Child Bronchiolitis Symptoms
Learn about child bronchiolitis symptoms, including cough, wheezing, breathing difficulties, and fever. Understand causes, diagnosis, and treatment options to ensure proper care for your child’s respiratory health.
Written by Dr.Sonia Bhatt
Last updated on 3rd Jul, 2025
Introduction
Bronchiolitis is a common respiratory infection affecting young children and infants, typically under the age of two. It causes inflammation, swelling, and mucus buildup in the bronchioles, which are the smallest airways in the lungs. The condition is usually caused by a viral infection, most commonly the respiratory syncytial virus (RSV), but can also result from other viruses like the flu, adenovirus, and parainfluenza.
While bronchiolitis shares early symptoms with the common cold, it can develop into a more serious respiratory illness, requiring close monitoring. The blog will explore its symptoms, causes, and severity and can help parents and caregivers ensure timely intervention and care for affected children.
Early Symptoms of Bronchiolitis
Bronchiolitis begins with mild symptoms resembling a common cold. These symptoms typically appear within a few days of viral exposure and include:
Runny Nose: A continuous discharge from the nose, which may start clear and turn thicker over time.
Stuffy Nose: Nasal congestion can make breathing more difficult, particularly for infants.
Cough: A persistent dry or wet cough that worsens over time.
Slight Fever: A mild increase in body temperature, usually below 38°C (101°F).
Fatigue: The child may appear more tired than usual due to breathing difficulties and disrupted sleep.
Irritability: Infants, in particular, may become fussier due to discomfort and difficulty breathing.
Severe Symptoms of Bronchiolitis
As bronchiolitis progresses, it can lead to increased difficulty in breathing and other complications. Severe symptoms require immediate medical attention and may include:
Rapid or Shallow Breathing: The child may take quick, short breaths, indicating difficulty in getting enough oxygen.
Wheezing: A high-pitched whistling sound when exhaling, caused by narrowing of the airways.
Grunting Noises: Audible grunting while breathing, signaling respiratory distress.
Nasal Flaring: Widening of the nostrils while breathing, indicating labored breathing.
Chest Retractions: Visible sinking of the skin around the ribs or collarbone when the child breathes in, showing increased effort to breathe.
Bluish or Pale Skin Tone: A bluish tint (cyanosis) on the lips, fingers, or toes suggests low oxygen levels and requires immediate emergency care.
Difficulty Feeding: Infants may struggle to nurse or drink from a bottle due to breathing difficulties.
Dehydration Symptoms: Dry mouth, lack of tears when crying, and fewer wet nappies indicate dehydration and the need for urgent medical attention.
Causes of Bronchiolitis
Bronchiolitis is caused by viral infections that inflame and block the small airways in the lungs. The most common causes include:
Respiratory Syncytial Virus (RSV): The leading cause of bronchiolitis, RSV is highly contagious and spreads through respiratory droplets when an infected person coughs, sneezes, or talks. Most children contract RSV by the age of two.
Influenza (Flu) Virus: The flu can cause bronchiolitis in infants, particularly during peak flu seasons.
Adenovirus: This virus is responsible for respiratory infections and can lead to severe bronchiolitis in some cases.
Parainfluenza Virus: Known for causing croup, this virus can also lead to bronchiolitis.
Metapneumovirus: A common virus affecting young children, leading to respiratory infections and bronchiolitis.
SARS-CoV-2 (COVID-19): In some cases, COVID-19 has been linked to bronchiolitis-like symptoms in young children.
Risk Factors for Developing Bronchiolitis
Bronchiolitis primarily affects children under the age of two, with infants younger than three months being at the highest risk. At this early stage of development, their lungs are still maturing, and their immune systems are not fully equipped to combat infections effectively. While bronchiolitis is most common in young children, it is rare in adults.
Several factors can increase the likelihood of a child developing bronchiolitis, including:
Premature birth – Babies born before 37 weeks of pregnancy have underdeveloped lungs, making them more susceptible to respiratory infections.
Pre-existing heart or lung conditions – Congenital conditions affecting the heart or lungs can heighten the risk of severe bronchiolitis.
Weakened immune system – Children with compromised immunity struggle to fight off viral infections, making them more prone to severe symptoms.
Exposure to tobacco smoke – Being around cigarette smoke can irritate the airways and weaken the immune response, increasing susceptibility to respiratory infections.
Contact with other children – Attendance at nurseries, child care centres, or frequent interaction with siblings who attend school can increase exposure to viruses that cause bronchiolitis.
Crowded environments – Spending time in congested places, such as public transport or shopping centres, raises the chances of contracting infections.
Diagnosis of Bronchiolitis in Children
Bronchiolitis is typically diagnosed based on a physical examination and an assessment of symptoms. A healthcare provider will listen to your child's lungs using a stethoscope to check for wheezing, crackling sounds, or signs of respiratory distress. In most cases, further testing is not necessary. However, if a child is at risk of severe bronchiolitis or if symptoms worsen, additional diagnostic tests may be conducted to rule out other conditions.
Common diagnostic procedures include:
Chest X-ray: This may be recommended if pneumonia is suspected. It helps identify lung inflammation or fluid buildup.
Viral Testing: A nasal swab may be taken to detect the presence of viruses such as respiratory syncytial virus (RSV), which is a leading cause of bronchiolitis.
Blood Tests: A blood sample may be analysed to check white blood cell levels, which can indicate an infection, and to measure oxygen levels in the bloodstream.
Pulse Oximetry: A small device is placed on the child's fingertip or toe to measure oxygen saturation levels in the blood. Low oxygen levels may suggest severe bronchiolitis.
Dehydration Assessment: Since some children with bronchiolitis struggle to drink fluids, healthcare providers may check for signs of dehydration, such as dry mouth, sunken eyes, lack of tears when crying, and reduced urine output.
Although bronchiolitis shares symptoms with other respiratory conditions, such as pneumonia and asthma, a healthcare provider can distinguish between these conditions based on the examination and test results.
Home Care Guidelines for Mild Bronchiolitis
Most cases of bronchiolitis are mild and can be managed at home with supportive care. While there is no specific cure, these steps can help relieve symptoms:
Keep Hydrated: Offer frequent small amounts of fluids (breast milk, formula, water). Older children can have juice or milk.
Use a Humidifier: A cool-mist humidifier adds moisture to the air, easing congestion. Clean it regularly to prevent mould growth.
Ease Nasal Congestion: Use saline nose drops and gently suction with a bulb syringe, especially before feeding or sleeping.
Encourage Rest: Allow plenty of rest; keeping your child upright may help breathing.
Manage Fever & Pain: Give paracetamol or ibuprofen if needed (age-appropriate). Avoid aspirin due to the risk of Reye’s syndrome.
Avoid Smoke Exposure: Keep your child away from tobacco smoke, as it worsens respiratory symptoms.
Monitor Breathing: Seek medical help if your child has rapid breathing, struggles to breathe, or develops a blue tint around the lips or fingernails.
Medical Treatment Options
While most cases of bronchiolitis resolve without medical intervention, some children, particularly those with severe symptoms, may require hospital treatment.
Oxygen Therapy: If a child's oxygen levels are low, they may receive supplemental oxygen via a face mask or nasal tubes.
Intravenous (IV) Fluids: If a child is dehydrated and unable to drink enough fluids, IV fluids may be administered.
Bronchodilators and Nebulised Medication: Although bronchodilators like albuterol are not routinely recommended for bronchiolitis, in severe cases, a nebulised treatment may be trialled.
Antibiotics: Since bronchiolitis is caused by a virus, antibiotics are ineffective unless a secondary bacterial infection, such as pneumonia, develops.
Hospitalisation: In severe cases, a child may require hospitalisation for close monitoring, oxygen support, and breathing assistance if necessary.
Prevention of Bronchiolitis
While it is difficult to completely prevent bronchiolitis, certain measures can help reduce the risk of infection:
Practice Good Hygiene: Regular handwashing with soap and water helps prevent the spread of viruses that cause bronchiolitis.
Avoid Contact with Sick Individuals: Keep infants and young children away from people with respiratory infections.
Clean and Disinfect Surfaces: Frequently touched objects, such as toys and doorknobs, should be cleaned regularly to reduce germ transmission.
Limit Sharing of Utensils: Avoid sharing cups, bottles, spoons, and other eating utensils.
Encourage Respiratory Hygiene: Teach older children to cover their mouth and nose when coughing or sneezing, preferably using a tissue or their elbow.
Keep Children Home When Unwell: If your child is showing symptoms of illness, keep them away from nursery, daycare, or school until they have recovered to prevent spreading the virus to others.
Conclusion
Bronchiolitis is a common viral infection in young children, usually resolving with home care. Keeping your child hydrated, ensuring rest, and managing symptoms can aid recovery. While most cases are mild, watch for signs of breathing difficulties and seek medical attention if symptoms worsen. Preventative measures, such as good hygiene and avoiding smoke exposure, can help reduce the risk of infection.
Consult Top Respiratory Disease Specialist
Consult Top Respiratory Disease Specialist
Dr Rakesh Bilagi
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