How bronchiolitis affects the lungs

The bronchioles are narrow tubes that carry air deep into the lungs. During bronchiolitis, their lining becomes swollen and mucus can restrict airflow. This may sound like crackles or wheezing and may cause a persistent cough. The child may use more energy to breathe and pause during feeds because sucking and breathing are harder together. A clinician may listen to the chest and assess breathing, colour, alertness, and hydration.

Keep the child calm and hold them upright when awake, particularly during feeds. Give frequent small amounts of milk or fluid rather than expecting a full feed when breathing is uncomfortable. Keep the air free from cigarette smoke. Check the child at regular intervals, including during sleep, for increased effort such as pulling in beneath the ribs, grunting, or marked tiredness. Arrange a child health consultation if you are unsure whether symptoms are settling or the child is feeding poorly.

Get emergency help for breathing pauses, blue or grey skin around the lips, severe struggle to breathe, or a child who is difficult to rouse. Contact a clinician promptly if the child is breathing with increasing effort, cannot drink enough, vomits repeatedly, or has far fewer wet nappies. The absence of fever does not make serious breathing difficulty safe to observe at home.

Ask how the clinician will judge the child's oxygenation and hydration, which breathing changes should trigger urgent review, and whether the child's feeding plan needs adjustment. Ask before using inhaled treatments or other medicines at home.