Acute bronchitis and bronchiolitis: what to know

Both commonly follow a viral respiratory infection and can cause cough or noisy breathing, but age, examination findings, breathing effort and hydration help a clinician distinguish them.

Acute bronchitis causes temporary irritation and mucus in the larger breathing tubes. A cough may be dry or bring up phlegm, and it can linger after other cold symptoms settle. Bronchiolitis causes swelling and mucus deeper in the small airways. It may produce wheezing, faster breathing, chest recession or difficulty feeding.

These names describe different airway patterns rather than the colour of mucus. A clinician may listen to the chest and assess oxygenation, alertness and fluid intake; tests are not needed for every uncomplicated illness.

Offer fluids regularly, allow rest and keep the air free from tobacco smoke, incense and strong fragrances. For a congested baby, saline nose drops and gentle nasal clearing before feeds may make drinking easier. Keep the child upright while awake and supervised, but follow safe sleep guidance for sleep.

Use fever or pain medicine only when it is suitable for the person's age and health, following the label or a clinician's instructions. Antibiotics do not treat viral infections. Inhaled or nebulised medicines are reserved for selected patients after assessment rather than used routinely for every cough or wheeze.

Seek emergency help for blue or grey lips, pauses in breathing, severe difficulty breathing, marked drowsiness, collapse or inability to wake normally. Chest pulling in with each breath, grunting or exhaustion while trying to breathe also needs urgent assessment.

Arrange prompt medical review when a baby feeds much less than usual, has noticeably fewer wet nappies, or symptoms are worsening rather than settling. People who are pregnant, frail, immunocompromised, or living with significant heart or lung disease should contact a clinician early if respiratory symptoms develop.

Ask which airway pattern the examination suggests, whether breathing and hydration are adequate, and what changes should trigger reassessment. If a medicine is proposed, clarify its purpose, the correct way to give it and which unwanted effects warrant help.