Infant Illnesses | Spotlight on bronchiolitis

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"Acute viral bronchiolitis is seasonal, occurring more commonly in the winter months typically from end of February till August". (Getty Images)
"Acute viral bronchiolitis is seasonal, occurring more commonly in the winter months typically from end of February till August". (Getty Images)
  • If your baby's coughing leaves her straining for breath, she may have bronchiolitis.
  • This lower respiratory tract infection is quite common and typically occurs in children aged 2 to 6 months.
  • A local expert talks more about this "disease of infancy" and what parents should know about homecare.

    Having a newborn baby is overwhelming enough, and if they show signs of illness, it can be really scary.

    Parent24 has put together a series on common infant illnesses to guide you when your baby is sick.

    Together with a local paediatrician or doctor, we'll help you decide when to panic. It's probably not as serious as you think, but let's be sure.

    Catch more instalments of our #infantillness series here.

    A typical concern:

    "My four-month-old's coughing is getting worse and worse, and she seems to have difficulty breathing. What's wrong with her?"


    Your baby might have bronchiolitis.

    Dr Elelwani Mathivha, a paediatrician practising at Netcare Femina Hospital, describes bronchiolitis as a seasonal "disease of infancy" since it occurs most commonly before the age of one.

    "Bronchiolitis is an acute lower respiratory tract infection usually caused by a virus. It causes inflammation and swelling (oedema) of small airways resulting in lower airway obstruction, air trapping and a classical 'wheezing' sound when listening to the chest with a stethoscope," explains Dr Mathivha.

    While the infection is unlikely to require hospitalisation, Mathivha says your child is likely to develop asthma in cases where recurrent episodes of wheezing occur.

    What causes bronchiolitis

    The condition is "almost exclusively caused by viruses," Mathivha advises, including respiratory syncytial virus (RSV), adenovirus and metapneumovirus.

    "Acute viral bronchiolitis is seasonal, occurring more commonly in the winter months, typically from the end of February till August, with slight differences between coastal and inland areas. The peak incidence is in babies 2 to 6 months of age, but it can occur in children up to 2 years of age," the paediatrician tells Parent24.

    ALSO READ | Nine dangerous newborn baby myths busted by an expert

    Symptoms to look out for:

    According to Mathivha, the symptoms of bronchiolitis include:

    • Coughing
    • Wheezing (which may not be audible)
    • Fast breathing (60 breaths or more per minute)

    In some cases, symptoms are more extreme. These include:

    • Chest indrawing
    • Inability to feed
    • Laboured breathing
    • Decreased consciousness
    • Convulsions
    • Blue lips and tongue (central cyanosis)

    Similar conditions

    Asthma and gastroesophageal reflux disease (GERD) present with similar symptoms, Mathivha says. However, with the latter, heartburn presents alongside a cough.

    How long will it last, and how is it spread?

    While a short-lived infection, Dr Mathivha notes that bronchiolitis is an airborne infection and is easily spread through close contact.

    "In general, most infections will clear within seven to 14 days but may persist for as long as 21 days. Sick babies ideally need to be isolated from well babies," the paediatrician advises.


    "Most cases of bronchiolitis can be treated at home. If symptoms worsen, patients need evaluation, which will include oxygen saturation evaluation. There is no curative agent for bronchiolitis; treatment is supportive, and in general, the outcome for infants is excellent. Less than 10% of infants with acute bronchiolitis require hospitalisation, and of those hospitalised, less than 5% require ventilation."

    When to call the doctor

    The paediatrician advises that a cough accompanied by fast breathing is considered serious enough for a doctor's visit.

    ALSO READ | Your baby's brain explained | A Parent24 Series

    Tips and advice for parents

    "Try to isolate sick children or limit contact where possible, e.g. discourage kissing, remove them from day care. Most cases need no treatment (oxygen, antibiotics, etc.) and will resolve spontaneously."

    You can also ask a doctor or paediatrician directly via Health24 here: Ask an Expert


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