What should you know about bacterial bronchiolitis?

Bacterial bronchiolitis affects the smallest airways and needs clinical assessment because breathing and feeding can worsen quickly. In babies and young children, bronchiolitis is more often viral, so antibiotics are not automatically helpful.

The inflamed small airways can produce cough, noisy breathing, fast breathing, and wheezing. A child may take less milk or food because breathing makes feeding tiring. Fever may occur, but its presence alone does not establish a bacterial cause. Read about [Bronchiolitis](/conditions/bronchiolitis/), [Cough](/symptoms/cough/), [Wheezing](/symptoms/wheezing/) and [Fever](/symptoms/fever/) for symptom context.

Arrange a [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) so a clinician can assess breathing effort, oxygen level, hydration, and feeding. Keep the child upright while awake, offer usual feeds in smaller amounts more often, and keep smoke away. Saline nose drops may help a blocked nose. A [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) is used only when a clinician identifies a reason; it is not a routine home treatment for every case.

Seek urgent help if the child is struggling to breathe, has pauses in breathing, becomes unusually sleepy, develops blue or grey lips, or cannot keep feeds down. Fewer wet nappies, a dry mouth, or marked weakness can signal dehydration. Infants who are very young or have an underlying heart, lung, or immune condition should be assessed promptly when breathing symptoms appear.

What findings suggest bacterial infection rather than a viral illness? Is the child hydrated and taking enough milk? Would observation at home be safe, and what changes should trigger review? Is any inhaled treatment appropriate?