Bronchiolitis is a respiratory infection, often preceded by a cold, that occurs in the lungs and airways. The bronchioles, or branches of the tracheal wall leading into the lungs, become swollen. This causes difficulty taking in air. A child who has bronchiolitis may wheeze (breathe tightly with a whistling sound in the chest cavity) and/or cough because of the difficulty to take in the needed oxygen. A cough caused by bronchiolitis will be a mucous, or phlegm-filled, cough. Bronchiolitis generally occurs in infants younger than 2 years old. However, anyone can catch it. It is more severe in those under 18 months old. Most prevalent in the winter months, bronchiolitis can occur any time of the year. Below you will learn phases of care for a child with bronchiolitis, as well as the risks it carries and what to expect.
Causes
Bronchiolitis most often starts with a simple cold. Because of the body’s reaction to the cold, the bronchioles become swollen causing bronchiolitis.
Symptoms To Watch For
A child with bronchiolitis may seem unusually tired or listless. Bronchiolitis can cause shortness of breath, coughing, fever, and wheezing. The wheezing and coughing may last up to 14 days, sometimes longer. The cough generally lasts longer than the wheeze. Expect the cough to be very mucousy. Before the cold turns into bronchiolitis, the cough may not be that bad.
Children with bronchiolitis are more susceptible to ear infections, so watch for those symptoms as well. To find out more about ear infections and their symptoms, click here. A child with bronchiolitis or an ear infection may not always have all the symptoms. If you suspect your child is ill, a doctor should always be contacted.
When To Call The Doctor
At the first sign or symptom of bronchiolitis, a doctor should be contacted. While bronchiolitis starts with a cold, it can progress into something worse, like the loss of oxygen or even asthma. While the risk is small when a physician’s instructions are followed, bronchiolitis can cause death. If your child is wheezing, having trouble breathing, or coughing excessively, take that child to the emergency room right away. Emergency rooms that deal exclusively with children or specialize in pediatric emergency care are the best option. However, if there is no emergency department like that close by, opt for the closest emergency room with good care. Some hospital emergency rooms have equipment that is too large for children. It will work, but a secure fit is better.
If the child’s face, lips, or fingernails are turning blue, this a sign of oxygen loss. Also, if the child’s neck or rib muscles are pulling in, this is called exacerbation and is a sign of struggling to breathe. In either of these situations, call 911 right away.
What Happens At the Hospital
If your child is wheezing or having other breathing troubles, the doctors and other staff will be giving the child breathing treatments on a nebulizer machine. Medicines typically used for this are Albuterol and Ipratropium Bromide. Albuterol will be given until the breathing is under better control, sometimes continuously. The Ipratropium Bromide must be used within the first 48 hours of the start of the breathing difficulties for the greatest benefit. It may only be given once or the child might receive subsequent doses. It’s generally given every 6 hours. The Albuterol is generally given every 4-6 hours. However, it is safe to give doses back to back (what the doctors may refer to as a “continuous” dose) under the supervision and guidance of a licensed medical professional. If these medicines aren’t working fast enough or aren’t working at all, the child is generally given prednisone. It comes either in pill or liquid form and which to give will be based on the child’s ability to safely swallow a pill. Prednisone is a steroid, but shouldn’t be confused with performance enhancing steroids often associated with athletes. Prednisone is not the same thing and is a very common medicine that is used widely in pediatric care. Your child will be placed under observation until the breathing improves to a level that is stable enough to be released into parental care.
If your child did not experience breathing problems with the bronchiolitis, the doctor will simply assess and diagnose your child based on the symptoms and other factors. Your child may or may not be given medications or prescriptions to take home and fill.
For both scenarios, the doctor will be explaining to you everything that is going on and depending on the severity of the symptoms, your child might be hooked up to an EKG, a Pulse Oximeter, receive an X-Ray, be intubated, or all of the above. Also expect a great deal of questions about family history, history of asthma, history of bronchiolitis, what led you to the visit, and more. Expect to repeat the same answers to more than one person and more than once. This information is important, so be sure to answer as accurately as possible.
Being Discharged and Going Home
Once your child’s breathing has shown enough improvement to be considered stable, your child will be released from the hospital and into your care. Depending on the child’s condition upon release, the doctor may prescribe medicines to be taken at home. Those will include one or more of the same medications used for treatment in the hospital. Be sure to fill those prescriptions right away and follow the doctor’s discharge instructions exactly, even if they vary from anything mentioned here. Each child’s personal instructions will be unique to the child’s needs, based on the medical observations.
Home Care
If your child was prescribed breathing treatments, you may have purchased or been loaned a nebulizer machine. For instructions on how to properly use a nebulizer machine, click here. If your child has breathing medications, but was given a spacer with or without a mask, it is imperative that you follow the instructions the doctor has given you for using the spacer. Generally, the child will need to shake the MDI (Metered Dose Inhaler) and attach it to the spacer immediately following the shake. Then, pump it one time. The child will then need to take 6 breaths through the spacer hole or mask, which should also be in place when the medicine is being pumped inside. Depending on the medicine and the doctor’s instructions, the process may need to be repeated.
In order to achieve a successful and speedy recovery, you will need to follow your doctor’s instructions exactly.
Follow-up Appointment
At the follow-up appointment the doctor will assess your child for signs of improvement, as well as make any further recommendations, if needed. Expect to answer a great deal of questions, much like the questions asked in the emergency room if you visited there. The doctor will also assess your child to see if there’s the possibility of asthma. This might be checked by X-Ray and/or other means, such as past episodes of bronchiolitis, family history of asthma, and other factors. If assessment and/or tests show that the child does not have asthma, the doctor will give any further care instructions if needed. If the examination indicates asthma, expect instruction on treatment, risks, discussion on the possibilities of medications, and what to watch for.
Extra Tips For Quick Recovery From Bronchiolitis
The tips below are things I have come up with (and had approved by doctors) for use on asthmatic children as well as those with bronchiolitis. As with anything else in this guide, be sure to ask a doctor before using these methods with your own child.
Sit the child in a steamy bathroom, created by running a hot shower. Just be careful that the child does not touch the hot water. Face the shower head onto the back wall so that the shower door or curtain can be open. This will steam up the room faster. 10 -15 minutes is a good amount of time to be in the steam. Anything more might be too much.
Use a notebook to jot down details about your child’s symptoms and recovery. Also, jot down each time the child takes a treatment (whether it’s scheduled or out of need), including the condition before and after the treatment. For example: 10:30am – Scheduled Treatment – Johnny is experiencing exacerbation in the rib area, as well as a loud wheeze. After the treatment, Johnny is still wheezing, but more lightly. The exacerbation is now gone. Details like this help the doctors at the follow-up appointment. Notes like this and attention to detail can help your child’s doctor better assess the situation.
Use a cool mist humidifier in your child’s recovery room (be it the bedroom or living room). You can also drape a few wet towels or sheets in that same room to help create a cool moist area.
Concentrated apple juice can help to open up the airways and ease breathing. Be sure your child drinks one to two glasses per day during any wheezing episode. Combined with the medicines, this can greatly reduce the symptoms your child is experiencing. It also loosens the mucus. Aside from the apple juice, be sure your child is also drinking plenty of water. Water also helps this condition, as well as prevents dehydration.
Apply Vicks or Mentholatum to the child’s neck and back. Then, place a warm wet cloth on both areas for a few minutes. Instruct the child to breathe deeply. If you’re dealing with a baby, use the Vicks designed for babies. Sometimes you can get a baby to mimic you if you breathe deeply. Keep doing it and they usually will copy you. If not, this method will still work some. It just works faster and better if they breathe deeply.
When the child is taking breathing treatments, it helps if the child has either Vicks or menthol cough drops during the treatment. It opens up the airways, causing the medicine to work more efficiently.
Keep the nose free of mucous, cleaning it out often. If you’re dealing with a baby or toddler, you’ll need to use a suction bulb. Older kids can just blow their noses unless it’s bad. If it’s bad, mix ¼ tsp of sea salt with ½ cup of water. Put a couple drops in each nostril one at a time with the child’s head tipped back. Then, suction it out with a bulb or have the child blow their nose. It works really well and is the same ingredients in saline nasal drops.
Keep the child calm. Stress can worsen the symptoms. Much of keeping the child calm is being calm yourself. Stories and silly songs also work.
If a high fever develops, and will not be reduced with children’s Tylenol or Motrin, contact the doctor and possibly return to the doctor or ER, depending on the severity.
When the child is lying down, prop up his or head and chest with pillows for support. When lying flat, it can be difficult to breathe properly.
If symptoms worsen, contact the doctor right away and return to the doctor or ER if necessary.
Click Here for more asthma remedies that may also help with bronchiolitis.
Will My Child Recover From Bronchiolitis?
Each case is different. However, most children make it through a bout of bronchiolitis perfectly fine. Do not over worry yourself. Just take good care of your child. Heed to any warnings, but do not assume that your child will face every horror imaginable. As with any condition, it is imperative to your child’s healing that you focus, not on the negative, but the positive. At times, it can seem like it is never going to end because it lasts so long, but in most cases, the child will be just fine afterward. Recovery takes from 2 weeks to even 2 months. The wheezing usually fully disappears within a week or less. The cough is the symptom that lingers longer and has even been known to last up to two months.
More On Recovery
The most important part of recovery is following all of the doctor’s instructions exactly. Never miss a breathing treatment or a medicine dosage. Breathing problems should not be taken lightly, even when the child seems to be acting normal. Not all children will over-react, even when something is seriously wrong. When it comes to caring for a patient with breathing problems, the parent or caregiver must be extremely observant. Reaction time can mean the difference between life and death. While death will not occur in many cases, it can and does happen. This statement is not meant to make a parent scared. It is just a word of caution.
Extra Resources
The Anatomy of an Ear Infection
http://www.associatedcontent.com/article/234905/the_anatomy_of_an_ear_infection.html
Natural and Prescription Remedies and Cures For Asthma
http://www.associatedcontent.com/article/380993/natural_and_prescription_remedies_and.html
How to Properly Use a Nebulizer Machine to Dispense Medications
http://www.associatedcontent.com/article/174266/how_to_properly_use_a_nebulizer_machine.html
Source
I have had personal experience dealing with this condition in children on numerous occasions. The first time occurred around ten years ago. The last time occurred less than one year ago. I have studied this condition and had advice from many medical professionals throughout the years.
*Note:
The author is not a medical professional. It is always best to consult with a medical professional before any medical advice. This is simply written to help parents and caregivers understand what they might go through with this condition. If you are curious about anything mentioned in this guide, consult with your child’s physician. If you suspect your child has any of the conditions mentioned in this article, contact your child’s doctor. If you are in an emergency situation, call 911.
**Have you experienced asthma or bronchiolitis (or a similar breathing problem)?
Are you a medical professional?
The author welcomes questions, feedback, personal stories, and extra tips and advice in the comments section below.
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