That terrible cough. You know the one, that phlegmy, raspy, cough that sounds like your kid has been possessed – it can be very frightening for any mom, but especially for moms of young children. Even more terrifying is when your doctor says it “could be,” or is bronchiolitis.
Bronchiolitis does sound like a scary word to parents, and not without some good reason. This common viral lung infection is notorious for causing a terrible cough lasting many worrisome nights, and an illness that can lead to hospitalization.
However, while bronchiolitis is indeed an infection that can be dangerous to young children, there are many myths surrounding it that cause unneeded concern and unnecessary doctor visits. Avoid worry by learning the facts.
First of all, people get “bronchiolitis,” mixed up with “bronchitis.” The names may sound similar, but they are two distinct conditions. They are both infections of the lungs, but “bronchitis” can affect people of all ages, though it’s most common in older children and adults. It causes inflammation and swelling in the trachea and upper bronchial tubes. Bronchitis can be both acute and chronic.
“Bronchiolitis,” on the other hand, almost always affects younger children, many under the age of 2. It occurs when there is swelling in the smallest airways in the lungs, called bronchioles, obstructing them and making it more difficult to breathe. This is why it is disconcerting to parents of young children, because bronchiolitis in some toddlers is no more severe than a common cold, yet, in some cases, it can be dangerous and require hospitalization.
Bronchiolitis is an infection of the smallest lung tubes (called bronchioles) caused by a variety of virus types. During the course of this disease, the virus attacks the cells lining the small lung tubes, causing irritation and inflammation. Once inflammation begins, the sensitive skin cells make a bunch of mucus that can clog the air tubes, triggering the well-known coughing and wheezing of bronchiolitis. The reason bronchiolitis causes so much trouble is simply physics. If you have tiny tubes in your lungs, it only takes a very small amount of mucus to clog them up and make breathing difficult.
This is why the littlest ones — babies from 2 to 6 months — are at the greatest risk of hospitalization from the condition. As kids get older and physically bigger, more mucous production is required to clog the lung tubes and severely impair breathing.
What Are the Symptoms of Bronchiolitis?
Mucus production is the biggest problem of the condition, therefore the classic symptoms include a very runny nose and wet cough or wheeze. Most kids will also run a fever during the early part of the illness. The combination of snot and persisting cough can make eating difficult for small children, increasing the risk of dehydration during the peak days of the disease.
How Is Bronchiolitis Treated?
Fortunately, the vast majority of children with bronchiolitis can be safely and effectively treated at home. Home care focuses on snot removal and basic comfort measures. Using nasal saline spray and nasal suction is critical to support a child with bronchiolitis. Especially before mealtime and naps or bedtime, sucking out as much snot from the nose and mouth as possible will allow your child to rest comfortably and stay hydrated.
Over-the-counter fever reducers (acetaminophen and ibuprofen) are helpful to decrease fever and calm a child’s respiration rate. Also, smaller and more frequent feedings are useful to keep a child hydrated when the child is ill.
When Should I Worry?
Many parents get frustrated that the cough and wheeze classic to bronchiolitis seem to last “forever.” While kids develop symptoms rapidly, the resolution time (or time to return to normal) for viral bronchiolitis can take many weeks.
Parents should watch closely for signs of respiratory distress (irritability, breathing more than 60 times per minute, increased fatigue) and dehydration (refusing to feed or peeing less). Respiratory distress and dehydration are the most common reasons that children will need medical support. If you are concerned about your child’s breathing for any reason, it’s time to call the doctor.