CHILD’S HEALTH/CHEST PROBLEMS: BRONCHIOLITIS
Bronchiolitis is a viral infection which causes inflammation of the small air passages in the lungs (bronchioles). It is most common in babies under 1 year of age. It generally occurs in epidemics during the winter months.
Cause
Bronchiolitis is usually caused by a virus called respiratory syncytial virus (RSV), which is spread by sneezing, coughing or personal contact.
Clinical features
The onset of the illness is somewhat like a cold, with a runny nose and a mild fever. This progresses rapidly to a nasty cough, and breathing may become rapid and laboured. A high whistling sound called a wheeze may be heard when your child breathes out. Your child may be difficult to feed and may become quite distressed. In severe cases, the child may look blue around the lips. In this case seek immediate medical attention.
Treatment
Mild attacks of bronchiolitis can be managed at home. Offer your child smaller but more frequent feeds. Give paracetamol according to direction if your child has a fever. Make sure that he drinks plenty of fluids. A humidifier in his room can help to ease the cough and make breathing easier. Make sure the child is in a smoke-free environment.
If your child is having difficulty breathing or feeding, and appears to be distressed, he may be better off in hospital for a few days until the worst of the illness has passed. The hospital staff can provide oxygen if necessary, and if your child cannot feed he may require an intravenous infusion for a few days. Anti-asthma drugs have not proved to be of much use in this age group, probably because the muscles surrouding their larger airways are not fully developed, and this is the site where these medications work. Anti-asthma medication may be tried, just in case your child responds to it well. Most children recover fully after 7-10 days.
When to see your doctor
• if your child is coughing and distressed;
• if your child has difficulty feeding.
Take your child to hospital immediately
• if he becomes short of breath or has difficulty breathing;
• if he looks blue around the lips.
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