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Have a fever
Cough
Shortness of breath
It all started with a runny nose
Have wheezing
Face is pale
Skin pale
Not seeing your symptoms? No worries!
It causes swelling and a buildup of mucus in the small airways of the lung called bronchioles. Bronchiolitis is almost always caused by a virus. It starts out with symptoms like a common cold but then it gets worse, causing coughing and a high-pitched whistling sound when breathing out called wheezing. Sometimes children have trouble breathing. Symptoms of bronchiolitis can last for 1 to 2 weeks but occasionally can last longer. It usually occurs in children less than 2 years and most common in babies less than 3 months. Most children get better with care at home. A small number of children need a stay in the hospital.
Your doctor may ask these questions to check for this disease:
Supportive care and careful monitoring for breathlessness is important. Infants and severe cases may need to be hospitalized for oxygen support or for fluids to be given through a needle in the vein.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Eisaku Kamakura, MD (Pulmonology)
Dr. Kamakura graduated from the Tokyo Medical and Dental University, School of Dentistry, and the Niigata University School of Medicine. He trained at Yokosuka Kyosai Hospital and held positions in the Respiratory Medicine departments at Yokosuka Kyosai Hospital, Tokyo Medical and Dental University, Ome City General Hospital, and Musashino Red Cross Hospital. In 2021, he became the specially appointed assistant professor at the Department of General Medicine, Niigata University School of Medicine.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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Q.
Is It Bronchiolitis? Why Your Baby Is Wheezing & Medically Approved Next Steps
A.
Bronchiolitis is a common cause of wheezing in babies under 2, often starting as a cold then peaking around days 3 to 5; most cases improve with saline nose care, smaller frequent feeds, hydration, humidified air, and close monitoring, but seek urgent care for fast or hard breathing, pauses in breathing, blue or gray lips, poor feeding or few wet diapers, or in very young infants. There are several factors to consider; see below for how to tell bronchiolitis from other causes, the key red flags, when to call the doctor versus go to the ER, and the medically approved next steps that can change based on age, severity, and risk factors.
References:
* Ralston SL, et al. AAP Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis (2024). Pediatrics. 2024 Feb 1;153(2):e2023065360. doi: 10.1542/peds.2023-065360. PMID: 38299103.
* Stafstrom C, et al. Bronchiolitis in children: a narrative review. Acta Paediatr. 2023 Feb;112(2):220-229. doi: 10.1111/apa.16540. Epub 2022 Sep 27. PMID: 36082496.
* Al-Hammash A, et al. Evidence-Based Management of Bronchiolitis in Infants. J Pediatr Intensive Care. 2022 Dec;11(4):254-261. doi: 10.1055/s-0042-1756534. Epub 2022 Nov 22. PMID: 36413958.
* Santamaria F, et al. Wheezing in children under 5 years of age: the role of diagnostic tools. Ital J Pediatr. 2021 Mar 22;47(1):61. doi: 10.1186/s13052-021-01007-z. PMID: 33757476. PMC ID: PMC7987820.
* Ralston SL, et al. Acute Bronchiolitis in Infants and Children. N Engl J Med. 2017 Jan 5;376(1):44-53. doi: 10.1056/NEJMcp1507716. PMID: 28052187.
Q.
Why Won’t They Stop? The Reality of Colic & Medically Approved Next Steps
A.
Most nonstop crying in an otherwise healthy young infant is often colic, a temporary pattern defined as crying more than 3 hours a day, more than 3 days a week, for at least 3 weeks, starting around 2 to 3 weeks and usually easing by 3 to 4 months. There are several factors to consider; see below to understand causes, what colic is not, and why this phase ends. Medically approved next steps include proven soothing techniques, targeted feeding changes with your pediatrician’s guidance, select probiotics, and a calm routine, plus tracking symptoms and getting prompt care for red flags like fever, poor feeding, breathing trouble, or blood in stool. For complete, actionable details that could change your next steps, including when to call the doctor now, see below.
References:
* Gelfand AA. Infant Colic: A State-of-the-Art Review. Pediatr Neurol. 2022 Jul;132:48-55. doi: 10.1016/j.pediatrneurol.2022.04.004. Epub 2022 Apr 20. PMID: 35687702.
* Johnson JD, Kruger E, Johnson T, et al. Infant Colic: The Etiology, Diagnosis, and Management. Children (Basel). 2022 Aug 23;9(9):1273. doi: 10.3390/children9091273. PMID: 36014415; PMCID: PMC9498226.
* Sung V, Nielson S, Johnson J, Johnson T, De Caprariis P, Gupta A. Management of Infant Colic: What Works? Children (Basel). 2021 Jun 24;8(7):527. doi: 10.3390/children8070527. PMID: 34208398; PMCID: PMC8304918.
* Lante T, Brusa J, Strisciuglio C, Fasano A. The Etiology and Treatments of Infantile Colic: The Possible Role of the Microbiome. Children (Basel). 2022 Aug 18;9(8):1233. doi: 10.3390/children9081233. PMID: 36011409; PMCID: PMC9407335.
* Xu M, Yin J, Sun H, et al. Pharmacological and non-pharmacological interventions for infantile colic: a systematic review and meta-analysis. Eur J Pediatr. 2021 Aug;180(8):2381-2396. doi: 10.1007/s00431-021-03991-6. Epub 2021 Mar 17. PMID: 33731802; PMCID: PMC8290209.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Florin TA, Plint AC, Zorc JJ. Viral bronchiolitis. Lancet. 2017 Jan 14;389(10065):211-224. doi: 10.1016/S0140-6736(16)30951-5. Epub 2016 Aug 20. PMID: 27549684; PMCID: PMC6765220.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30951-5/fulltextCaballero MT, Polack FP, Stein RT. Viral bronchiolitis in young infants: new perspectives for management and treatment. J Pediatr (Rio J). 2017 Nov-Dec;93 Suppl 1:75-83. doi: 10.1016/j.jped.2017.07.003. Epub 2017 Aug 30. PMID: 28859915.
https://www.sciencedirect.com/science/article/pii/S0021755717306587?via%3DihubMeissner HC. Viral Bronchiolitis in Children. N Engl J Med. 2016 Jan 7;374(1):62-72. doi: 10.1056/NEJMra1413456. PMID: 26735994.
https://www.nejm.org/doi/10.1056/NEJMra1413456Fretzayas A, Moustaki M. Etiology and clinical features of viral bronchiolitis in infancy. World J Pediatr. 2017 Aug;13(4):293-299. doi: 10.1007/s12519-017-0031-8. Epub 2017 May 4. PMID: 28470580; PMCID: PMC7090852.
https://link.springer.com/article/10.1007/s12519-017-0031-8Bronchiolitis - Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565