Bronchiolitis

(a cause of persistent cough, mild fever and feeding difficulties in infants) Advice for parents and carers of children younger than 1 year old

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 phone 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 in those over 3 months
  • Getting worse or you are worried about them

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

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


Using the advice overleaf you can look after your child at home

How can I look after my child?

  • If your child is not feeding as normal offer smaller feeds but more frequently. Offer.........ounces every..........hours
  • Children with bronchiolitis may have some signs of distress and discomfort. You may wish to give either Paracetamol or liquid Ibuprofen to give some relief of symptoms (Paracetamol can be given from 2 months of age). Please read and follow the instructions on the medicine container.
  • If your child is already taking medicines or inhalers, you should carry on using these. If you find it difficult to get your child to take them, ask your Pharmacist, Health Visitor or GP. Bronchiolitis is caused by a virus so antibiotics will not help.
  • Make sure your child is not exposed to tobacco smoke. Passive smoking can seriously damage your child’s health. It makes breathing problems like bronchiolitis worse.
  • Remember smoke remains on your clothes even if you smoke outside.

If you would like help to give up smoking you can get information / advice from your local GP surgery or by calling the National Stop Smoking Helpline Tel: 0800 169 0 169 from 7am to 11pm every day.

What is Bronchiolitis?

Bronchiolitis is an infection that causes the tiniest airways in your child’s lungs to become swollen. This can make it more difficult for your child to breathe:

  • Bronchiolitis is caused by virus infections.
  • It is common in winter months and usually only causes mild cold like symptoms.
  • Most children get better on their own.
  • Some children, especially very young ones, can have difficulty with breathing or feeding and may need to go to hospital.

How can I help my baby?

  • Your child may have a runny nose and sometimes a temperature and a cough.
  • After a few days your child’s cough may become worse.
  • Your child’s breathing may be faster than normal and it may become noisy.
  • He or she may need to make more effort to breathe.
  • Sometimes, in the very young babies, bronchiolitis may cause them to have brief pauses in their breathing.
  • If you are concerned see the traffic light advice overleaf.
  • As breathing becomes more difficult, your baby may not be able to take their usual amount of milk by breast or bottle.
  • You may notice fewer wet nappies than usual.
  • Your child may vomit after feeding and become miserable.

How long does Bronchiolitis last?

  • Most children with bronchiolitis will seem to worsen during the first 1-3 days of the illness before beginning to improve over the next two weeks. The cough may go on for a few more weeks. Antibiotics are not required.
  • Your child can go back to nursery or day care as soon as he or she is well enough (that is feeding normally and with no difficulty in breathing).
  • There is usually no need to see your doctor if your child is recovering well. But if you are worried about your child’s progress discuss this with your Health Visitor, Practice Nurse or GP or contact NHS 111.

This guidance is written by healthcare professionals from across Hampshire, Dorset and the Isle of Wight

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