Bronchiolitis as a lower respiratory tract infection

Swelling and mucus in the bronchioles, the tiniest breathing tubes, can produce a runny nose followed by cough, noisy breathing, or wheezing. Symptoms may change over the course of the illness, so watch breathing effort and feeding as well as temperature. Antibiotics do not treat the usual viral cause. A child may need assessment to distinguish bronchiolitis from another chest problem.

Offer smaller, more frequent feeds and keep your child comfortably upright while awake. Clear the nose gently if congestion makes feeding difficult, and avoid tobacco smoke or strong fragrances. Let the child rest, but check regularly for changes in breathing, alertness, wet nappies, and ability to drink. Use medicines only when suitable for the child's age and after checking the label or a clinician's advice. A child health consultation can help when symptoms are difficult to judge.

Seek urgent medical help if the child is struggling for each breath, has pauses in breathing, develops blue or grey lips, is unusually difficult to wake, or cannot keep feeds down. Prompt assessment is also needed when breathing becomes much faster or more effortful, the child is taking very little fluid, or wet nappies become noticeably less frequent. Do not wait for a fever if breathing or hydration is worsening.

Ask which changes mean the child needs reassessment, how to support feeds, and whether any prescribed treatment is appropriate. You can also ask how to recognise dehydration and what information to record about breathing and wet nappies.