Bronchiolitis in a child with asthma

Bronchiolitis is swelling and mucus in the smallest airways, most often during a viral illness in a young child. Asthma involves sensitive, narrowing airways and may cause episodes of cough, wheeze, or chest tightness. A viral infection can aggravate asthma, while bronchiolitis can look similar in a child who already has asthma.

The distinction depends on age, previous episodes, examination, breathing effort, and response to prescribed treatment. [Cough](/symptoms/cough/) and [Wheezing](/symptoms/wheezing/) describe symptoms rather than confirming one diagnosis.

Follow the child's written asthma plan if one exists, including the prescribed reliever instructions. Do not start, stop, or increase medicines without clinical advice. Keep smoke and vapour away, offer fluids or feeds in manageable amounts, and allow rest. Note the frequency of reliever use, work of breathing, and ability to speak or feed. A clinician may discuss whether [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) is suitable.

Seek emergency help if the child is struggling for each breath, cannot speak or feed because of breathlessness, becomes drowsy, has blue or grey lips, or does not improve with the prescribed emergency plan. Arrange same-day review for worsening wheeze, repeated reliever need, poor intake, or unusual tiredness. A [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) can separate overlapping causes.

Ask how to tell an asthma flare from bronchiolitis, which medicines to use during a viral illness, and what response should trigger urgent care. Bring the asthma plan and list any recent doses.