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Bronchiolitis is a common chest infection that affects babies and children under 2. Bronchiolitis is caused by a virus, often the respiratory syncytial virus (RSV). This means antibiotics cannot treat it, and we need to manage symptoms.
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 1st 2024, pregnant women in England are eligible for a vaccine to protect their babies against RSV from birth.
What should I look out for?
The early symptoms of bronchiolitis are similar to a cold, such as:
- Sneezing
- A runny or blocked nose
- A cough
- Slightly high temperature of 38C.
A child with bronchiolitis may then get other symptoms, such as:
- Breathing more quickly
- Finding it difficult to feed or eat
- Noisy breathing
- Becoming irritable
Bronchiolitis usually gets better on its own. But it can be serious in some children, who may need to be treated in hospital.
Symptoms are usually worst between days 3 and 5, and the cough can last 3 weeks.
What to do if your child is unwell
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.
The green / amber / red information below tells you what to look out for and where to seek help. If you're reading this page on your mobile, you may need to scroll across to see the whole table.
| Green |
If your child does not seem to be seriously ill, you can usually look after them at home:
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Self care:
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|---|---|---|
| Amber |
If your child has any of the following:
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You need to contact a doctor or nurse today. Please ring your GP practice or call NHS 111 – dial 111. |
| Red |
If your child has any of the following:
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You need urgent help. Go to the nearest hospital emergency (A&E) department or phone 999 to call an ambulance. |
Top tips for taking care of your child
Monitoring
- You should watch them closely in case their condition gets worse.
- It’s important to trust your instincts if your child is unwell. Get medical help if you think you need it.
Feeding
- Babies may find it more tiring to feed so they should be offered shorter, more frequent feeds.
- Encourage children to drink plenty of fluids.
- In children over one, you can offer them a little bit of honey in a drink to sooth 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.
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.
RSV vaccine for pregnant women
The vaccine boosts the immune system to produce antibodies against the virus which are then passed to the baby through the placenta, reducing their risk of infection. While the vaccine is not 100% effective it does reduce the risk of severe bronchiolitis by 70% during the first six months of life. It has undergone rigorous testing and monitoring to ensure its safety.
The vaccine will be offered at around the time of the 28-week antenatal appointment. If you’ve not been contacted by this stage of your pregnancy, please get in touch with your maternity service or GP practice to book an appointment. The vaccine is most effective if given at 28 weeks or within a few weeks of this as it will provide a good level of antibodies to pass on before birth. This will give your baby the best protection, including for babies who are born early. Although it may not be as effective, the vaccine can be given at a later stage of pregnancy, including up until you give birth. If you have the vaccine very late in pregnancy, it may reduce your risk of RSV infection and reduce the chances of you giving it to your baby.
Some babies, such as those who are very premature, have a weakened immune system or have severe heart disease, are at increased risk of RSV. These babies may be offered an antibody injection which will provide extra protection alongside the antibodies they may receive from their mother.
For more information on the vaccine, please visit the NHS website.