Bronchiolitis and RSV: how to spot the symptoms – and what to do next

RSV is a common virus that can cause bronchiolitis and breathing problems in young children. Here's your guide to the key signs to look out for and what to do if you think your child has the illness

sick baby

In a nutshell: Bronchiolitis is a common chest infection, caused by the respiratory syncytial virus (RSV), that can affect babies and children under 2 years old. It’s most common in babies aged 3 to 6 months. Usually, the infection is mild and clears up without medical treatment but a small number of children with severe symptoms will need to be treated in hospital.

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What are the symptoms of bronchiolitis?

The symptoms of bronchiolitis can be similar to a cold, such as a runny or blocked nose and a cough, but the most telltale signs are:

  • Cough: a dry and rasping cough
  • Slight fever: a raised temperature
  • Runny nose
  • Decreased appetite: not feeding and no interest in food
  • Fast or noisy breathing: if your child is having difficulty breathing or working hard to breathe, please seek urgent medical help

Your child is more likely to develop bronchiolitis after coming into contact with the RSV virus that causes it if they have been exposed to smoke (from adult smokers around them), if they have never been breastfed or were breastfed for less than 2 months or if they have older siblings who attend school or nursery (and could bring the infection home).

What do I do if I think my child has bronchiolitis?

There’s no medical treatment you can use at home to treat bronchiolitis and, for most children, the infection will clear up on its own within 2 weeks. Generally speaking, the symptoms tend to be their worst for 2 or 3 days, then start to ease.

To help alleviate the symptoms, you could:

  • Keep your baby upright as much as possible when they’re awake, to make breathing easier.
  • Raise the ‘head’ end of your baby’s cot by putting the legs on blocks or putting a pillow under the mattress (never put a pillow directly under your baby’s head, as that’s not considered safe).
  • Try to make your baby is getting enough fluid, to avoid dehydration.
  • Use a humidifier in your baby’s room to help with their breathing.
  • Ask your pharmacist about saline drops. If your pharmacist thinks they’re appropriate for your baby, you can put a few inside your baby’s nostril to help clear their nose.
  • Treat any fever with age-appropriate doses of child paracetamol or ibuprofen.

When should I seek medical help for a child with bronchiolitis?

Most children will recover from bronchiolitis without medical treatment but some children can develop severe symptoms that do need treatment. Your child is more likely to be vulnerable to a severe bronchiolitis infection if:

  • They were born prematurely
  • They are under 3 months old
  • They have a heart defect, lung disease or a weakened immune system

Whether your child falls into 1 of these more vulnerable categories or not, you should see a doctor or call the NHS on 111 if:

  • Your child has a persistent high temperature of 38°C or above
  • Your child hasn’t had a wet nappy for 12 hours or more
  • Your child has been drinking less than half of their usual amount of milk over the last 2 to 3 feeds
  • Your child seems very irritable or tired
  • You’re worried about your child

You should call 999 for an ambulance if:

  • Your child is having great difficulty breathing: taking rapid, shallow, quick or wheezy breaths, with the muscles under and in between the ribs and the base of the throat pulling in with each breath, and nostrils flaring with each breath
  • Your child’s tongue and lips turn blue
  • There are long pauses in your child’s breathing

‘I’ve never seen a baby’s tummy pumping so fast for breaths’:  one mum’s story

Mum Beth Foster took to Facebook to warn other parents about bronchiolitis, after her 6-week-old daughter Myah (pictured) developed the infection.

“Please be aware of bronchiolitis this winter,” Beth posted. “It’s so easily missed and so bloody dangerous. It starts with just a simple cough and cold and can turn to so much more within hours.

“I’ve never seen a baby’s tummy pumping so fast fighting for the breaths, and I’ve never been so scared.

“I took her to the doctor on Tuesday and he prescribed some eye drops for a gunky eye, and at that point she wasn’t struggling. But on Saturday she had a coughing fit and her face turned purple for around 15 seconds. I phoned 111, got an out of hours doctor’s appointment and then we got sent straight to the hospital.

“When I arrived they checked Myah’s sats and 3 nurses ran off with her to immediately get her straight on oxygen. We had no clue how serious this all was until that point. 

“There is nothing more heart-breaking. Even if your baby has a slight cough or cold, just get checked out.”

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Does bronchiolitis cause any long-term complications?

The vast majority of children who get bronchiolitis recover quickly and aren’t left with any long-term health problems.

For some children, particularly if they’ve had bronchiolitis severely, they may have a lingering cough and wheeze for another 3 or 4 months.

If your child has repeated bouts of bronchiolitis, their risk of getting asthma in later life may be increased.

What can I do to prevent my child getting bronchiolitis?

RSV, the virus that cause bronchiolitis is incredibly common and very easily spread, so it’s more or less impossible to make sure your child never comes into contact with it. However, you can reduce the likelihood of your child getting or spreading it by taking the following steps:

  • Keep your baby away from other children and people who are sick, especially in your baby’s first 2 months of life, and avoid contact with anyone who has cold or flu-like symptoms
  • Wash your hands and your child’s hands often and thoroughly, especially before picking up or feeding your baby
  • Ask anyone caring for or coming to see your baby to wash their hands first
  • Use disposable tissues and throw them away immediately after use
  • Wash or wipe down toys regularly
  • Do not smoke around your child or let other smoke around them (children who passively inhale tobacco smoke are at increased risk of developing bronchiolitis).

What is bronchiolitis exactly – and what causes it?

Bronchiolitis is a viral infection that’s caused inflammation of the bronchioles – small breathing tubes that branch of the main passageways in your child’s lungs. The inflammation makes the tubes swell and produce more mucus than usual, which can clog the space in the tubes, reduce the amount of air entering the lungs and make it harder to breathe.

It’s the most common lower-lung chest infection in infants. It’s estimated that 1 in 3 babies in the UK will develop bronchiolitis before their 1st birthday.

Most bronchiolitis cases are caused by the respiratory syncytial virus (RSV), which is usually most prevalent between October and March. It is an airborne virus and is transmitted through the coughs and sneezes of people who have colds, or through sharing or touching hard-surface items, such as toys, cups, door handles and taps, that other people who are ill have recently touched.

Pics: Getty Images; Beth Foster/Facebook

Last updated: September 10 2021

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