Bronchiolitis clinical manifestations

Bronchiolitis may manifest as a runny nose followed by cough, wheeze, rapid breathing and trouble feeding. Babies can become tired during feeds and may take less milk than usual. Watch the child’s breathing effort, alertness and urine output together rather than relying on one symptom.

The illness affects the narrow air passages leading to the lungs. Their lining swells and mucus narrows the space for airflow, so breathing can sound rattly or whistling. Symptoms can change over the course of a day. Explore [Bronchiolitis](/conditions/bronchiolitis/), [Cough](/symptoms/cough/) and [Wheezing](/symptoms/wheezing/) for related information.

Keep the child comfortably upright when awake, allow frequent rest, and offer small amounts of fluid or milk at regular intervals. Nasal saline and gentle clearing of mucus may help before feeds. Keep the environment smoke-free. A clinician can decide whether a [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) is needed.

Seek emergency care for blue or grey lips, breathing pauses, severe chest pulling-in, grunting, or a child who is limp or hard to wake. Seek same-day advice if the child is taking much less fluid, has markedly fewer wet nappies, or is breathing harder than earlier. Fever in a very young baby also needs prompt clinical advice.

Ask which breathing changes matter most for your child, how to maintain feeds, and when reassessment is needed. Ask before using medicines or a [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/).