Bronchiolitis clinical features

Bronchiolitis commonly begins like a cold, then causes cough, noisy breathing and increased work of breathing in young children. A child may breathe faster, use the muscles between the ribs, or have difficulty feeding because breathing interrupts sucking.

The small airways become swollen and filled with mucus. This can produce wheezing or crackly sounds and make breathing less efficient. Symptoms may be more noticeable during feeding or sleep. A mild fever can occur, but fever is not required. Read more about [Cough](/symptoms/cough/), [Fever](/symptoms/fever/) and [Wheezing](/symptoms/wheezing/).

Offer smaller feeds more often and keep the child upright while awake. Clear visible mucus around the nose before feeds, encourage rest, and monitor wet nappies or toilet trips. Avoid tobacco smoke and do not give cough medicines unless a clinician recommends them. A [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) can assess breathing and hydration.

Get urgent help if the child is struggling for each breath, has pauses in breathing, looks blue or grey around the lips, is unusually difficult to wake, or cannot keep fluids down. Arrange prompt medical assessment when feeds are clearly reduced, wet nappies become much less frequent, or breathing is worsening.

Ask how to count breathing, which changes should trigger urgent help, and whether the child needs monitoring for hydration. You can also ask whether [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) has a role in this child’s assessment.