Bronchiolitis in the Hospital
What is bronchiolitis?
- A breathing problem that is common in young children, especially during the winter.
- Can be caused by many different types of viruses.
- Viral illnesses cannot be treated with antibiotics. The virus has to run its course.
- Sometimes children need to be in the hospital to help support them as they fight this infection.
- Young children catch these viruses during close contact with other people who are infected. Symptoms usually start 1 week later.
What are the symptoms?
This illness usually starts as a cold. The peak of illness is often around 5 days, but symptoms can last up to 3-4 weeks. Symptoms often include:
- Stuffy and runny nose.
- Breathing fast (more than 50-60 times per minute).
- Breathing hard (flaring nostrils, grunting sound with each breath, seeing the outline of ribs during breathing).
- A whistling sound (wheeze) when breathing.
- Fever (temperature greater than 100.3°F).
- Fussy or tired.
- Not eating well.
What is the treatment?
In healthy children, the illness will usually go away on its own. Symptoms are most often mild. Sometimes, the infection is more serious and requires a hospital stay. The treatment is to care for the symptoms caused by the infection. Your child may receive all or some of these treatments:
- Suction of the nose to help with breathing and feeding.
- In the hospital, your child will be in “isolation.” This means that all hospital staff will need to wear gowns, gloves, and masks when entering your child’s room. This keeps the infection from being spread to other patients.
- Humidified oxygen through a tiny tube placed in the nose.
- Fluids through an I.V. or feeding tube if your baby is breathing fast or not able to eat well.
- Blood tests and x-rays may or may not need to be done based on your child’s evaluation by the medical team.
Bronchiolitis After Leaving the Hospital
When can my child be discharged from the hospital?
The normal hospital stay is 3-5 days. Your child may go home when:
- Your child is breathing more easily than on admission.
- Your child is drinking well enough to stay hydrated.
- Any needed medicines can be given at home.
- Your doctor is comfortable that your child is doing well.
- You have learned to care for your child. This includes knowing how to use bulb or nasal suction, identify breathing problems, and know your child is getting enough fluids.
How will I care for my child at home?
- Suction the nose and mouth if needed, using a bulb or nasal suction, especially before your child eats or sleeps. Use saline in the nose before suctioning if needed.
- Encourage your child to drink by offering small, frequent feedings.
- Acetaminophen (for all ages) and Ibuprofen (only if older than six months of age) as needed if your child is fussy with fever.
- Do not smoke around your child. If you would like help to quit smoking, please call 1-800-NO-BUTTS.
- Wash your hands and your child’s hands often.
- Make a follow up appointment with your child’s doctor.
How long will my child be sick?
- It is normal for your child to keep having some symptoms after leaving the hospital.
- Stuffy nose and cough may last 3 to 4 weeks.
- Sleeping and eating routines may not return to normal for 3 to 4 weeks.
When should I call my doctor or nurse after we are home?
- Breathing is fast (over 50-60 times per minute), especially if breathing appears difficult.
- Poor drinking of fluids OR has 2 or fewer wet diapers in 12 hours.
- More sleepy than usual or hard to comfort.
- If you have any questions or concerns.
Seek immediate medical attention by calling 911 or going directly to the Emergency Department if your child develops worsening symptoms. These symptoms include:
- Difficult or fast breathing that is not improving, including severe coughing episodes.
- Pale or blue-tinged skin.
- Severe sucking in of the skin around the ribs or base of the throat (retractions).
- Cannot drink formula or fluids.