Diagnosis

Tests and X-rays are not usually needed to diagnose bronchiolitis. The doctor can usually identify the problem by observing your child and listening to his or her lungs with a stethoscope. However, it may take more than one or two visits to distinguish the condition from a cold or the flu.

If your child is at risk of severe bronchiolitis, if symptoms are worsening or if another problem is suspected, your doctor may order tests, including:

  • Chest X-ray. Your doctor may request a chest X-ray to look for signs of pneumonia.
  • Viral testing. Your doctor may collect a sample of mucus from your child to test for the virus causing bronchiolitis. This is done using a swab that's gently inserted into the nose.
  • Blood tests. Occasionally, blood tests might be used to check your child's white blood cell count. An increase in white blood cells is usually a sign that the body is fighting an infection. A blood test can also determine whether the level of oxygen has decreased in your child's bloodstream.

Your doctor may also ask you about signs of dehydration, especially if your child has been refusing to drink or eat or has been vomiting. Signs of dehydration include sunken eyes, dry mouth and skin, sluggishness, and little or no urination.

Treatment

Bronchiolitis typically lasts for two to three weeks. The majority of children with bronchiolitis can be cared for at home with supportive care. It's important to be alert for changes in breathing difficulty, such as struggling for each breath, being unable to speak or cry because of difficulty breathing, or making grunting noises with each breath.

Because viruses cause bronchiolitis, antibiotics — which are used to treat infections caused by bacteria — aren't effective against it. If your child has an associated bacterial infection, such as pneumonia, your doctor may prescribe an antibiotic for that.

Drugs that open the airways (bronchodilators) haven't been found to be routinely helpful. But your doctor may elect to try a nebulized albuterol treatment to see if it helps.

Oral corticosteroid medications and pounding on the chest to loosen mucus (chest physiotherapy) have not been shown to be effective treatments for bronchiolitis and are not recommended.

Hospital care

A tiny percentage of children need hospital care to manage their condition. At the hospital, your child may receive humidified oxygen to maintain sufficient oxygen in the blood, and perhaps fluids through a vein (intravenously) to prevent dehydration. In severe cases, a tube may be inserted into the windpipe (trachea) to help the child's breathing.

Lifestyle and home remedies

Although it may not be possible to shorten the duration of your child's illness, you may be able to make your child more comfortable. Here are some tips to try:

  • Humidify the air. If the air in your child's room is dry, a cool-mist humidifier or vaporizer can moisten the air and help ease congestion and coughing. Be sure to keep the humidifier clean to prevent the growth of bacteria and molds. Another way to humidify the air is to run a hot shower or bath in the bathroom and let it steam up the room. Sitting in the room holding your child for about 15 minutes may help ease a fit of coughing.
  • Keep your child upright. Being in an upright position usually makes breathing easier.
  • Have your child drink. To prevent dehydration, give your child plenty of clear fluids to drink, such as water or juice. Your child may drink more slowly than usual, because of the congestion.
  • Try saline nose drops to ease congestion. You can purchase these drops over-the-counter (OTC). They're effective, safe and nonirritating, even for children. To use them, instill several drops into one nostril, then immediately bulb suction that nostril (but don't push the bulb too far in). Repeat the process in the other nostril. If your child is old enough, teach your child how to blow his or her nose.
  • Use OTC pain relievers. OTC pain relievers such as acetaminophen (Tylenol, others) may help relieve a sore throat and improve your child's ability to drink fluids. Never give your child aspirin. It's associated with a rare but serious illness called Reye's syndrome. Don't give OTC cough and cold medicines to children younger than age 2.
  • Maintain a smoke-free environment. Smoke can aggravate symptoms of respiratory infections. If a family member smokes, ask him or her to smoke outside of the house and outside of the car.

Preparing for your appointment

You're likely to start by seeing your family doctor or your child's doctor. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

  • Write down any symptoms your child is experiencing, including any that may seem unrelated to an upper respiratory infection, and when they started.
  • Write down key personal information, such as if your child was born prematurely or if he or she has a heart or lung problem.
  • Write down questions to ask your doctor.

Questions to ask your doctor

Some basic questions to ask your doctor include:

  • What is likely causing my child's symptoms? Are there other possible causes?
  • Does my child need any tests?
  • How long do symptoms usually last?
  • Is my child's infection contagious?
  • What is the best course of action?
  • What are the alternatives to the primary approach that you're suggesting?
  • Does my child need medication? If so, is there a generic alternative to the medicine you're prescribing me?
  • What can I do to make my child feel better?
  • Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

Don't hesitate to ask questions during your appointment anytime that you don't understand something.

What to expect from your doctor

Be ready to answer questions your doctor may ask:

  • When did your child first begin experiencing symptoms?
  • Have your child's symptoms been off and on or continuous?
  • How severe are your child's symptoms?
  • What, if anything, seems to improve your child's symptoms?
  • What, if anything, appears to worsen your child's symptoms?

What you can do in the meantime

If your child has a fever and is older than 3 months, you can give him or her acetaminophen (Tylenol, others) or ibuprofen (Children's Advil, Children's Motrin).

Never give a child under age 2 over-the-counter cough and cold products without checking with your child's doctor.

It's also important to have your child drink plenty of fluids to prevent dehydration.

Aug. 19, 2017
References
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