Bronchiolitis (RSV)

Symptoms

Wheezing is a high-pitched purring or whistling sound
You can hear it best when your child is breathing out
Rapid breathing at a rate of over 40 breaths per minute
Tight breathing (having to push the air out)
Coughing (may cough up very sticky mucus)
Fever and a runny nose often precede the breathing problems.
Symptoms are similar to asthma. About 30% of children with bronchiolitis later develop asthma. This is more likely if they have close relatives with asthma. Also likely if they have bronchiolitis more than 2 times.

Diagnosis

A doctor can diagnose bronchiolitis by listening to the chest with a stethoscope.

Cause

A narrowing of the smallest airways in the lung (bronchioles) causes wheezing. This narrowing results from swelling caused by a virus.
The respiratory syncytial virus (RSV) causes most bronchiolitis. RSV occurs in epidemics almost every winter.
People do not develop life-long immunity to the RSV virus. This means they can be infected many times.

Prevention of Spread to Others

Overview:

Asthma Medicines:

Some children with bronchiolitis are helped by asthma-type medicines. Most children are not helped by these medicines.
If one has been prescribed for your child, give it as directed.
Continue the medicine until your child's wheezing is gone for 24 hours.

Coughing Fits or Spells:

Breathe warm mist (such as with shower running in a closed bathroom).
Give warm clear fluids to drink. Examples are apple juice and lemonade.
Amount. If 3 - 12 months of age, give 1 ounce (30 ml) each time. Limit to 4 times per day. If over 1 year of age, give as much as needed.
Reason: Both relax the airway and loosen up any phlegm.

Homemade Cough Medicine:

Do not give any over-the-counter cough medicine to children with wheezing. Instead, treat the cough using the these tips:
AGE 3 months to 1 year: Give warm clear fluids to treat the cough. Examples are apple juice and lemonade. Amount: Use a dose of 1-3 teaspoons (5-15 ml). Give 4 times per day when coughing. Caution: Do not use honey until 1 year old.
AGE 1 year and older: Use HONEY ½ to 1 teaspoon (2-5 ml) as needed. It works as a homemade cough medicine. It can thin the secretions and loosen the cough. If you don't have any honey, you can use corn syrup.

Nasal Saline To Open a Blocked Nose:

Your baby can't nurse or drink from a bottle if the nose is blocked. Suction alone can't remove dry or sticky mucus.
Use saline (salt water) nose drops or spray to loosen up the dried mucus. If you don't have saline, you can use a few drops of bottled water or clean tap water. (If under 1 year old, use bottled water or boiled tap water.)
STEP 1: Put 3 drops in each nostril. (If age under 1 year old, use 1 drop).
STEP 2: Suction each nostril out while closing off the other nostril. Then, do the other side.
STEP 3: Repeat nose drops and suctioning until the discharge is clear.
How often: Do nasal saline when your child can't breathe through the nose. Limit: No more than 4 times per day.
Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
Other option: use a warm shower to loosen mucus. Breathe in the moist air, then suction.

Humidifier:

If the air in your home is dry, use a humidifier. Reason: Dry air makes coughs worse.

Smaller Feedings:

Avoid Tobacco Smoke:

What to Expect:

Wheezing and rapid breathing usually improve over 2 or 3 days.
Mild wheezing may come and go for up to a week.
Coughing may last 3 to 4 weeks.
Recovery is gradual. Symptoms last longer in young infants.
Some children (2%) with bronchiolitis need to be in the hospital. These children need oxygen or fluids given through a vein.

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