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Bronchiolitis: A Respiratory Illness in the Very Young

In young children, bronchiolitis often starts with cold symptoms, such as a runny nose, mild cough, nasal congestion and fever.


The virus causes swelling of the small airways of the lungs (bronchioles) and increases the production of mucous. This blocks
air movement through the lungs and makes it difficult to breathe.

Bronchiolitis is more common in young infants and children because their airways are smaller and more easily blocked than the airways of older children and adults. If adults have RSV, their symptoms are mild and similar to the common cold.

Bronchiolitis typically lasts up to seven days, with the worst symptoms occurring on day three or four of the illness. In young children, bronchiolitis often starts with cold symptoms, such as a runny nose, mild cough, nasal con- gestion and fever. After a few days, the cough may get worse and the child may begin to breathe faster, have difficulty breathing and begin to wheeze. These symptoms can be scary both for parents and children.

When to Seek Medical Attention

If you see any of the following signs, you should seek medical attention. Promptly bring your child to your pediatrician
or the Emergency Room:

  • Flaring or widening of the nostrils and pulling in of the abdomen under the rib cage
  • Grunting and tightening of the stomach muscles while breathing
  • Making a high-pitched whistling sound, called a wheeze, with each breath
  • Difficulty drinking and eating
  • A bluish tint around the lips and fingertips

Bronchiolitis may cause more severe illness in children who also have a chronic illness such as congenital heart disease. If you think your child has bronchiolitis and he or she has a chronic illness, call your pediatrician immediately or go to the Emergency Room.

Know the Signs of Dehydration

While your child has bronchiolitis, it is very important to prevent dehydration, which may occur if your child cannot comfortably drink fluids. Call your pediatrician if your child develops any of the following signs of dehydration:

  • Drinking less than normal
  • Dry mouth
  • Crying without tears
  • Urinating less often than normal

RSV and many other respiratory viruses are spread by direct contact with an infected person’s mucous or saliva, such as during coughing and sneezing. It is easily passed among family members and children in daycare centers. To prevent the spread of illness, it is very important to wash your and your child’s hands frequently, especially after coughing or sneezing.

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