Bronchiolitis
Bronchiolitis is a very common infection that causes the tiniest airways in your child’s lungs to become swollen, which can make it harder for them to breathe. It is caused by viral infections often by a virus called RSV and is more common over the winter months. It mostly affects young children under 2 years of age.
Most children do not need any treatment and getter better on their own. Some children, especially very young babies, may need to go to hospital due to the need for extra help with their breathing or feeding. The two most common reasons for children to need to stay in hospital are if they need extra oxygen or they are taking less than half of their normal feeds.
When should I worry?
If your child has any of the following:
Breathing very fast or breathing that stops or pauses
Working hard to breathe, drawing in of the muscles below the rib, unable to talk or noisy breathing (grunting)
A harsh breath noise as they breathe in (stridor) present all of the time (even when they are not upset)
Becomes pale, blue, mottled and/or unusually cold to touch
Difficult to wake up, very sleepy or confused
Weak, high-pitched, continuous cry or extremely agitated
Has a fit (seizure)
A temperature less than 36oC.
A temperature 38oC or more if baby is less than 3 months
Develops a rash that does not disappear with pressure and seems unwell (see the 'Glass Test')
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
Breathing a bit faster than normal or working a bit harder to breathe
Noisy breathing (stridor) only when upset
Dry skin, lips, tongue or looking pale
Not had a wee or wet nappy in last 12 hours
Sleepy or not responding normally
Crying and unsettled
Poor feeding (babies) or not drinking (children)
A temperature 39oC or above in babies 3-6 months
Temperature of 38oC or above for more than 5 days or shivering with fever(rigors)
Getting worse or you are worried about them
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If your child has none of the above
Watch them closely for any change and look out for any red or amber symptoms. For additional advice please follow the support available for families to help cope with crying in otherwise well babies
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
What can you do?
Most babies and children can be safely cared for at home. If your baby / child is struggling with their feeding, try smaller, more frequent feeds.
A mild fever is common in the first few days. Give paracetamol to lower your child's temperature. Paracetamol will also help to soothe any sore throat and make your child feel more comfortable.
Bronchiolitis can get worse before it starts to get better. Babies and children are often most poorly on day 5 of the illness then gradually start to get better. Keep a close eye on your baby's breathing and feeding. If you have any new concerns, please re-visit our red/amber/green table to see if your child needs to see a healthcare professional or not, and to find out where and when is best for your child to be seen.
· Wash your hands with soap and water regularly
· Avoid exposure to tobacco smoke which makes their breathing worse
· Antibiotics aren't needed as bronchiolitis is caused by a virus
How long does bronchiolitis last?
Babies are usually unwell for 5 to 10 days. Most will get better within two weeks. Babies may still have a cough for up to 4 weeks afterwards and this is completely normal
Your child can go back to nursery as soon as you feel they are well enough. Bronchiolitis does not normally cause long term problems for your child
For wear and tear, minor trips and everything in between.
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
