Bronchiolitis in a 3-month-old baby

A clinician can assess breathing effort, hydration and oxygenation. Young babies have narrow airways and may tire while feeding, which is why changes can matter quickly.

Bronchiolitis is usually a viral infection of the small breathing tubes. It often starts like a cold, then may cause cough, wheezing, faster breathing, noisy breathing and difficulty taking a full feed. Some babies become unsettled or unusually sleepy.

The sound alone does not show how unwell a baby is. Breathing effort, skin colour, alertness, feeding and wet nappies give more useful clues. Symptoms may change over several days, so continue checking even after an initial assessment.

Offer the baby's usual breast milk or formula in smaller, more frequent feeds if full feeds are tiring. Keep the baby upright while awake and feeding, and clear visible nasal mucus gently. Continue safe sleep on the back on a firm, flat surface; do not prop up the mattress.

Keep the environment smoke-free. Do not give cough or cold remedies, antibiotics, or use a nebuliser unless a clinician has specifically prescribed them for this baby. Note feeding amounts, wet nappies, breathing changes and any measured temperature to share at the consultation.

Seek emergency help now if the baby has pauses in breathing, blue or grey lips or skin, severe difficulty breathing, marked chest pulling, grunting, is floppy, or cannot be woken normally.

Request urgent same-day care if breathing is becoming faster or harder, feeds are much smaller than usual, wet nappies are clearly reduced, the baby repeatedly vomits feeds, seems unusually drowsy or irritable, or has a fever. If you are unsure whether breathing is normal, have the baby assessed rather than waiting for another symptom.

Ask how to recognise increased breathing effort, what feeding pattern is acceptable during recovery, which changes require reassessment, and whether any medicine has a role. Confirm how to monitor hydration and whom to contact outside clinic hours.