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Bronchiolitis. When a cold stops being simple

Posted on 12-01-2017

Bronchiolitis is a viral infection that affects young children, particularly children under 2 years of age. Several viruses can cause bronchiolitis, but the most feared is RSV or Respiratory Syncytial Virus. It typically goes around during the cold months of the year and is the most feared because, in addition to sometimes becoming serious, it often leaves aftereffects and the child who has suffered bronchiolitis due to RSV, then, during the following 2-3 years, may suffer from the same symptoms every time he/she has flu or a simple cold.


How do we know when it is bronchiolitis?

First of all, the child’s age. The virus can affect anyone, older children and adults, but symptoms in older children are usually indistinguishable from those of a common cold.

At first the symptoms are mild and similar to those of a cold - sneezing, mucus, noisy breathing through the nose. As the illness progresses, the noises become more noticeable and if the child has trouble breathing, he/she will also stop eating.

There may be a temperature, but it is not the symptom that worries us the most. The worst is respiratory distress. Gradually breathing becomes faster and the child will need to use "extra" muscles to breathe. If we look closely, we can see that the ribs become visible whilst breathing, the abdomen goes up and down in a marked way and sometimes, even the nostrils flare as if trying to catch more breath. It is time to go to the doctor.


Unfortunately, like most viruses, there is no specific treatment for RSV. As the breathing sounds are similar to those heard in asthma, at one time bronchodilators (inhalers like the well-known Ventolin®) were used, but for years we have known they do not improve the symptoms nor do they decrease the duration or severity of the disease. Currently, no clinical guide, prepared by experts based on the latest scientific studies, recommends the use of these treatments. Nor are corticosteroids useful, much less antibiotics.

If the pediatrician considers the child can get through the infection at home, he will recommend support measures to make the more comfortable:

  • Keep your nose clear, rinsing with serum and gently aspirating, especially before eating and when lying down.
  • Ensure the child is hydrated, giving him/her fluids more frequently. If the child breastfeeds or bottle-feeds, give him/her milk. If the child already eats other foods, you can also give him/her water.
  • Prop up the head of the crib a little by placing something under the mattress, never a pillow, which causes the neck to bend.
  • Administer antipyretic treatment if there is fever.


After the first 3 or 4 days the child’s condition tends to improve, and in a week or 10 days the child will be fine, will breathe without difficulty and eat as usual, even a little better to make up for lost energy.

From now on, during the next few years, or rather, during the next winters, every time the child catches a cold, the same symptoms may appear again. It is what pediatricians call "wheezing triggered by viruses" but can also be called bronchitis, asthma in infancy (or simply asthma), bronchospasm crisis or bronchial hyperreactivity.

Whatever we call it, the symptoms are the same: cough, respiratory distress and respiratory noises (wheezing or whistling). In these new episodes bronchodilators can work and the condition is usually less serious, or at least easier to treat.