Treating acute bronchitis in children

A clinician may adjust the plan when examination suggests another cause, the child has an underlying condition, or breathing and hydration are affected. A lingering cough alone does not show that an antibiotic or nebuliser is required.

Acute bronchitis temporarily irritates the larger airways and increases mucus. Cough helps move that mucus, so completely suppressing it is not always helpful. The child's age, breathing sounds, fever pattern and general condition matter more than whether phlegm looks clear or coloured.

Wheezing can accompany airway narrowing, but it may also point to a different airway problem. A clinician decides whether an inhaled medicine trial is appropriate after assessing airflow and previous episodes. Nebulised treatment is not routine for every child with bronchitis.

Encourage frequent drinks and quiet activity, and let appetite return gradually. Warm drinks may soothe an older child's throat. Keep the home and car free from smoke or vaping aerosols, which can worsen airway irritation. A blocked nose can be eased with saline and gentle clearing.

For pain or fever, use an age-appropriate medicine only if the child can take it safely, and follow the labelled dose based on the product and the child's details. Avoid combining cold remedies with overlapping ingredients. Do not give a prescription medicine left over from another illness or prescribed for someone else.

Get emergency help if the child's lips turn blue or grey, breathing pauses, severe breathlessness develops, or the child is confused, floppy or hard to wake. Grunting, pronounced chest recession or being too breathless to drink are also emergency signs.

Request prompt review for worsening breathing, persistent vomiting, reduced urination, increasing drowsiness, chest pain, blood in coughed-up mucus, or fever with a child who looks increasingly unwell. Earlier assessment is appropriate for a young infant or a child with significant heart, lung, immune or neurological needs.

Consider asking how the examination supports bronchitis rather than pneumonia or another diagnosis, which comfort medicines are suitable, and how long to continue them. Check whether wheeze needs reassessment and what specific change in breathing, drinking or alertness should prompt a return.