RSV bronchiolitis treatment: what to know

RSV can inflame the smallest airways in a baby or young child. Bronchiolitis commonly causes a runny nose followed by cough, faster breathing, wheezing and difficulty feeding. Symptoms may change over several days, so watching the child’s breathing effort, alertness and wet nappies is more useful than judging the cough alone.

Treatment is usually supportive. A clinician may clear nasal secretions, assess oxygen levels and recommend fluids or feeding adjustments. Oxygen or hospital care may be needed when breathing or hydration is unsafe. Antibiotics do not treat RSV itself, and inhaled treatments are used only when a clinician believes they are appropriate.

Offer smaller, more frequent feeds and keep the child upright while awake and supervised. Use saline nasal drops if advised, and keep smoke away from the child. Give medicines only in the dose recommended for the child’s age and weight. Check breathing, colour, alertness and urine output regularly. A child-health consultation can help if feeding is worsening or you are unsure how to monitor symptoms.

Get urgent help if the child has pauses in breathing, blue or grey lips, severe chest pulling-in, grunting, exhaustion, cannot drink, or is unusually difficult to wake. Contact a clinician promptly for worsening wheeze, faster breathing, repeated vomiting, fewer wet nappies or a fever in a very young infant. Trust your concern if the child looks substantially worse.

Ask how often to offer feeds, which breathing signs to count, whether oxygen assessment is needed, and which medicines or nebuliser treatments should be avoided or considered.