Managing Bronchiolitis in Infants: A Parent's Guide
The best way to manage bronchiolitis in infants is through supportive care, focusing on maintaining adequate hydration, clearing nasal secretions, monitoring breathing, and avoiding unnecessary medications like bronchodilators and steroids. 1
Understanding Bronchiolitis
- Bronchiolitis is a common viral respiratory infection affecting infants, typically caused by respiratory syncytial virus (RSV) 1
- It's a self-limiting illness that usually lasts 2-3 weeks, with 90% of children being symptom-free by 21 days 2
- Symptoms include runny nose, cough, wheezing, rapid breathing, and increased respiratory effort 1
Home Management Strategies
Supportive Care
- Nasal suctioning is crucial to clear secretions and help your baby breathe and feed more easily 2
- Proper positioning - slightly elevating the head of the bed can help with breathing 2
- Adequate hydration - offer smaller, more frequent feedings if your baby is having trouble feeding 1
- Monitor breathing - watch for signs of increased respiratory effort like nostril flaring, grunting, or chest retractions 1
What NOT to Do
- Avoid over-the-counter cold medications - these are not effective and may be harmful 1
- Avoid routine use of bronchodilators (like albuterol) - research shows they don't help most infants with bronchiolitis 1, 3
- Avoid steroids - these medications don't improve outcomes in bronchiolitis 1
- Avoid antibiotics unless there's a specific indication of bacterial infection 1
When to Seek Medical Care
Take your child to a healthcare provider if you notice:
- Difficulty breathing or very rapid breathing 1
- Difficulty feeding or signs of dehydration 1
- Lethargy or extreme irritability 1
- Blue color to the lips or face 1
Risk Factors for Severe Disease
Some infants are at higher risk for severe bronchiolitis:
- Age less than 12 weeks 1
- History of prematurity 1
- Underlying heart or lung conditions 1
- Weakened immune system 1
Prevention Strategies
- Breastfeeding is recommended to decrease your child's risk of respiratory infections - studies show it can reduce hospitalization risk by up to 72% 1
- Avoid tobacco smoke exposure - this significantly increases both illness severity and hospitalization risk 1
- Hand hygiene - proper handwashing is crucial to prevent spread of viruses 1
- For high-risk infants (premature, with heart disease, etc.), ask your doctor about palivizumab (Synagis), a preventive medication given during RSV season 4
What to Expect at the Doctor's Office
- Diagnosis is typically made based on symptoms and physical examination 1
- Chest X-rays and laboratory tests are not routinely needed 1, 3
- If oxygen levels are low (below 90%), supplemental oxygen may be provided 1
- For severe cases, various forms of respiratory support may be needed 5
Hospital Care
If hospitalization is needed:
- The focus remains on supportive care 3
- Oxygen therapy if oxygen levels are low 1
- IV or nasogastric fluids if your baby can't drink enough 1
- Respiratory support if needed 5
- Most children improve within a few days 3
After Recovery
- Some children may have a lingering cough for several weeks 2
- Having bronchiolitis doesn't necessarily mean your child will develop asthma, though there may be an association 2
- Avoid unnecessary medications for persistent cough after bronchiolitis unless specifically recommended by your doctor 2
Remember that while bronchiolitis can be scary for parents, most children recover completely with proper supportive care. Focus on keeping your baby comfortable, well-hydrated, and monitoring for any signs that medical attention is needed.