Pediatricians recognize two seasons of the year: “sick” and “well.”
“Well” season begins in April and runs through September – these are months when infections are less prevalent. “Sick” season begins in October and lasts through winter until April. Interestingly, this pattern is reversed in the Southern Hemisphere, but we’re, of course, talking about the metro area. During “sick” season, bronchiolitis is a common infection.
Bronchiolitis is an infection that causes inflammation and narrowing in the bronchioles – the smaller breathing tubes of the lungs – and most commonly affects those 2 and under, whose airways are naturally narrower. It’s caused by viruses such as respiratory syncytial virus (RSV), metapneumovirus, parainfluenza and influenza. Regardless of the cause, the symptoms are similar. Bronchiolitis begins with an upper respiratory infection or a common cold. In some infants, this progresses to a cough and difficulty breathing.
Symptoms your child is getting worse include:
- Flaring – He or she will widen his or her nostrils when inhaling.
- Grunting – He or she will make a grunting sound and tighten the stomach muscles when breathing.
- Wheezing – You will hear a high-pitched sound when he or she breathes out.
Your baby might just seem sicker, feed less and have much less energy. You should call your baby’s physicians or seek medical care if you notice any of the above concerning symptoms.
The diagnosis of bronchiolitis is a clinical one based on medical history and physical examination. Chest X-rays and blood tests are usually not recommended. Although there are some specific viral tests available, they’re also rarely needed, as treatment does not vary based on the causative virus.
Treatment is symptomatic and involves the following:
- Hydration is essential, so you should feed your baby frequently and in smaller, easier-to-consume amounts.
- Nasal congestion is usually significant, so keeping your baby’s nose clear with a bulb syringe and saltwater nose drops is important.
- Some babies will run a fever, which can be controlled with acetaminophen or ibuprofen, if recommended by your doctor.
Antibiotics, cough medicines and decongestants are not recommended and may make your baby worse due to side effects. About 3 percent of all babies with bronchiolitis will require hospitalization for fluids and oxygen therapy.
Every baby will eventually get colds, coughs and bronchiolitis symptoms. I hope this helps you recognize differentiating symptoms and care for your baby when it is his or her turn.
For more information or to find a pediatrician, visit mercy.net/laduenews.
Dr. Joseph Kahn is president of Mercy Kids (mercykids.org), an expansive network of pediatric care dedicated to meeting the needs of every child, every day.
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