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 the lungs with a stethoscope.
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.
Bronchiolitis typically lasts for two to three weeks. Most 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. Bacterial infections such as pneumonia or an ear infection can occur along with bronchiolitis, and your doctor may prescribe an antibiotic for that infection.
Drugs that open the airways (bronchodilators) haven't been found to be routinely helpful and typically aren't given for bronchiolitis. In severe cases, 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.
A small percentage of children may need hospital care to manage their condition. At the hospital, a child may receive humidified oxygen to maintain sufficient oxygen in the blood, and he or she may receive fluids through a vein (intravenously) to prevent dehydration. In severe cases, a tube may be inserted into the trachea to help the child's breathing.
Lifestyle and home remedies
Although it may not be possible to shorten the length 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.
- Keep your child upright. Being in an upright position usually makes breathing easier.
- Have your child drink liquids. 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. Frequently offer small amounts of fluid.
- Try saline nose drops to ease congestion. You can buy these drops over-the-counter (OTC). They're effective, safe and nonirritating, even for children. To use them, put 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.
- Consider OTC pain relievers. For treatment of fever or pain, ask your doctor about giving your child infants' or children's over-the-counter fever and pain medications such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) as a safer alternative to aspirin. Aspirin is not recommended in children due to the risk of Reye's syndrome, a rare but potentially life-threatening condition. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin, as they have a higher risk of Reye's syndrome.
- Maintain a smoke-free environment. Smoke can worsen symptoms of respiratory infections. If a family member smokes, ask him or her to smoke outside of the house and outside of the car.
Don't use over-the-counter medicines, except for fever reducers and pain relievers, to treat coughs and colds in children younger than 6 years old. Also, consider avoiding use of these medicines for children younger than 12 years old.
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
Before your appointment, make a list of:
- Any symptoms your child is experiencing, including any that may seem unrelated to an upper respiratory infection, and when they started
- Key personal information, such as if your child was born prematurely or has a heart or lung problem
- Questions to ask your doctor
Questions to ask your doctor may include the following:
- 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?
- What can I do to make my child feel better?
- Are there any brochures or other printed material that I can have? What websites do you recommend?
Don't hesitate to ask more questions during your appointment.
What to expect from your doctor
Your doctor may ask questions, such as:
- 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?
Your doctor will ask additional questions based on your responses and your child's symptoms and needs. Preparing and anticipating questions will help you make the most of your time with the doctor.