Bronchiolitis and RSV

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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.

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: Make sure they have enough water and milk   Look out for signs it could be getting worse	Self care: Continue to care for your child at home. Contact a community pharmacist or your health visitor for advice. If you are still concerned about your child, call NHS 111 – dial 111.
Amber	If your child has any of the following:  Breathing is hard work – they suck in their ribs   Breathing is sometimes noisy or irregular   No wet nappies for 12 hours   Shivering or complaining of muscle pain   Raised temperature 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 practice or call NHS 111 – dial 111.
Red	If your child has any of the following: Abnormal colour (pale, purple or blue) Very noisy or irregular breathing  Unable to feed  Floppy and lethargic or extremely agitated  A new rash that doesn’t disappear when you press a glass against the skin	You need urgent help. Go to the nearest hospital emergency (A&E) department or phone 999 to call an ambulance.

Green

If your child does not seem to be seriously ill, you can usually look after them at home:

Make sure they have enough water and milk  
Look out for signs it could be getting worse

Self care:

Continue to care for your child at home.
Contact a community pharmacist or your health visitor for advice.
If you are still concerned about your child, call NHS 111 – dial 111.

Amber

If your child has any of the following: 

Breathing is hard work – they suck in their ribs  
Breathing is sometimes noisy or irregular  
No wet nappies for 12 hours  
Shivering or complaining of muscle pain  
Raised temperature 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 practice or call NHS 111 – dial 111.  

Red

If your child has any of the following:

Abnormal colour (pale, purple or blue)
Very noisy or irregular breathing 
Unable to feed 
Floppy and lethargic or extremely agitated 
A new rash that doesn’t disappear when you press a glass against the skin

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.

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