Your doctor will ask about your child’s symptoms, for example whether they have had a runny nose, cough or high temperature (fever). They will also listen to your child’s breathing using a stethoscope (a medical instrument that transmits sounds). Your doctor will listen for any crackling or high-pitched wheezing as your child breathes in and out.

If your child has not been feeding very well or has been vomiting, your doctor may also look for signs of dehydration to determine whether the water content of their body is reduced. Signs of dehydration include:

• a dipped fontanelle (the soft spot on the top of the head) in babies
• dry mouth and skin
• drowsiness
• producing little or no urine

Further tests

Further tests for bronchiolitis are not usually necessary. However, some conditions cause similar symptoms to bronchiolitis, such as cystic fibrosis (a condition that makes the internal bodily secretions thick and sticky) and asthma (another condition that affects the lungs).

If it is not clear what condition your child has, your doctor may recommend further tests to confirm the diagnosis.

Chest X-ray

X-rays use radiation to create images of the inside of the body. A chest X-ray can be used to check for any abnormalities in the lungs. This may be used if your child has any unusual symptoms or if the diagnosis is uncertain.

For example, a chest X-ray can be used to diagnose pneumonia or may reveal whether your child has inhaled something small that is affecting their breathing.

Mucus sample test

Your doctor may use a swab to collect a sample of mucus from your child’s nose. The sample can be tested to confirm the virus that is causing your child’s bronchiolitis.

Treating bronchiolitis 

If your child’s bronchiolitis is not severe, the infection will usually last about two weeks and will not require treatment. 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

There is no medicine that can kill the viruses that cause bronchiolitis. However, if your child’s symptoms are mild, there are some treatments that you can provide at home. These may help to ease your child’s symptoms and make them more comfortable.

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.

Paracetamol or ibuprofen

If your child has a high temperature (fever) that is making them miserable, consider using paracetamol or ibuprofen. These are available over-the-counter (OTC) from pharmacies without prescription. Always follow the manufacturer’s instructions and do not give aspirin to children under 16 years of age.

Do not try to reduce your child’s high temperature by removing their clothes or sponging them with cool water.

Monitor your child

Continue to monitor your child. Check on them regularly, including throughout the night. If their condition worsens, contact your doctor. See Symptoms of bronchiolitis for advice about when to call an ambulance.

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 doctor again.

Treatment in hospital

Approximately 3% of infants who are under one year of age and have bronchiolitis are 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. See Causes of bronchiolitis for a full list of risk factors.

Your child may be admitted to hospital if:

• they are not getting enough oxygen into their blood because they have difficulty breathing
• they are not eating or drinking enough

Once in hospital, your child will be monitored and treated in a number of ways, as explained below.

Oxygen level

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.

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).

Mucus sample test

If it has not already been tested, 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.

Nasal suction

If your child’s nose is blocked and is causing them breathing difficulties, nasal suction may be used. This involves a small, plastic tube being inserted into their nostrils to clear out the mucus. 

Other hospital treatments

A number of other medicines have been tested to determine whether they benefit children with bronchiolitis, and most have been shown to have little or no effect. Current research also suggests that chest physiotherapy, where physical movements or breathing techniques are used to relieve the symptoms, are also of little 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. Further research is needed, but nebulised hypertonic saline solution may be a possible treatment.

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 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

Related articles

1. Inflamed air­ways — Bron­chitis 
2. Res­pir­at­ory tract infec­tion — Bron­chi­olitis
3. Fungal infec­tions — Asper­gil­losis
4. Chest infec­tion in adults 
5. Cystic fibrosis
6. Asbestosis – Chronic lung dis­ease 
7. Avian influ­enza (or bird flu)

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