Bronchiolitis

What are bronchioles?

Air enters the lungs through the trachea, which is a breathing pipe that goes down into your chest. Before the air reaches your lungs, it divides into 2 big pipes called the bronchi. One goes to your right lung and one to your left.

The air continues to divide into smaller and smaller airways within your lungs – these are your bronchioles. They help pass the oxygen from air into your blood for your body to use. 

What is bronchiolitis?

Bronchiolitis is inflammation of the bronchioles. This is usually caused by a virus and is most common in children under the age of 1. 

What’s the difference between bronchitis and bronchiolitis?

Bronchitis is inflammation of larger airways in the lungs, which usually happens in adults. A risk factor for developing bronchitis is long-term smoking. 

Bronchiolitis affects the smaller airways, and more commonly affects infants. Bronchiolitis obliterans is not the same as bronchiolitis. 

What are symptoms of bronchiolitis?

You might notice your child has symptoms such as: 

• A runny nose

• Sneezing

• A temperature of 38 degrees celsius or higher

• A cough

After 2-3 days, the symptoms can get worse as mucous clogs up tubes. You might notice that your child: 

• Is more breathless

• Is breathing faster 

• Has noisier breathing 

• Has a change in behaviour, for example they might not be playing as they normally would.

How common is bronchiolitis?

Bronchiolitis is a very common illness in children, and in winter months is responsible for 1 in 6 of all children’s admissions to hospital. 

How is bronchiolitis diagnosed?

Bronchiolitis is diagnosed by a healthcare professional looking at their symptoms and examining them. Some tests which help with this include: 

• Attaching a small oxygen monitoring device to your child’s fingers or toes – this monitors oxygen levels in the blood and can be used to determine whether your child needs oxygen, and if they do, how much to give them 

• A blood sample – this will be taken if your child is struggling to breathe. It can influence whether your child needs a different type of support for their breathing, such as a ventilator. 

• If your child is admitted to hospital, a sample of mucous from the nose is often taken to see what virus is causing the symptoms.

How is bronchiolitis treated?

There’s no specific treatment for bronchiolitis. Some infants get better after just experiencing symptoms of a common cold, whereas others might have the more serious symptoms listed above. 

Bronchiolitis is caused by a virus so antibiotics would be ineffective.

Whether symptoms are more mild or severe, keeping your child hydrated is the most important thing. If your child is struggling to feed, they may need to be treated in hospital. A tube may need to be passed into their stomach so that milk can be given to avoid dehydration. 

If your child is admitted to hospital, it’s likely because they need a little help with their breathing to make sure they get enough oxygen. This might be through a device which is connected to their nose, known as a nasal cannula, or if they need a little bit more help, might be through a mask. 

In some cases, children might struggle with their breathing despite having oxygen support and might need to be ventilated. Although this might seem a little scary given how small your child is, this is often used for a short period of time and is taken off once your child recovers and is able to breathe by themselves. 

Why does bronchiolitis affect children more?

Infants usually develop bronchiolitis in the winter months, and it mainly happens because of a virus called RSV (respiratory syncytial virus). Usually, when a virus enters an adult’s body, the inflammation it causes in the lungs and the mucus it produces does not affect the amount of air that is able to enter the lungs. This means that the effect on breathing is not as noticeable or obvious.

But in an infant, the airways are already quite small, so if these become inflamed or filled with mucus, it can mean that a larger proportion of the airway is narrowed or affected, which means that symptoms become more noticeable. 

How can bronchiolitis be prevented?

As with all viruses, some simple measures can help, such as:

• Washing hands regularly 

• Using a tissue when sneezing or coughing and disposing straight away

• Try to avoid contact with anyone suffering from a cold or flu.

When should I seek help?

If you’re worried about your child’s breathing at all, or if they don’t seem to be recovering after an initial cold, speak to a GP or call 111 in the first instance. 

If they have any of the symptoms below, call 999 or take your child to a children’s A&E so that they can get the support they need: 

• If they’re making grunting noises when they breathe in 

• If their tummy seems to disappear underneath their ribs 

• If they’re not eating or drinking as they usually do and have dry nappies for 12 hours or more 

• If you notice any colour changes, such as their tongue, lips or skin turning blue.