Bronchiolitis and RSV
Bronchiolitis is an infection that causes the small airways in your child’s lungs to become swollen. This can make it more difficult for your child to breathe.
- Bronchiolitis affects children under the age of 2. It is caused by a virus, often the Respiratory Syncytial Virus (RSV).
- The number of children with RSV is usually highest in winter but bronchiolitis can happen at any time of year.
- Bronchiolitis usually causes cold like symptoms and mild breathing difficulty. Breathing may be faster than normal as well as noisy and your child may not be able to take their usual amount of milk by breast or bottle.
- Your child may get a little worse each day until the 3rd or 4th day of their illness after which they are likely to start improving.
- Most children get better on their own. There are no medical treatments that speed up recovery from bronchiolitis. Many children will continue to cough for a few weeks afterwards.
Some children, especially those under 6 weeks of age or young children with heart or lung problems, can develop worse breathing difficulty and may need to go to hospital for help supporting their breathing and feeding.
Please see Red-Amber-Green tables for advice on when and where to seek care for your child.
Many thanks to ASKSNIFF for providing the clips of abnormal signs.
Many thanks to ASKSNIFF for providing the clips of abnormal signs.
When should you worry?
If your child has any of the following:
- Breathing very fast or breathing that stops or pauses
- Makes a grunting noise every time they breathe out
- A harsh noise as they breathe in (stridor) present all of the time (even when they are not upset)
- Becomes pale, blue, mottled and / or unusually cold to touch
- Difficult to wake up, very sleepy or confused
- Weak, high-pitched, continuous cry or can’t be settled
- Has a fit (seizure)
- Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red or amber features)
- Has a rash that does not go away with pressure (the glass test)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or call 999 - dial 999.
If your child has any of the following:
- Working hard to breathe, drawing in of the muscles below the ribs
- A harsh noise as they breathe in (stridor) only when upset
- Dry skin, lips or tongue
- Not had a wee or wet nappy in last 8 hours
- Poor feeding in babies (less than half of their usual amount)
- Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
- Is 3-6 months old with temperature 39oC or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
- Temperature of 38oC or above for more than 5 days or shivering with fever(rigors)
- Temperature less than 36°C
- Getting worse and I am still worried
You need to contact a doctor or nurse today.
Please contact your GP surgery or call NHS 111 - dial 111.
If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.
If your child has none of the above
- Watch them closely for any change and look out for any red or amber symptoms
- Additional advice is also available for families for help cope with crying in otherwise well babies
- If your child has a long term condition or disability and you are worried please contact your regular team or follow any plans that they have given you.
Self care
Continue providing your child’s care at home. If you are still concerned about your baby, speak to your health visitor, local pharmacist or call NHS 111– dial 111
For parents from ethnic minority groups, you can contact the Barnado's Boloh advisors who can provide practical advice and support in many different languages. Call 0800 151 2605 or visit our web chat function.
Self care and Prevention
What can you do?
- Most babies and children can be safely cared for at home.
- Bronchiolitis can get worse before it starts to get better. Babies and children are often most poorly on day 5 of the illness then start to get better.
- Keep a close eye on your baby's breathing and feeding. If you have any new concerns, please look at our red/amber/green table again.
- If your child is not feeding as normal, offer smaller feeds more often.
- Children with bronchiolitis may have some distress and discomfort. You may wish to give either Paracetamol or Ibuprofen to make them feel better (Paracetamol can be given from 2 months of age). Please read and follow the instructions on the medicine container.
- Bronchiolitis is caused by a virus so antibiotics generally don’t help.
- Keep your baby’s sleep surface flat. Do not incline, tilt or prop the mattress, cot or baby unless advised by a health care professional.
- Avoid co-sleeping with your baby if they are unwell with bronchiolitis or a respiratory tract infection. For more information, see our safe sleeping page.
- Avoid exposure to tobacco smoke which makes their breathing worse. Remember that smoke stays on your clothes even if you smoke outside.
- If you would like help to give up smoking you can get information and advice from your local GP surgery or by calling the National Stop Smoking Helpline Tel: 0300 123 1044 from 7am to 11pm every day.
How long does bronchiolitis last?
Babies are usually unwell for 5 to 10 days. Most will get better within two weeks. Babies may still have a cough for up to 4 weeks afterwards and this is completely normal.
Your child can go back to nursery as soon as you feel they are well enough. Bronchiolitis does not normally cause long term problems for your child.
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