Chest / Lungs Conditions and Diagnoses

Bronchiolitis is usually mild and the child gets better after 3 or 4 days. However, sometimes the infection is more serious and admission to a hospital is required.

What causes bronchiolitis?

Several different viruses that cause colds and flu-like illnesses can cause bronchiolitis. Respiratory Syncytial Virus (RSV) is the most frequent cause, followed by parainfluenza viruses.

Young children catch these viruses during close contact with older children, family members and others that are infected, but often have only mild illness. The virus is spread directly to mucous membranes when an infected person sneezes or coughs into another's face. It can be spread indirectly by hands that touch contaminated toys or tabletops and then touch the eyes or nose. Illness begins about 3 to 7 days later.

What to expect if your child is hospitalized

Isolation precautions

Because the virus causing bronchiolitis can be spread to others, your child will be put into an isolation room. An isolation sign will be posted on the door to remind others of precautions, including the following.

• The patient room. The door to the room must remain closed. If the room is shared with other patients, parents and visitors should not provide care to the other patients in the room or share equipment or toys.

• Hand washing. Everyone going in and out of the room must wash his/her hands. Hands must also be washed after providing direct care to the child; whenever hands are soiled by secretions or excretions; and after touching toys, medical equipment and furniture. Hand washing is the best way to prevent the spread of infection.

• Gloves, gowns and masks. Healthcare workers who provide care to multiple patients are required to wear a mask to enter the room, and they put on gloves and gowns during procedures to prevent direct contact of skin and clothing with respiratory secretions and contaminated surfaces. To limit further exposure to these viruses, parents and visitors will be shown when and how to wear gloves, gowns and masks. However, their use is not required and, when worn, they should be discarded into the garbage can inside the room before going outside the room.

• Play activities and visitors. Since isolated patients must stay in their bed area, toys and play activities will be provided in your child's room. For the protection of all children, visits are not permitted by brothers, sisters, and friends who are your child's age.

Feeding your baby

Most babies are offered a regular formula or breast milk. Your baby will get plenty of liquids while in the hospital. Liquids are one of the most important things needed by a baby with bronchiolitis.

Sometimes while in the hospital, feedings may be decreased or stopped for a short time. This is done if feeding makes your child breathe harder. Feedings may also be decreased or stopped if your baby starts vomiting. If feedings are decreased or stopped for a short time, liquids may be given through a small needle that is put into a vein (IV).

Suctioning the nose

When babies have bronchiolitis, the nose often gets plugged. This can make it hard to breathe while eating. Often the nose of an infant with bronchiolitis will be suctioned before being fed. Sometimes it is hard to suction mucus out of the nose because it is very thick. When this happens, a little bit of saltwater (saline nose drops) is dropped into the nose before suctioning. While in the hospital, you will want to learn how to use a bulb suction so that you will feel comfortable suctioning your baby's nose after you go home.

Oxygen

Every few hours, or more often, your child's nurse or respiratory therapist will do an assessment of how easily your baby is breathing. This assessment will help decide: 1) if extra oxygen is needed, or 2) if the baby is ready to gradually come off the extra oxygen. The nurse or therapist will teach you how to look for the signs and symptoms of difficult breathing.

A machine called an oximeter may be used with these assessments, but it is not necessary for your child to be connected all the time to this machine.

Laboratory and other tests

Bronchiolitis does not usually require testing, but there are some individual exceptions. These tests include some blood tests and a chest X-ray. If any of these are needed, their purpose will be explained to you.

Medicines

Bronchiolitis usually goes away by itself and is not usually helped by giving a lot of medicines, but there are some exceptions. A few medicines may be tried to see if they make your baby feel better. These medicines include:

• A non-aspirin fever medicine may be used if your baby is very uncomfortable or has a fever (Remember, never give aspirin to a baby unless instructed by a doctor)

• Medicines that your baby can breathe into his/her lungs are sometimes tried and, in some cases, may work in a baby with bronchiolitis

Going home

Discharge from the hospital

Very few babies with bronchiolitis stay in the hospital more than 2-3 days. They usually go home when:

• Breathing is slower and easier

• They are eating well

• Any medicines or oxygen, if still needed, can be given at home

• There is someone in the home who can use a nasal bulb suction

• Your baby's doctor is comfortable with and agrees to all of the discharge plans

• A follow-up appointment with the doctor has been arranged

• And, most importantly, you are comfortable that your baby is ready for discharge

What to expect after discharge

• It is normal for your child to have symptoms for a few days after discharge (Your family may find they need to take time off work during this initial time to provide extra care for your baby)

• Wheezing usually gets better in 2-5 days

• Stuffy nose and cough may last another 1-2 weeks

• Sleeping and eating routines may not return to normal for 4-7 days

Special reminders

• Be sure no one smokes in the house. Smoke can be very bad for babies and especially bad for babies with bronchiolitis.

• For the next several weeks, be sure to wash hands frequently especially after handling your infant.

• Use saltwater nose drops and suction your baby's nose if stuffy and if plugged up before feedings or putting your baby down to sleep. You can buy saltwater nose drops at any drug store, or you can make saltwater nose drops at home.

• Don't give decongestant nose drops or any antihistamines or other cold medicines unless told to do so by the doctor.

• For more information talk with your child's doctor or nurse. You can also find very good books on children's illnesses in bookstores or libraries. A librarian can often find exactly what you want. Because it takes a long time to publish books, some books or articles may not have the most recent information. Before worrying about any differences in information, talk with your child's doctor.

Related Topics

Bronchiolitis -- Essential Facts

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Patient Education Program I 1050 11/99
Revised 11/06