Fever and bronchiolitis in children

Bronchiolitis inflames the small airways, often after a viral upper-respiratory illness. A child may develop cough, fast or noisy breathing, wheezing, a runny nose, reduced feeding, and fever. Fever is one part of the picture; the sound of breathing and the child’s work to breathe are more useful for judging severity.

Offer smaller, more frequent feeds and keep the child upright while awake. Clear nasal mucus gently if it interferes with feeding, allow rest, and check breathing and wet nappies regularly. Keep smoke and strong scents away. Give only medicines recommended for the child’s age and weight. A clinician can decide whether a Child Health Consultation or Nebuliser Treatment is appropriate; do not start inhaled treatment without assessment.

Seek emergency help if the child struggles for each breath, has pauses in breathing, looks blue or grey, is unusually floppy or difficult to wake, or cannot feed because of breathlessness. Arrange same-day medical review for clearly worsening breathing, much less drinking, repeated vomiting, very few wet nappies, or fever in a young infant. Trust a noticeable change in the child’s normal behaviour.

Ask how to count breaths, which signs show dehydration, how often to offer feeds, whether an oxygen check is needed, and exactly when to return for review.