it easier for you or your child to breathe.
- Make sure your child drinks a lot of fluids. If you’re caring for a baby with RSV, try giving them smaller feeds more often.
Do not
- Do not give aspirin to children under 16 years old.
- Do not smoke around children. Children who breathe in cigarette smoke are more likely to get serious RSV infections.
- Do not try and lower your child’s temperature by sponging them with cool water or taking off their clothes.
Treatment in hospital
Around 3 in 100 babies with bronchiolitis need treating in hospital. There are different treatments your child might get in hospital.
Oxygen therapy
A healthcare professional may measure how much oxygen is in your baby’s blood using a pulse oximeter. This is a small electronic device that should not hurt your baby.
If your baby has low blood oxygen levels, they may be given oxygen through a small soft tube placed in their nostril (nasal canula) or a face mask.
Continuous positive airway pressure (CPAP)
Continuous positive airway pressure (CPAP) is a type of breathing support.
If your child is given CPAP, they will breathe in air and oxygen through small tubes placed in their nose (nasal prongs) or a face mask. CPAP can help improve your baby’s breathing by changing the pressure of the air they breathe in.
With CPAP, your baby is still breathing by themselves.
Help feeding
If your baby cannot drink enough fluids, they might get feeding support.
Your baby might be given fluids through a small tube that takes fluids from their mouth or nose to their stomach. If this is not right for your baby, they might get fluids through their veins.
Suctioning
If your baby has extra phlegm (mucus) in their airways and they cannot clear it by themselves, they might get airway suctioning. This is where a healthcare professional will use a small tube to suck away the extra phlegm.
Support for parents and carers
We know seeing your baby being treated in hospital can be a very difficult experience, but it’s important to remember your baby is in the right place to get the best care.
If you’d like to talk to someone, our helpline is there for you. You can call 0300 222 5800, Monday to Friday, 9.15am to 5pm. Our team of health care advisors and nurses can offer expert advice and support.
Bliss is the leading charity for babies born premature or sick. Their website has information, support and stories shared by people with experience of bronchiolitis and neonatal care.
National Childbirth Trust (NCT) is the UK’s leading charity for parents. They have information and support for parents, aimed at babies and toddlers up to 24 months.
Watch: our experience of bronchiolitis and RSV
Claire and Shaun talk about how their twins, Evie and Isaac, got bronchiolitis (a viral chest infection) when they were just three weeks old.
We're a family of five. We have three children; our twins Isaac and Evie who are eight and our eldest who is twelve, Elijah, and we have our lovely golden retriever Asha too.
The twins were about three weeks old when they became ill with what we thought was just quite a bad cold and they just were very bunged up, not feeding particularly well, not sleeping particularly well, they weren't quite right were they?
And so we decided to check with the GP. He came out and he checked them over. He reassured us that they actually were OK and that we were doing all of the right things.
After about three days their temperatures were kind of rising and we weren't really sure and so I contacted the GP again but within minutes of walking into the GP surgery they just took one look at Isaac and said "He needs to go to hospital now."
The main focus at that point was on Isaac because he really, really was very poorly
by this point and barely breathing. He'd gone completely blue which is
a colour I don't think I'll ever forget, it was quite frightening really.
A specialist team from Southampton came and they would need to take him to theatre.
In the meantime Evie was now moved to a ward where she was with my dad and they were keeping her under close eye and on oxygen.
Once he came out of the theatre, we were then told we would need to go straight to another hospital. He was taken straight to the Paediatric Intensive Care Unit.
I think we both felt quite dazed and confused at this point because we didn't really knew what was going on.
I don't think we really find found out until we got his discharge papers so by this point he'd been moved to the first hospital again for a few days just to get him, you know, feeding and all of that and when they gave us the discharge paper, I read bronchiolitis with overwhelming sepsis.
We had never heard of bronchiolitis or RSV.
We hadn't had anything through antenatal classes or any information given to us by the health visitor and now that we're aware, we understand that most children can be treated at home effectively and in our case both children were hospitalised;
Evie for a few days on oxygen and Isaac obviously is much, much more of a severe case that then developed into sepsis.
Obviously the key thing is trust your instincts if your child's not well and also just be mindful of who you're allowing to visit your children, maybe in the very early stages.
Being a little bit more mindful about hygiene and if you're allowing someone into your house that may have a cold already.
The twins now are... They're thriving. Yeah, thriving.
When will my child get better?
In most children, bronchiolitis symptoms get better on their own. They might be worse between days three and five of the infection. A cough can take around three weeks to get better.
If your child goes to hospital, their healthcare professional will keep you updated about their treatment and how they’re progressing.
Get support
Call or WhatsApp our Helpline for support with your condition. Get advice on your medicines, symptoms or travelling with a lung condition, or just call us to say hello.