Bronchiolitis not getting better: when to seek help

Bronchiolitis can leave a cough and noisy breathing after the child first becomes unwell. The key question is whether breathing, feeding, alertness, and wet nappies are stable or deteriorating. A child who was drinking well but now tires during feeds needs a fresh clinical assessment. New or increasing [wheezing](/symptoms/wheezing/) can also change the plan. Review the [Bronchiolitis](/conditions/bronchiolitis/) guide while preparing the details of the illness.

Not improving may reflect ongoing airway swelling, dehydration, or another problem that resembles bronchiolitis. A clinician may listen to the chest, check oxygenation and hydration, and decide whether observation, supportive treatment, or another evaluation is needed.

Contact the child’s clinician for advice when symptoms plateau, worsen, or interfere with sleep and feeds. Bring a record of drinking, wet nappies, temperature, breathing changes, and any medicines already given. Keep offering small feeds with pauses, clear the nose gently with saline, and avoid smoke. Do not add antibiotics or cough remedies without advice. A [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) provides a focused review.

Seek emergency help if the child has severe breathing effort, pauses, blue or grey lips, becomes difficult to wake, or cannot drink. Seek prompt same-day care if ribs pull in with breaths, breathing is clearly faster or harder, wet nappies decrease, vomiting prevents fluids, or the child is becoming less alert. A [cough](/symptoms/cough/) or [fever](/symptoms/fever/) matters more when it accompanies these changes; do not wait for fever before seeking help.

Ask what improvement should look like for your child, which signs require immediate return, and how to support feeds safely. Ask whether oxygen, monitoring, or [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) is appropriate, and whether another diagnosis needs consideration.