Bronchiolitis and RSV

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For most children, bronchiolitis is a mild infection which gets better on its own but some children, especially those under 6 months of age or young children with heart or lung problems, can develop significant breathing difficulty and may need to go to hospital. 

As of September 1^st 2024, pregnant women in England are eligible for a vaccine to protect their babies against RSV from birth.

The early symptoms of bronchiolitis are similar to a cold, such as: 

• Sneezing 
• A runny or blocked nose 
• A cough  
• A temperature of up to 39 degrees 

A child with bronchiolitis may then get other symptoms, such as:  

• Breathing more quickly or working harder to breathe
• Finding it difficult to feed or eat (usually after 3 to 5 days of illness)
• Noisy breathing 
• Becoming irritable  

Usually, bronchiolitis gets worse before it gets better and symptoms are usually worst between days 3 and 5. The cough can last up to 3 weeks.

It can be difficult to tell when a child is seriously ill, but the main thing is to trust your instincts. You know better than anyone else what your child is usually like, so you’ll know when something is seriously wrong and if you are worried you should get medical help.  

The green / amber / red information on Healthier Together will tell you what to look out for and where to seek help. below tells you what to look out for and where to seek help.

Monitoring 

• You should watch them closely in case their condition gets worse. 
• You should check on your child whilst they are sleeping, they should still respond normally to your touch.
• It’s important to trust your instincts if your child is unwell. Get medical help if you think they need it. 

Feeding 

• Babies may find it more tiring to feed so they should be offered shorter, more frequent feeds. 
• If they are feeding less than usual, check the traffic light guidance to see how to get more help.
• Encourage children to drink plenty of fluids. 
• In children over one, you can offer them a little bit of honey in a drink to soothe their throat. 

Managing symptoms 

• If your child is feeling uncomfortable, you can give them children’s paracetamol or children’s ibuprofen. Check the leaflet to make sure the medicine is suitable for your child and to see how much to give them. 
• You can use saline drops in their nose to help break up any blockages, and raise the head end of their bed or cot.  
• Visit ICON parent advice for soothing crying babies. 
• Consider air quality around your child: they should not be exposed to tobacco smoke, pollution or scented air fresheners, as these can all make breathing problems worse Wherever possible, rooms should be kept well-ventilated and any mould cleaned from the walls. 
• It is important that people avoid smoking in the home where your baby or child is as this can make their symptoms worse.

Avoid spreading infections 

• Wash hands often with soap and water. 
• Cover your mouth and nose with a tissue when you cough or sneeze. 
• Bin used tissues as quickly as possible. 
• While your child is very unwell, you should keep them at home where possible. Let your childcare or nursery know. 

Here’s what you need to know about the RSV vaccine during your pregnancy.

Having the vaccine helps protect you and your baby against the virus and here is how it helps. It boosts the immune system to produce antibodies which are passed to your baby through the placenta. These antibodies help to reduce the risk of infection to your baby. During the first 6 months of life your baby could be up to 70% less likely to get severe bronchiolitis, thanks to the vaccine. 

When will this be offered to me?

This will usually be offered at around 28 weeks at your routine midwife appointment. Having the vaccine at 28 weeks or within a few weeks of this will provide the best level of protection, including for babies who are born early, as it is most effective at this time. If you have passed 28 weeks, please don’t panic. Just ask when you see your midwife next or speak to your GP to book. Although it may not be as effective it can still be given at later stages in pregnancy, including up until your baby arrives. You can still reduce your risk of getting the RSV infection and passing it to your baby.

You may be unsure about whether to have the vaccine, but please be assured that it has been thoroughly tested and monitored to make sure it is safe for you both.

Some babies can be more likely to be at risk of RSV especially if born very early, have a weakened immune system or have severe heart disease. If this is your baby, please be reassured they may be offered an extra level of protection and antibody injections can be given to top up what they may receive from you! If this is needed, your hospital team will discuss it with you.

We hope this has been helpful but if you would like some more information, grab a cuppa (decaf!) and visit the NHS website. There is also information on Gov.uk, where there is also information available in other languages.