If your child's bronchiolitis is not severe, they will usually get better without treatment after two weeks. A small proportion of children (up to 9%) may still have symptoms after four weeks.
To avoid the infection spreading to other children, take your child out of nursery or day care and keep them at home until their symptoms have improved (see below).
Treatment at home
Continue to monitor your child. Check on them regularly, including throughout the night. If their condition worsens, contact your GP. Read more information about the symptoms of bronchiolitis for advice about when to call an ambulance.
There is no medicine that can kill the viruses that cause bronchiolitis. However, you should be able to ease mild symptoms and make your child more comfortable by following the advice below.
Once your child is feeding normally and no longer has difficulty breathing, they can return to nursery or day care. If your child is recovering well, there is no need to see your GP again.
Keep your child upright
This may help make their breathing easier and may be useful when they are trying to feed. If your child has a nap in an upright position, make sure that their head does not fall forward by supporting it with something, such as a rolled-up blanket.
Drink plenty of fluids
Make sure that your child drinks plenty of water or fruit juice to avoid dehydration (when the normal water content of the body is reduced). If your child is being breastfed or bottle fed, try giving them smaller feeds more frequently.
Keep the air moist
If you have access to an air humidifier, using it to moisten the air may help to ease your child's cough.
Your home should be heated to a comfortable temperature, but do not make it too warm as this will dry out the air.
Keep a smoke-free environment
Inhaling smoke from cigarettes or other tobacco products may aggravate your child's symptoms. If you smoke, avoid doing so around your child.
Passive smoking can affect the lining of your child's airways, making them less resistant to infection. Therefore, keeping smoke away from your child may help prevent future episodes of bronchiolitis.
Paracetamol or ibuprofen
If your child has a high temperature (fever) that is making them miserable, you may consider using paracetamol or ibuprofen, depending on their age. These are available over the counter from pharmacies without prescription.
Always follow the manufacturer’s instructions and do not give aspirin to children under the age of 16.
Babies and children can be given paracetamol to treat fever or pain if they are over two months old. Ibuprofen may be given to children who are three months old or over and weigh at least 5kg (11lbs).
Do not try to reduce your child’s high temperature by sponging them with cold water.
Saline nasal drops
Saline (salt water) nasal drops are available over the counter from pharmacies. Placing a couple of drops of saline inside your child’s nose before they feed may help to relieve a blocked nose. However, always follow the manufacturer’s instructions or check with your pharmacist before using saline nasal drops.
Treatment in hospital
Approximately 3% of babies with bronchiolitis need to be admitted to hospital.
Children are more at risk of being admitted to hospital if they were born prematurely (before week 37 of pregnancy) or with an underlying health problem. Read more information about the causes of bronchiolitis for a full list of risk factors.
Your child may be admitted to hospital if:
- They aren't getting enough oxygen into their blood because they are having difficulty breathing.
- They aren't eating or drinking enough.
Once in hospital, your child will be monitored and treated in a number of ways, as explained below.
Further testing
The level of oxygen in your child’s blood will be measured with a pulse oximeter. This is a small clip or peg that is attached to your baby’s finger or toe. It transmits light through your baby’s skin and the sensor uses this to detect how much oxygen is in your baby’s blood.
If your child needs more oxygen, it can be given to them through a thin tube in their nose or a mask that goes over their face.
If it hasn't already been tested, at this point a sample of your child’s mucus may be tested to see which virus is causing the bronchiolitis. This will confirm whether the respiratory syncytial virus (RSV) is responsible.
If your child has RSV, they will need to be kept away from other children in the hospital who are not infected with the virus. This is to control the spread of the virus.
Read more information about how bronchiolitis is diagnosed.
Feeding
If your child is having trouble feeding, they may be given fluids or milk through a feeding tube. This is a thin plastic tube that goes into your child’s mouth or nose and down into their stomach. Alternatively, they may be given fluids intravenously (directly into a vein).
Nasal suction
If your child’s nose is blocked and they have trouble breathing, nasal suction may be used. This involves a small, plastic tube being inserted into their nostrils to clear out the mucus.
Other hospital treatments
Several other medicines have been tested to determine whether they benefit children with bronchiolitis, and most have been shown to have little or no effect. Research also suggests that chest physiotherapy, where physical movements or breathing techniques are used to relieve the symptoms, is of no benefit.
Nebulised hypertonic saline solution is one possible treatment that may be of benefit. Hypertonic saline solution is fluid that has a high concentration of salt. A nebuliser is a device that converts liquid into mist so that it can be breathed in.
One review of medical research found that nebulised hypertonic saline solution reduced the amount of time that children with bronchiolitis spent in hospital and also reduced the severity of their symptoms. A large UK research study is underway to test this further.
Leaving hospital
Most children who are admitted to hospital will need to stay there for two-to-four days. Your child will be discharged from hospital and able to go home when:
- They have enough oxygen in their blood without the need for medical assistance.
- They are able to take (and keep down) over 75% of their normal feeds.
