Bronchiolitis in Babies – Causes, Signs, and Treatments by Dr. Srikanta J T

10 min read

Written by Dr. Srikanta J T

Dr. Srikanta J T

Dr Srikanta J.T is a Interventional Paediatric Pulmonologist based in Bangalore with 12+ years of experience.

His expertise lies in Paediatric Pulmonary Medicine, Paediatric Interventional P More

bronchiolitis in babies

Lungs are the respiratory organs of the body. They are present on either side of the chest cavity. They bring oxygen to the body through the process of inhalation and send the carbon dioxide out through the process of exhalation. The passages or airways that carry air to the lungs can get infected and cause respiratory issues in both infants and adults. One such commonly occurring infection in infants is bronchiolitis. We will further discuss what bronchiolitis is in babies, its causes, signs, and treatments.

Normally, the air that we inhale passes through the nasal cavity, trachea, bronchi, and bronchioles thus reaching the lungs. The trachea that extends from the nasal cavity divides itself into two parts, right pulmonary bronchi and left pulmonary bronchi. These bronchi further extend into the right and left lung respectively dividing themselves into bronchioles. The air that reaches bronchioles is exchanged through the small sacs called alveoli that are attached to the tip of bronchioles. When the bronchioles of the lungs get infected by a virus called Respiratory Syncytial Virus (RSV), a pulmonary disease called bronchiolitis occurs.

In This Article

What is Bronchiolitis?

lung with bronchioles

Bronchiolitis is a viral infection that often occurs in age groups ranging from infants to children under two. This condition leads to inflammation of the inner walls of the bronchioles that pass air to the lungs. The inflammation can lead to congestion by narrowing the airways, this can create a problem with breathing. Bronchiolitis mostly occurs during the winter season, in rainy and tropical climates as the cold climates can lead to an increased outbreak of the virus. Bronchiolitis can make babies very fussy as it is an extremely uncomfortable situation. It can be treated at home and takes time to regress. Most mild cases can be resolved at home by taking proper care, but some babies may need the attention of a doctor. Rare cases with chances of secondary infection might also need hospitalization for a few days.

Difference Between Bronchitis and Bronchiolitis

Bronchitis and bronchiolitis are both viral infections that are caused by the inflammation of the inner walls. Bronchitis occurs if the inflammation occurs inside the bronchi, which are the larger airways. Bronchiolitis occurs if the inflammation occurs inside the bronchioles, which are the smaller airways. Bronchitis mostly occurs in adults while bronchiolitis affects infants and younger children. Both have similar symptoms that start with a cold, cough, and mild fever which usually subsides within a week or two. Bronchitis and bronchiolitis can become aggressive leading to shallow or fast breathing because of the extreme mucus collection in the airways. Serious symptoms might require immediate doctor attention and the necessary steps to comfort the person.

Can Bronchiolitis Occur in Babies?

Prematurely Born

Yes, it can occur at any age. Babies under six months of age can be extremely vulnerable to this disease as their immune system is still very immature. This can be a problem for the babies if they are

1. Prematurely Born

Premature babies are more vulnerable. They will need extra care as their development requires acute monitoring. Their immune system will need more time to adapt to the changes.

2. Not Breastfed

Breastfed babies develop immunity from mother’s milk as it supplies the required vitamins and monounsaturated fatty acids that are very much necessary for a better immune system.

3. Has an Existing Heart or Lung Disorder

If the baby has any existing heart or lung condition, such babies can be more vulnerable to infections.

As there is no proper treatment for this infection, the main motto lies in making the baby feel relieved from the symptoms.

  • Do not expose them to very cold climates.
  • Keep the environment around the baby clean and disinfected.
  • Do not sneeze or cough without any protection.
  • Make sure not to expose the baby to anyone who is ill.
  • Do not smoke inside the house.
  • Wash your hands before holding the baby.

How Long Does Bronchiolitis in Babies Last?

Bronchiolitis in babies normally lasts for 5-10 days, it may extend to two or three weeks. The symptoms still linger even after the disease is gone. It can be treated at home by taking the necessary care. Babies might require hospitalization in very rare cases like

  • If they are completely dehydrated.
  • Breathing is shallow and fast. This is an indication that they have difficulty breathing. This can often lead to sluggish behaviour.
  • If they make more wheezing sounds, this can indicate that the infection has worsened.

Consult your paediatrician immediately if you observe such symptoms. In case of hospitalization, it can take up to 2-3 days for the infant to get discharged.

Which Babies are at a High Risk of Getting Bronchiolitis?

Babies from birth to 2 years are at high risk of getting bronchiolitis at least once in their growing phase. Babies who are born with a weak immune system and babies with an underlying condition of the lungs are at risk of getting this infection. This can spread and is highly contagious in cold climates. Proper care and precaution during these months can reduce the risk of babies falling for this infection.

Causes of Bronchiolitis in Babies

Bronchiolitis is caused by a virus called Respiratory Syncytial Virus. In rare cases, other viruses like Rhinovirus cause common cold and pneumonia, and adenovirus (another virus that causes colds and throat infections) can also cause bronchiolitis in infants. The virus blocks the smaller airways called bronchioles by causing inflammation and leading to difficulty in breathing.

There will be a collection of mucus in the airways because of the inflammation. The inflammation or swelling of those small airways makes them narrow and causes difficulty in breathing. This infection is highly contagious and spreads very fast. It can be spread by sneezing, coughing, or by touching infected surfaces, by using the towels and other utensils of those who are infected.

Bronchiolitis can cause extreme discomfort for the baby. It reduces the appetite and reduces the intake of water and other fluids which may worsen the infection. Babies with bronchiolitis need more hydration and proper care. Fluid intake can help in decreasing the thickness of mucus that is formed inside the airways and helps in reducing the trouble in breathing.

[Read : Pneumonia in Children]

Symptoms of Bronchiolitis in Babies

Symptoms of Bronchiolitis in Babies

Bronchiolitis starts like a common cold and the babies start experiencing symptoms like

  • Runny nose
  • Fever, a mild temperature that is caused by cold and cough
  • Stuffy nose
  • Cough

These symptoms are often treated at home by taking the necessary care. Other serious symptoms include.

  • The baby starts to make wheezing sounds while breathing.
  • Fast or shallow breathing, rapid movements were observed on the abdominal area with a grunting sound.
  • Short pauses with every breath intake.
  • Lips and fingertips turning blue. This is called cyanosis. This happens if the body does not get enough oxygen.
  • If your baby draws their chest inside while breathing. This is an indication that they are having difficulty in inhaling.
  • Not urinating or passing urine just once or twice a day. This is a symptom of extreme dehydration which can worsen the infection.

Diagnosing Bronchiolitis in Babies

Bronchiolitis usually regresses on its own. It will stay for a week or two and starts to reduce slowly. Mild symptoms like cold cough and slight temperatures can be treated at home by taking proper care. Fluids play an important role in reducing the symptoms of bronchiolitis and that is why it is very important to make a note of any other symptoms of dehydration that your baby experiences.

It does not require any specific test to know that the baby is suffering from bronchiolitis. Doctors check for wheezing sounds and can tell that the baby is suffering from bronchiolitis. They may instruct steps for proper care till the infection starts to reduce.

In some cases, an infant might need a chest x-ray to rule out some complications like pneumonia and other bacterial infections. These bacterial infections can be treated by using antibiotics. Depending on the severity of the disease, doctors may suggest swab testing where the sample will be collected through the nostrils and mouth by using a swab. In very rare cases, doctors may suggest blood tests to check the amount of white blood cells. Required treatment will be decided based on the reports.

Complications of Bronchiolitis in Babies

Cyanosis baby

Premature babies and babies who are younger than a year might see some complications if they are infected. Infants with existing heart and lung conditions, premature babies, are more likely to see the risk of complications. They must be placed under the care and supervision of a doctor in such cases. Some expected complications are like

  • Severe breathing problem, unable to take any fluids in.
  • Extreme dehydration, like not urinating for a complete day or two.
  • Cyanosis, lips, and fingertips turning blue because of the loss of oxygen.
  • An ear infection.
  • Secondary infections like pneumonia and other bacterial infections.

Although most infants recover without the need for any serious treatments. Some babies who are at the risk of developing secondary infections might need a nasal cannula, a pipe that supplies oxygen to maintain the levels of it. This is a temporary need and can be removed once there is an improvement in the baby. The symptoms of bronchiolitis may stay for some extended time even after the baby is completely recovered from the infection.

Older children are not much prone to any complications. Secondary infections like pneumonia, ear infections, and severe dehydration are seen in rare cases. It is important to keep track of all the symptoms that your child is experiencing. Do not hesitate to seek medical help in case of anything serious.

[Read : Breathing Problems In Children]

Treating Bronchiolitis in Babies

Bronchiolitis does not have any particular treatment that works. It is all about comforting the baby for better breathing and keeping them hydrated. In some serious cases, infants might require hospitalization where

  • They will insert a nasal cannula for a better oxygen supply until the baby is fine and can breathe normally.
  • The oxygen levels are monitored periodically.
  • There will be a need for intravenous fluids in case of extreme dehydration and if the baby is not taking any fluids orally.
  • For slight fever doctors prescribe a medicine called acetaminophen.

Giving bronchodilators that help in opening up the airways was not of any use lately for bronchiolitis in babies. Chest physiotherapy is strictly not recommended for infants. The treatment for this only lies in proper monitoring and enough fluid supply for the baby to be fine and to recover from this infection.

Home Remedies For Bronchiolitis in Babies

humidifier in baby room

Babies with bronchiolitis usually recover on their own without the need for hospitalization. If you still feel concerned and overwhelmed about your baby’s condition, talk to your doctor about the symptoms, and take them to the hospital if needed. But, some home remedies might help the infant breathe easy and stay active at home.

  • Keep the baby upright in a sitting position. This will ease breathing.
  • Make sure they are urinating and help them stay hydrated.
  • Giving plenty of fluids like fresh fruit juices and water will be helpful. Babies with bronchiolitis may feel uncomfortable drinking a large amount at once. Helping them consume fluids in small intervals of time can make them stay hydrated.
  • If you see a mild fever, do not hesitate to contact your paediatrician. Consulting the doctor before giving any medicine to infants is always a better thing to do.
  • Use a humidifier in your baby’s room to keep the environment moist.
  • Maintain a smoke-free environment. Keep the often touched surfaces disinfected and dust-free.

Preventing Bronchiolitis in Babies

Since bronchiolitis is highly contagious, some preventive measures discussed here can help your baby stay unaffected if they are at the risk of catching the infection.

  • Avoid contact with people who are ill. Do not let them hold the baby if your little one is at risk of catching bronchiolitis.
  • Refrain from sending your baby to daycare during peak winters.
  • Avoid crowded areas as much as possible.
  • Keep the environment dust-free and disinfect whenever possible.
  • Do not share the utensils of those who are ill in the family.
  • Create a smoke-free environment at home. Avoid and refrain from smoking at home.
  • Use a humidifier if you feel the air is dry.
  • Breastfeed the baby. Breast milk can help increase immunity.

When to Consult a Doctor For Bronchiolitis?

doctor checking a baby

This infection can be dealt with with proper care and by monitoring the baby for the symptoms. But, it is always important to note down some symptoms that indicate peak infection and can be dangerous. Consult the doctor immediately if you see your baby is

  • Very sluggish and not able to drink any fluid for the whole day
  • Breathing very fast and shallow.
  • Looking very tired and does not urinate.
  • Suffering from cyanosis. Fingertips, lips, and toes turn blue because of the lack of oxygen.
  • Suffering from fever and losing appetite.
  • Making wheezing sounds that are audible. This indicates that there is a lot of difficulty in breathing.

Bronchiolitis can be an extremely difficult and uncomfortable phase that a baby can suffer. It is very important to take care and prevent it if your baby is at risk of catching the disease. Maintaining a smoke-free environment can help babies stay away from such breathing difficulties. Bronchiolitis has no particular medicine, keeping the baby hydrated only can help them recover as early as possible. Mild symptoms can be treated at home, but it is very important to track what your little one is experiencing during that phase. Consult your paediatrician immediately if you feel concerned or if the symptoms start to worsen.

[Read : Wheezing In Toddlers]


1. How Long Does Bronchiolitis Last in a Baby?

Bronchiolitis typically lasts for 5-10 days or it can even stay for two weeks or more. It is very important to track the symptoms of your baby at this phase.

2. Is Bronchiolitis Worse at Night?

Bronchiolitis normally worsens at night. The symptoms start to increase only to regress afterwards. Call your doctor immediately if you feel concerned.

3. How Can I know That My Baby Has Bronchiolitis?

Bronchiolitis starts with a mild cold and fever slowly extends until there is trouble breathing. Your baby starts to make wheezing and grunting sounds while breathing. Difficulty in breathing is shown by drawing their chest closer while inhaling. Rapid abdominal movements while breathing. The baby does not take any fluids or has a very low appetite. Persistent colds, filled with mucus are the symptoms of bronchiolitis.

4. What is the Reason For Bronchiolitis in Infants?

Bronchiolitis is caused by a virus called Respiratory Syncytial Virus which outbreaks in cold seasons. Babies with compromised immune systems, babies who are prematurely born, and babies with any underlying heart and lung conditions are at high risk of catching this infection rapidly.

Read also : Asthma in Toddlers: Symptoms and Treatment by Dr. Srikanta J T

Dr. Srikanta J T, MBBS, Diploma in Child Health (DCH), Diplomate of National Board(DNB), Fellowship in Pediatric Pulmonology and Sleep Medicine(NUH, Singapore), Training in Interventional Pulmonology
Consultant - Paediatric Interventional Pulmonology, Allergy and Sleep Medicine, ASTER CMI Hospital
10 years of experience

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