Bronchiolitis is an infection that affects the lungs and breathing small airways in the lungs. Bronchiolitis is caused by viruses, the most common being respiratory syncytial virus (RSV). The RSV virus is so common that almost all children get RSV by the time they are 2 years of age. For most healthy children, the illness is similar to a cold, with symptoms such as runny nose, mild fever, and cough. However, bronchiolitis can lead to trouble breathing or breathing fast. This can be frightening for parents. Approximately 1% of all healthy babies and 2% to 3% of all high-risk babies are hospitalized for bronchiolitis each year. Most of these hospitalizations are among babies younger than 6 months.

WHO IS AT RISK FOR SEVERE BRONCHIOLITIS?

• Babies younger than 3 months.
• Babies with ongoing illnesses such as heart or lung disease.
• Babies who were born prematurely (before 32 weeks of pregnancy).
• Babies who are exposed to tobacco smoke.

HOW IS BRONCHIOLITIS TREATED?

You cannot cure a virus with antibiotics, herbs, or other medicines; your baby’s immune system will fight the virus. The symptoms usually go away after 1 to 2 weeks. You can treat bronchiolitis the same way you would treat a cold: by trying to keep your baby comfortable while your baby’s body fights the virus. You can help reduce your baby’s symptoms in the following ways:

• Thin the mucus in your baby’s nose using saline (saltwater) nose drops.Do not use any nose drops that have medicine in them.
• Clear your baby’s nose using a soft suction bulb. Be sure to squeeze the bulb before you gently put it in your baby’s nose.
• Be sure your baby gets enough fluids to drink.
• Treat fever with acetaminophen or ibuprofen (if your baby is older than 6 months).
• Cold medicines are not helpful in treating bronchiolitis.
• Although severe bronchiolitis can lead to wheezing, similar to wheezing seen in asthma, often the medicines used to treat asthma do not work very well for bronchiolitis. An article in this month’s Archives compared babies who were treated with a medicine (nebulized epinephrine) with babies who were treated with the same medicine as well as saline (saltwater) and found no difference between the 2 treatments. Many treatments are being researched to try to effectively treat babies with bronchiolitis, but the optimal treatment has not been found.

WHEN SHOULD I CALL THE DOCTOR?

Call the doctor if your baby is:

• having trouble breathing or is breathing faster than normal.
• making a high-pitched whistling sound when he or she breathes, also called wheezing.
• acting fussy and restless.
• not eating or drinking well.

HOW CAN I PREVENT BRONCHIOLITIS?

Bronchiolitis and RSV are most common in the fall, winter, and early spring. If you have a young baby, you can help prevent your child from getting bronchiolitis by:

• Making sure anyone who touches or holds your baby has washed his or her hands.
• Keeping your baby away from anyone with cold symptoms.
• Avoiding crowded places such as shopping malls.
• Avoiding any exposure to tobacco smoke.

FOR MORE INFORMATION

http://www.cdc.gov/rsv/

INFORM YOURSELF

To find this and other Advice for Patients articles, go to the Advice for Patients link on the Archives of Pediatrics & Adolescent Medicine Web site at http://www.archpediatrics.com.

Source: American Academy of Pediatrics, http://patiented.aap.org/content.aspx?aid=6347.