COVID-19 and bronchiolitis: what to know

Bronchiolitis is inflammation and narrowing of the small airways, usually during a viral infection. A child may start with a runny nose, then develop cough, faster breathing, wheezing, reduced feeding, or tiredness. COVID-19 is one possible viral trigger; the symptoms do not show which virus is responsible. Breathing effort and hydration matter more than the sound of the cough alone. Babies born early and children with heart, lung, or immune conditions may need closer assessment.

Offer small, frequent feeds and keep the child comfortably upright while awake. Clear visible nasal mucus gently before feeds, wash hands, and avoid smoke around the child. Monitor breathing, alertness, wet nappies, and how much the child drinks. Do not give cough medicines or antibiotics unless a clinician specifically advises them. A clinician may assess oxygen levels and breathing; nebuliser treatment is used only when appropriate for the child’s findings.

Seek emergency help if the child is struggling to breathe, has pauses in breathing, looks blue or grey, is unusually floppy, cannot stay awake, or is taking very little fluid. Arrange prompt medical assessment for worsening wheeze, persistent fast breathing, repeated vomiting, fewer wet nappies, or a child who is difficult to settle. Young infants and children with significant medical conditions should be assessed early when breathing symptoms appear.

How hard is my child working to breathe? How can I monitor feeding and hydration at home? Does my child need oxygen assessment or a child health consultation? What change should prompt immediate return?