Bronchiolitis is a common chest infection in babies and young children under 2, most often caused by respiratory syncytial virus (RSV). It inflames the smallest airways in the lungs, and cases rise sharply in the cold season.
Your baby has a cold, but by day three she is breathing faster and only taking half her feeds. Because you know the warning signs, you get her seen early, before she becomes seriously unwell.
Symptoms
- Starts like a cold: runny nose, cough, mild fever
- After 2–3 days: faster breathing, wheeze or crackly breathing
- Feeding less and having fewer wet nappies
The feeding rule
If your baby is taking less than half their usual feeds over 2–3 feeds, or has no wet nappy for 12 hours, get them checked.
Call your emergency number if your baby has pauses in breathing, turns blue or grey around the lips, is struggling to breathe with the chest sucking in, grunts, or is very floppy and hard to wake.
Caring for your baby at home
- Offer smaller, more frequent feeds
- Use saline drops to clear the nose before feeds
- Give paracetamol for fever if over 2 months, at the right dose
- Keep them away from smoke
- Most babies improve within 2–3 weeks; the cough can last longer
Protection
Several countries now offer RSV protection: a vaccine in pregnancy and/or a long-acting antibody injection for babies. Ask your midwife or health visitor what is available.
“But it is just a cold, so it cannot be serious.”
For most babies it is mild, but bronchiolitis can make breathing hard, especially in babies under 3 months or born early. Watching breathing and feeding tells you when to act.
Your next step: Learn to count your baby’s breaths for a full minute while they are calm, so you know what is normal.
Related: RSV in adults
Sources: NICE guideline NG9, Bronchiolitis in children; World Health Organization RSV resources; NHS bronchiolitis guidance.
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