What should you know about early bronchiolitis?

Bronchiolitis mainly affects babies and young children. A common presentation is a runny nose followed by cough and noisy or wheezy breathing as the small airways swell and contain mucus. Fever may occur, but its absence does not rule it out. Watch the child's breathing effort, alertness and ability to drink rather than judging severity from the cough alone.

A clinician may check breathing rate, oxygen level, hydration and chest sounds. Most care is supportive; antibiotics do not treat the viral cause. A nebuliser is not automatically needed, and its use depends on the child's assessment.

Offer frequent small feeds and keep the child upright while awake. Clear nasal mucus gently before feeds if congestion makes drinking difficult. Keep smoke and strong scents away, and monitor wet nappies, energy and breathing. Do not give cough medicines or use someone else's inhaler unless a clinician has advised it.

Arrange a Child Health Consultation if symptoms are worsening, the child is drinking less, or you are unsure how hard they are working to breathe. Follow the clinician's instructions if nebuliser treatment is discussed.

Seek emergency help if the child has pauses in breathing, blue or grey lips, severe chest sucking-in, grunting, extreme sleepiness or cannot drink. Obtain prompt medical advice for clearly faster breathing, fewer wet nappies, repeated vomiting, or a fever in a very young infant. Do not wait for wheezing to become loud before asking for help.

How can I tell whether breathing effort is worsening? How much should my child drink? Does my child need monitoring or a nebuliser? Which fever or feeding changes should lead me back for review?