What is bronchiolitis?
Bronchiolitis is an infection in the bronchioles. The bronchioles are small airways in the lungs. These airways become inflamed and filled with mucous making it rather difficult to breathe.
Bronchiolitis is primarily a winter disease occurring during the winter months. Though the peak for the disease is January through March.
Who is at Risk for Bronchiolitis?
Any child under the age of two. Though the peak age range is from 3-6 months of age. Male infants are at higher risk than female infants. Also infants that were born premature (less than 37 weeks gestation) are at much greater risk for bronchiolitis.
Other risk factors to be aware of include the following:
Never been breast fed (breast fed babies receive immunities from their mother)
Exposure to tobacco smoke
Underlying heart or lung condition
Contact with multiple children (such as a child care setting)
Depressed immune system
Crowded living environment
Having siblings that attend school or child care and brings the infection home with them
What is the Cause of Bronchiolitis?
The primary cause of bronchiolitis is a virus called Respiratory Syncytial Virus (RSV). Though there are other viruses that can cause the disease as well, such as: Rhinovirus, Influenza (flu), Parainfluenza and Adenovirus.
What are the Symptoms of Bronchiolitis?
Early symptoms are similar to those of the common cold. These symptoms include stuffiness, runny nose, cough and mild fever. These symptoms may last for several days.
Then the symptoms may worsen and you will start to notice:
nasal flaring (widening of the nostrils when the infant breathes)
tachypnea (rapid breathing)
retractions (drawing in of the neck, chest or upper abdomen with breathing)
wheezing (high pitched sound when breathing out) or crackling in the breath sounds
rapid heart beat
irritability
The child may also have difficulty eating because they can't breathe and eat at the same time. When this occurs you need to watch and be aware of dehydration. Symptoms of dehydration include a dry mouth, crying without tears and urinating less than normal. If you notice any of these, contact your physician.
Severe bronchiolitis can include all of the above symptoms, but is most notable by extreme difficulty breathing and a bluish discoloring of the skin and mucous membranes. This is a sign of inadequate oxygenation and requires emergency medical treatment.
The symptoms of bronchiolitis can last for around two weeks, though severe cases can last longer.
What is the treatment for Bronchiolitis?
There really is no treatment other than supportive therapy. Since it is caused by a virus, antibiotics are of no use.
Ensure that the child is receiving adequate fluids through breast feeding, formula or electrolyte balanced drinks such as Pedialyte. In a hospital setting they may start in IV and give fluids through that as well.
Humidified air can also help. However, if you use a humidifier remember to thoroughly clean it daily to prevent mold. The humidified air can help to thin the secretions and make them easier for your child to cough up.
Suctioning can also help make it easier for your child to breathe. You can use a bulb syringe with a saline to suction at home. Just put a couple of drops of the saline into each nostril and then suction it out with the bulb syringe. You can also use a nasal aspirator that you may be able to purchase from a pharmacy. In the hospital setting they may suction the child more aggressively with a suction catheter. They may nasopharyngeal or nasotracheal suction your child. You may not like to watch it, but it needs to be done to assist your child in clearing the mucous from their airway. They will breathe much easier afterwords.
In severe cases the child may need to be placed on humidified oxygen or even need assistance breathing such as with a ventilator.
Breathing treatments have not been found to be helpful in the treatment of bronchiolitis. Though your hospital may give your child a breathing treatment just to try it.
Is There a way to Prevent Bronchiolitis?
The best way to prevent bronchiolitis is through hand washing. I know it sounds rather cliche but it is true. Encourage anyone that comes in contact with your young child to wash their hands first. Do not allow anyone to smoke around your child. Also practice and encourage others to practice good respiratory etiquette (i.e. cover coughs and sneezes) as the viruses that cause bronchiolitis are transferred through moisture droplets that are put into the air through coughs and sneezes. And again, FREQUENT hand washing is key.
I hope that you have found this information helpful. When in doubt or if your child is showing signs of distress contact your physician or take them to the emergency department immediately. You can never be to careful, especially when it comes to your child's health.
On a side note, there has been a relationship discovered between bronchiolitis and asthma. The nature and extent of this relationship is still being researched. So it will be interesting to get the results of that.
Sources:
Pub Med
Kids Health
Mayo Clinic
Healthy Children
Other useful article:
American Association of Pediatrics
