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Bronchiolitis and RSV

Bronchiolitis is an infection that causes the small airways in your child’s lungs to become swollen. This can make it more difficult for your child to breathe.

  • Bronchiolitis affects children under the age of 2 years. It is caused by a virus, often the Respiratory Syncytial Virus (RSV).
  • The number of children with RSV is usually highest in winter but bronchiolitis can happen at any time of year. 
  • Bronchiolitis usually causes cold like symptoms and mild breathing difficulty. Breathing may be faster than normal as well as noisy and your child may not be able to take their usual amount of milk by breast or bottle.
  • Your child may get a little worse each day until the 3rd or 4th day of their illness after which they are likely to start improving.
  • Most children get better on their own. There are no medical treatments that speed up recovery from bronchiolitis. Many children will continue to cough for a few weeks afterwards.

Some children, especially those under 6 weeks of age or young children with heart or lung problems, can develop worse breathing difficulty and may need to go to hospital for help supporting their breathing and feeding.

When should you worry?

 

Red

If your child has any of the following:

  • Becomes pale, mottled and feels abnormally cold to touch
  • Has pauses in their breathing lasting more than 10 seconds, makes a grunting noise every time they breathe out or has blue lips
  • Is stiff or rigid or makes repeated, jerky movements of arms or legs that doesn't stop when you hold them (a fit or seizure)
  • Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
  • Develops a rash that does not disappear with pressure (the ‘Glass Test’)
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features)

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

 

Amber

If your child has any of the following:

  • Difficulty breathing, including breathing fast all of the time; widening their nostrils or pulling in of the muscles below the ribs when breathing
  • Not interested in feeding and/or looks dehydrated (dry mouth, sunken eyes, no tears, drowsy, no wet nappies in the last 8 hours or sunken fontanelle (soft spot on the head)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
  • Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations) or continues to have a fever of 38.0°C or above for more than 5 days
  • Is getting worse or if you are worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

We recognise that during peak times, access to a health care professional may be delayed. If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any RED features.

 

Green

  • None of the above features are present
  • It is normal for a baby to take slight pauses in their breathing for a few seconds, or to breath rapidly for a short period. By 6 weeks of age they should have a more regular breathing pattern.
  • Addition information is available about infant crying and how to cope – click here

Self care

Continue providing your child’s care at home. If you are still concerned about your baby, speak to your health visitor, local pharmacist or call NHS 111– dial 111

For parents from ethic minority groups, you can contact the Barnado's Boloh advisors who can provide practice advice and support in many different languages. Call 0800 151 2605 or click here for the web chat function.

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

What can you do to help your child?

  • Most babies and children can be safely cared for at home.
  • Bronchiolitis can get worse before it starts to get better. Babies and children are often most poorly on day 5 of the illness then start to get better.
  • Keep a close eye on your baby's breathing and feeding. If you have any new concerns, please look at our red/amber/green table again.
  • If your child is not feeding as normal, offer smaller feeds more often.
  • Children with bronchiolitis may have some distress and discomfort. You may wish to give either Paracetamol or Ibuprofen to make them feel better (Paracetamol can be given from 2 months of age). Please read and follow the instructions on the medicine container.
  • Bronchiolitis is caused by a virus so antibiotics generally don’t help.
  • Keep your baby’s sleep surface flat. Do not incline, tilt or prop the mattress, cot or baby unless advised by a health care professional
  • Avoid co-sleeping with your baby if they are unwell with bronchiolitis or a respiratory tract infection. For more information, see our safe sleeping page.
  • Avoid exposure to tobacco smoke which makes their breathing worse. Remember that smoke stays on your clothes even if you smoke outside. 
  • If you would like help to give up smoking you can get information and advice from your local GP surgery or by calling the National Stop Smoking Helpline Tel: 0300 123 1044 from 7am to 11pm every day.