Bronchiolitis

Background

 

Bronchiolitis is what happens when babies and young children under 2 years of age get a “chest cold”.

 

It can be caused by any respiratory virus but is most associated with RSV (respiratory syncytial virus).

 

Bronchiolitis affects the small air tubes called bronchioles.

 

Our whole airway system from our nose all the way down through our lungs is lined with the same kind of tissue called mucosa. When we get a respiratory virus (commonly known as a cold) that tissue gets swollen, and secretes mucus, causing a runny/stuffy nose. If the virus moves down into our lungs, the same thing can happen in our air tubes. That’s what we call a chest cold. It makes our breathing feel heavy, perhaps we get a bit short of breath when we wouldn’t normally such as walking up the stairs. This happens because the lining of the air tubes is thicker when it’s swollen and there is mucous inside the tubes resulting in less space for the air to move through.

 

In adults with larger air tubes, this narrowing is minimal. But in infants, with their small lungs, the same amount of swelling and mucus can completely plug off their small bronchioles.

 

 

Thus bronchiolitis is simply a chest cold in very young children. Because of their smaller size, they are much more affected, and can develop trouble breathing.

 

Most commonly in young children we see them using extra muscles to breathe. This is called work of breathing. See this video: https://www.youtube.com/ watch?v=Radr3Fr_Nro

 

If the air tubes are narrowed enough, you can hear the air moving through them, similar to when you purse your lips to whistle. This noise is called wheezing. Wheezing is a breathing out noise.

 

What To Do

 

The best treatment is prevention.

 

Hand hygiene, protecting young infants from people who are sick, wearing masks in clinic, and now immunization for RSV are the best ways to prevent bronchiolitis.

 

If your child gets sick, then the management is the same as outlined in our coughs, colds, and congestion page

 

When To Be Concerned:

 

If your baby is having trouble feeding, despite clearing their nose, they should be assessed.

 

They should also be seen if they have more than a little bit of work of breathing. If they are using a lot of muscles, unable to feed, lethargic or their colour doesn't look right then go immediately to the emergency room.

 

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