Acute bronchiolitis in infants

Symptoms often begin like a cold and then include cough, noisy breathing, wheezing, or faster breaths. Because babies breathe mainly through their noses and need to coordinate sucking with breathing, congestion can interrupt feeds before an older child would have the same difficulty.

Look at the infant while calm. Concerning effort includes nostril flaring, grunting, the skin drawing in between or beneath the ribs, or the head bobbing with breaths. Listen for pauses and notice whether the lips retain their normal colour.

Feeding gives another useful clue. Track how much the baby takes compared with normal, whether feeds must stop repeatedly for breath, and whether wet nappies become less frequent. Premature infants and babies with heart, lung, or immune conditions may need earlier clinical review.

Offer breast milk or the baby's usual milk in smaller, more frequent amounts. Saline drops followed by gentle nasal suction before a feed can clear secretions. Keep the baby upright while awake and supervised, but place the baby flat on their back on a firm sleep surface for sleep.

Keep the home free of tobacco smoke and vaping aerosol. Do not give cough or cold remedies, leftover antibiotics, or another child's medicine. If fever or discomfort needs treatment, obtain age- and weight-appropriate dosing advice from a clinician or pharmacist.

Get emergency help for blue or grey lips, pauses in breathing, severe chest recession, exhaustion, limpness, poor responsiveness, or obvious inability to breathe. Do not prop the baby up and wait for these signs to settle.

Contact a medical service promptly if breathing is becoming faster or harder, the baby cannot complete feeds, vomits repeatedly, has far fewer wet nappies, or seems unusually sleepy or irritable. A fever in a very young infant warrants prompt assessment even when the breathing appears comfortable.

Describe when the cold symptoms started, changes in feeding and nappies, any breathing pauses, and the infant's birth and medical history. Ask what specific change should trigger reassessment, how to clear the nose safely, and whether a follow-up check is needed.