Bronchiolitis in kids: Educate yourself beyond the basics

Bronchiolitis commonly affects children below the age of two and can lead to partial or complete blockage of airways. 

Does your child have difficulty breathing? Are you noticing a whistling sound each time he breathes out? Has this been going on for more than five days?

Then he may be suffering from Bronchiolitis, an acute throat infection that commonly affects children below the age of two and can lead to partial or complete blockage of airways. 

Bronchiolitis in kids: All you need to know about it

Bronchiolitis is a virus-borne illness wherein Respiratory Syncytial Virus (RSV) or rhinovirus causes a severe form of lower respiratory tract infection.

This virus essentially inflames bronchioles (a passageway of air connecting the mouth and nose to the lungs), leading to partial or complete blockage of airways and is often characterized by wheezing (that whistling sound while breathing out). And because less oxygen enters the child’s lungs, blood levels in the body also decrease. 

In many cases, hospitalization can ensure the child consumes adequate fluids and is able to breath without difficulty. Many children are also able to get better after a week of treatment.

Unfortunately, in some cases Bronchiolitis in kids can become fatal. Infants and newborns may find it difficult to fight this viral infection since their immune systems are not properly built. It is thus crucial for parents to learn more about this illness, its symptoms as well as its treatments. 

What causes Bronchiolitis in kids?

As mentioned, Bronchiolitis in kids is caused by a virus and breaks out seasonally in different hemispheres.

For instance, in the Northern hemisphere, Bronchiolitis outbreaks are usually seen between November and April, peaking around January and February. While in the Southern hemisphere it may break, this wintertime illness may occur anytime between May and September.

And, in tropical countries such as Singapore, Bronchiolitis in kids is mostly seen during the monsoon season.    

While Bronchiolitis is common in children below the age of two, it can also occur in older kids.

Typically, they do not develop Bronchiolitis, they may still have RSV in their bodies and may exhibit some symptoms such as wheezing and coughing. But these are not the only symptoms to watch out.

Bronchiolitis in kids

Unfortunately, just as any viral infection Bronchiolitis is also contagious and it can risk other infants

What are the symptoms of Bronchiolitis in kids?

You will notice that Bronchiolitis infection breaks out towards the fag end of a common cold. So you may notice the following initial symptoms: 

  • Mild cough
  • Runny nose or decongestion 
  • Fever higher than 100.4°F (38 degree C)
  • Loss of appetite   

Now, as the infection progresses over the week and the lower respiratory tract gets inflamed a child may exhibit the following symptoms: 

  • Apnea (pause of 15 seconds in breathing, most common in preemies and infants)
  • Wheezing, which can last upto a week as well
  • Fast breathing, 60 to 70 times per minute and with great difficulty 
  • Dehydration due to rapid breathing 
  • Severe cough that lasts upto two weeks 
  • Retractions, which is sucking in of the base of the lungs as well as the throat to breathe
  • Nasal flaring, which is the enlargement of nostrils in order to breathe properly 
  • Grunting, making a sound while trying to breathe 

Soon after the infant exhibits the aforesaid symptoms, as the infection progresses, you may also notice very low oxygen levels (hypoxia) and in severe cases the skin takes on a blue color (cyanosis). Both these symptoms require urgent medical attention. 

Unfortunately, just as any viral infection Bronchiolitis is also contagious and it can risk other infants. 

The RSV and rhinovirus (also responsible for Bronchiolitis in some cases) can get transmitted through droplets. In fact, these can easily be exhaled into the air while coughing, sneezing, and even breathing. So, adults who may have this virus must stay away from infants as their immunities are low. 

Similarly, an infant who has Bronchiolitis must be kept away from other babies and infants younger than three months who are not infected; especially from those who have lung issues or even heart diseases.

This, as a precaution must be followed till the baby is cured completely. 

What are the risks of Bronchiolitis in kids? 

Unfortunately, it is these infants (younger than three months) who are at greatest risk when infected by Bronchiolitis. Since their immune systems are not fully developed, their bodies do not have the capacity to fight off this viral infection. 

But infants may also run into the risk of developing Bronchiolitis due to the following:

  • Premature birth 
  • Siblings who may be suffering from Bronchiolitis
  • Living in a crowded, unhygienic environment  
  • Constant exposure to (tobacco) smoke 
  • Never having been breastfed
Bronchiolitis in kids

In case of severe bronchiolitis in kids, they may be put on a ventilator and that does the breathing for him/her

How to diagnose Bronchiolitis in kids?

Bronchiolitis in kids is usually diagnosed by a physical exam. While a child may not have to go through routine blood tests or x-rays, there are certain tests that can identify the underlying cause of Bronchiolitis in kids. This is done based on the level of the illness and the age of the child.

These tests include: 

  • White blood cell count
  • Pulse oximetry 
  • Urine analysis 
  • Blood cultures 
  • C-reactive protein test 

Meanwhile, you can work on its further spread at home by following a few preventive measures. 

What are some of the preventive measures of Bronchiolitis?  

Since the viruses are air-borne and can spread from one person to another, make sure to keep yourself clean and always sanitize your hands before touching a baby. Those who are infected must not touch an infant’s mouth, eyes and nose. 

If possible, you can also wear a face mask and prevent further spread of the infection. You can also try the following ways:

  • Limit your baby’s contact with those who already have cough or cold
  • Keep your house clean and disinfected 
  • Use your own drinking glass
  • Use a face mask even at home 
  • Wash your hands frequently with alcohol-based hand cleanser 
  • Breastfeed your baby to boost his immunity

As far as vaccinations are concerned, make sure you speak with your health care provider about the symptoms and get a proper diagnosis. 

What are the treatments for Bronchiolitis? 

While there are no specific vaccines for Bronchiolitis in kids, infants less than six months of age may be given an annual flu shot. In severe cases, infants who run a higher risk of Bronchiolitis may be given palivizumab (Synagis) to decrease the risk of RSV or rhinovirus. 

Those hospitalized in extremely critical conditions may be given a nasal cannula to supplement oxygen. Some infants are also given an oxygen box and tested periodically to for blood oxygen levels.

Some may also be put on a ventilator and that does the breathing for the child. 

The important thing to remember is that since Bronchiolitis in kids is cause due to a virus, keep your kids clean and away from places that are unclean and unhygienic.   

Sources: emedicine, study.com, mayoclinic

Also read: Study: children with asthma are more likely to be prescribed unnecessary antibiotics 

(All images courtesy: Shutterstock)