Bronchiolitis in Children

What are the signs and symptoms of bronchiolitis?

The incubation period for bronchiolitis (the time between contact with the virus and the beginning of symptoms) ranges from several days to a week, depending on the type of virus causing the bronchiolitis.

The first symptoms of bronchiolitis usually look like a common cold:

• Stuffy/runny nose
• Mild cough
• Mild fever
• Mild wheezing that sounds like high-pitched whistling noises when your child exhales

You should seek immediate medical attention if your child is showing these signs of severe respiratory difficulties:

• Fast, shallow breathing
• A fast heartbeat
• Retractions (drawing in of the neck and chest with each breath)
• Flaring of the nostrils
• Irritability, with difficulty sleeping and signs of constantly being tired or sluggish
• Poor feeding and dehydration
• Apnea (pauses in breathing longer than 15 seconds)
• Cyanosis (blue color of the lips, tongue and skin)

Symptoms of bronchiolitis usually last about 12 days but can last as long as 2 to 3 weeks.

Learn how to spot the differences between bronchiolitis symptoms and symptoms of other respiratory infections.  

How do we diagnose bronchiolitis?

Your child’s doctor will do a physical exam and ask you about your child’s symptoms to diagnose bronchiolitis. They look for coughing, wheezing, trouble breathing and other signs of illness. Your child’s doctor may also check their oxygen levels and in some cases, perform diagnostic tests such as chest X-rays, blood work or viral testing.

How do we treat bronchiolitis?

Fortunately, most cases of bronchiolitis are mild and do not require medical care. Most babies and children with bronchiolitis get better with rest and fluids. Be sure to offer your child fluids in small amounts and more often than usual.

A bulb syringe and saline (saltwater) nose drops can help loosen nasal congestion. This can be especially helpful just before feeding and sleeping. A cool mist vaporizer or humidifier can help loosen mucus and relieve cough and congestion. Breathing treatments with medicines such as albuterol or epinephrine can also be helpful.

Acetaminophen (Tylenol) can help reduce fever and make your child more comfortable. Be sure to follow appropriate dosing and timing of medication based on your child’s weight. Over-the-counter cough and cold remedies are not recommended or approved for infants and young children.

Antibiotics are not useful because bronchiolitis is caused by a viral infection and antibiotics are only effective against bacterial infections.

Babies or children with moderate or severe bronchiolitis may need to be hospitalized, watched closely and given fluids and humidified oxygen. In rare, severe cases, a baby may need a respirator to help them breathe until they start to get better.

Why choose us for bronchiolitis treatment?

At the Breathing Institute at Children’s Hospital Colorado, we provide comprehensive clinical care and consultation for children with common and complex breathing problems. We are experts at treating conditions such as bronchiolitis.

As part of a regional care center, our Breathing Institute provides professional education and advancement of knowledge through research. Our doctors are responsible for discoveries in pulmonary medicine, including the first use of inhaled nitric oxide (iNO) to treat premature infants with respiratory failure.

We are nationally recognized for our expertise in asthma, cystic fibrosis, airway anomalies and disease, pulmonary hypertension, apnea and sleep-disordered breathing, primary ciliary dyskinesia and children's interstitial lung disease. Children's Colorado has the experience and knowledge to treat a broad spectrum of breathing conditions in children and we offer the latest in diagnostic testing for both infants and older children. Our experienced staff of pediatric specialists includes physicians, nurses, dietitians, social workers and respiratory therapists and we work with you and your family to form an effective treatment plan based on your child’s unique symptoms and medical history.

Helpful resources

Healthy Children provides parents with health information on health issues like bronchiolitis and is part of the American Academy of Pediatrics.

Medline Plus provides easy-to-understand information based on the latest medical research with links to pictures, related topics and other trusted sources.