Bronchiolitis in kids: Educate yourself beyond the basics

Do you notice a wheezing sound when your child breathes? Parents, here’s what you need to know about bronchiolitis in kids.

Is your child having difficulty breathing? Are you noticing a whistling sound each time he breathes out? Has this been going on for more than five days?

You better bring him in for a checkup because he may be suffering from bronchiolitis, an acute throat infection that commonly affects children below the age of two and can lead to partial or complete blockage of airways.

Bronchiolitis in kids: All you need to know

Bronchiolitis is a virus-born illness wherein Respiratory Syncytial Virus (RSV) or rhinovirus causes a severe form of lower respiratory tract infection.

This virus essentially inflames the bronchioles (the air passages connecting the mouth and nose to the lungs), causing partial or complete blockage of airways. It often manifests with wheezing (the whistling sound during exhalation). The reduced entry of oxygen into the child’s lungs also results in decreased blood levels in the body.

In many cases, hospitalization can ensure the child consumes adequate fluids and is able to breathe without difficulty. Many children are also able to get better after a week of treatment.

Unfortunately, in some cases, bronchiolitis in kids can become fatal. Bronchiolitis in babies is more severe, and infants and newborns may find it difficult to fight this viral infection since their immune systems are not yet properly built. Thus, it is crucial for parents to learn more about this illness, its symptoms as well as its treatments.

What causes Bronchiolitis in kids?

As mentioned, Bronchiolitis in kids is caused by a virus and breaks out seasonally in different hemispheres.

For instance, in the Northern hemisphere, Bronchiolitis outbreaks are usually seen between November and April, peaking around January and February. While in the Southern hemisphere it may break, this wintertime illness may occur anytime between May and September.

And, in tropical countries such as ours, bronchiolitis is mostly seen during the monsoon season.

While bronchiolitis is more common in children below the age of two, it can also occur in older kids.

Typically, they do not develop bronchiolitis, but they may still have RSV in their bodies and may exhibit some symptoms such as wheezing and coughing. But these are not the only symptoms to watch out for.

Bronchiolitis vs. bronchitis

What is the difference between bronchitis and bronchiolitis?

According to the Cleveland Clinic website, these two conditions not only sound similar, but they are similar in some ways. First, both of these infections can be caused by a virus. While both diseases affect the airways in the lungs, bronchitis affects the larger airways (the bronchi) and bronchiolitis affects the smaller airways (bronchioles).

Bronchitis is more common among older children and adults, while bronchiolitis is usually seen in babies and younger children.

What are the symptoms of bronchiolitis in kids?

The bronchiolitis infection breaks out towards the far end of a common cold, so you may notice the following initial symptoms:

1. Mild cough
2. Runny nose or decongestion
3. Fever higher than 100.4°F (38 degrees C)
4. For babies, difficulty in sucking and swallowing, which may also lead to
5. Poor appetite

As the infection progresses over the week and the lower respiratory tract gets inflamed, the following symptoms may develop:

1. Apnea (pause of 15 seconds in breathing, most common in preemies and infants)
2. Wheezing, which can last up to a week as well
3. Fast breathing, 60 to 70 times per minute and with great difficulty
4. Signs of dehydration due to rapid breathing
5. Severe cough that lasts up to two weeks
6. Retractions, which is sucking in of the base of the lungs as well as the throat to breathe
7. Nasal flaring, which is the enlargement of nostrils in order to breathe properly
8. Grunting, making a sound while trying to breathe

Soon after the infant exhibits the aforesaid symptoms, as the infection progresses, you may also notice very low oxygen levels (hypoxia) and in severe cases, the skin takes on a blue color (cyanosis). Both these symptoms require urgent medical attention.

Unfortunately, just like any viral infection, bronchiolitis is also contagious and it can risk other infants.

The RSV and rhinovirus (also responsible for bronchiolitis in some cases) can transmit through droplets. In fact, individuals can easily exhale these into the air while coughing, sneezing, and even breathing. Therefore, adults who may have this virus should stay away from infants since their immune system may not be strong enough to fight the infection.

Similarly, a baby who has Bronchiolitis must be kept away from other infants younger than three months who are not infected; especially from those who have lung issues or even heart diseases. This, as a precaution, must be followed until the baby is cured completely.

What are the risks of Bronchiolitis in kids?

Unfortunately, it is these infants (younger than three months) who are at greatest risk when infected by Bronchiolitis. Since their immune systems are not fully developed, their bodies do not have the capacity to fight off this viral infection.

But infants may also run into the risk of developing bronchiolitis due to the following:

• Premature birth
• Siblings who may be suffering from bronchiolitis
• Living in a crowded, unhygienic environment
• Constant exposure to (tobacco) smoke
• Never having been breastfed

How to diagnose Bronchiolitis in kids?

Bronchiolitis in kids is usually diagnosed by a physical exam. While a child may not have to go through routine blood tests or x-rays, there are certain tests that can identify the underlying cause of Bronchiolitis in kids. This is done based on the level of the illness and the age of the child.

These tests include:

• White blood cell count
• Pulse oximetry
• Urine analysis
• Blood cultures
• C-reactive protein test

Meanwhile, you can work on its further spread at home by following a few preventive measures.

What are some of the preventive measures of bronchiolitis?

Since the viruses are airborne and can spread from one person to another, make sure to keep yourself clean and always sanitize your hands before touching a baby. Those who are infected must not touch an infant’s mouth, eyes, and nose.

If possible, you can also wear a face mask to prevent the further spread of the infection. You can also try the following ways:

• Limit your baby’s contact with those who already have a cough or cold
• Keep your house clean and disinfected
• Use your own drinking glass
• Use a face mask even at home
• Wash your hands frequently with an alcohol-based hand cleanser
• Breastfeed your baby to boost his immunity

As far as vaccinations are concerned, make sure you speak with your health care provider about the symptoms and get a proper diagnosis.

Bronchiolitis treatment

No specific vaccines exist for bronchiolitis in kids, but infants less than six months of age may receive an annual flu shot. In severe cases, healthcare providers may administer palivizumab (Synagis) to infants at a higher risk of bronchiolitis, reducing the risk of RSV or rhinovirus

Healthcare providers may administer a nasal cannula to supplement oxygen to those in extremely critical conditions. They may also provide some infants with an oxygen box and periodically test their blood oxygen levels. In some cases, healthcare providers may also use a ventilator to assist with the child’s breathing.

Remember that a virus causes bronchiolitis in kids, and you can help prevent your child from acquiring this disease by keeping them clean (encouraging frequent handwashing and maintaining proper hygiene) and avoiding unclean and unhygienic places.

And if you notice the symptoms of bronchiolitis in your child, or even just a cough that won’t go away in 5 days, don’t hesitate to contact her pediatrician.

Republished with permission from theAsianparent Singapore

Additional information from Camille Eusebio

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