What is the first treatment for bronchiolitis?

Bronchiolitis is a viral infection that makes the small airways in a baby or young child swollen and mucus-filled. A blocked nose, cough, noisy breathing, reduced appetite, and faster breathing may follow. Most care is aimed at keeping the child comfortable while the illness settles. A clinician checks breathing effort, hydration, alertness, and feeding; antibiotics do not treat the usual viral cause.

Offer smaller, more frequent feeds if a full feed is tiring, and keep the child upright while awake and supervised. Saline nose drops may help loosen mucus before feeds; use them according to local clinical advice. Keep smoke and strong fragrances away. A Child Health Consultation can assess an infant who is feeding poorly or breathing noisily. A nebuliser is not routinely needed, but a clinician may consider treatment when a child needs specific respiratory support.

Call emergency services for pauses in breathing, blue or grey lips, severe chest pulling-in, grunting, unusual sleepiness, or difficulty waking. Seek urgent assessment if feeds are much smaller, wet nappies are noticeably reduced, breathing is persistently fast, or the child is becoming exhausted. Babies who are very young or have heart, lung, or immune problems may need earlier review.

Ask how to judge breathing effort, how often to offer feeds, which signs of dehydration to watch for, and when your child should be reviewed. Clarify whether a nebuliser has a specific role and how to keep other children or vulnerable family members safer around respiratory infections.