So now that I have gone through what is NOT helpful for bronchiolitis, you might be asking, “Is there anything that is helpful if my kid has bronchiolitis?” The short answer is YES and the good news is that most of the things can be done at home without a prescription or visit to the doctor’s office.
Having the Right Expectations
Understanding the expected time-course of bronchiolitis is the first thing you need to know when it comes to the treatment of bronchiolitis at home. Bronchiolitis is typically a 7-10 day illness. That’s right! If your child has bronchiolitis you can expect that they will probably be sick for about 7-10 days. The overall course is very typical – mild symptoms on the first day with slightly worse symptoms each day. The worst day is typically day 4, after which things slowly improve.
When you are evaluating your child at home it is important to know where they are in the course of their illness. If your child is really struggling with the congestion and not eating well and it is only day 2 of illness, you can expect that things will probably get worse. You will need to work extra hard to treat your baby’s congestion and avoid dehydration. You will need to keep a close eye on their breathing and may need to see your doctor if you think dehydration or low oxygen levels are an issue. On the other hand, if you are on day 5 of illness, the worst is probably behind you. You may be exhausted from all the sleepless nights, but you are probably in the clear.
What to Do?
Small Babies
Babies less than one month of age do not handle bronchiolitis well. If you think your newborn has bronchiolitis, you should contact your doctor. Because newborns are so unpredictable and hard to evaluate, we tend to follow them a little closer than older children. Also remember that small babies (less than 3 months) should not have fever. If your small baby has a fever, they need to be evaluated by a physician.
Nasal Congestion
As I mentioned before, nasal congestion is the biggest problem for most kids with bronchiolitis. Read my page on treating nasal congestion to learn more. Remember that you should only treat the congestion if it is causing your baby some sort of problem like: difficulty eating, breathing, or sleeping. Do not torture your baby with nasal saline and suction just because it sounds bad.
Dehydration
As I mentioned previously, many babies find it difficult to feed well when they have lots of congestion. Breast milk is always the preferred way to keep your baby hydrated. You should make every effort to continue to nurse as normal. If you find that baby is having trouble, you should first try to relieve the nasal congestion. If that does not work you might consider pumping, and letting baby feed through a bottle. If this does not work, you might consider diluting the breast milk with pedialyte. If things are still not working out, consider a trial of straight pedialyte. Often babies who are having trouble nursing will be able to drink pedialyte because it requires so much less work.
Difficulty Breathing
All babies with bronchiolitis will have some increased work of breathing. Mostly this is related to nasal congestion. If you think your baby is having trouble breathing, you should attempt to treat the nasal congestion. You may have to repeat this every few hours especially in the first few days of illness. If, despite adequate attempts to treat the nasal congestion, you still feel like your baby is having difficulty breathing, then a trip to the doctor is in order.
Fever
Remember, fever in babies less than 3 months always requires evaluation. However, it is not uncommon for babies to have a low-grade fever (less than 102) when they have bronchiolitis. If your baby is over 3 months old, you might try treating the fever if you feel like they are having trouble with any of the things above. Click here to read more about fever.
When to see the Doctor?
Mom always knows best when it comes to the health of her baby. You spend all day with your baby and you know best. However, remember to control parental anxiety and attempt to care for your baby at home if at all possible. If despite a reasonable attempt to take care of your baby at home you do not feel like things are going well, call your doctor. Remember though, when you see the doctor there is unlikely to be any magic bullet to fix the symptoms of bronchiolitis. For the most part you are seeing your doctor to evaluate for dehydration, low oxygen levels, or to rule out some other more serious illness. Breathing treatments, steroids, and antibiotics do not have a role in the treatment of routine bronchiolitis.
Remember… I am not YOUR doctor!!!
Some people mistakenly think that they can use the internet as a resource for the medical treatment of their children when they are acutely ill. Let me be clear that I am not your doctor and I am not dispensing medical advice for your child. I am simply providing you with useful information to use in collaboration with your own health care provider.
Since this Blog is about Smart Parenting, let me also be clear that attempting to take care of your sick child based solely on any internet information is a BAD idea. The information you will find here and other places is useful to educate yourself so your can have a more intelligent discussion with your own physician.
Related Posts:
Breathing Treatments for Bronchiolitis
How do you think Smart Water compares to pedialyte? My kids have never liked anything strong tasting or sweet so I’ve used Smart Water instead.
My son had bronchiolitis at 3.5 months and we ended up in the hospital. His O2 levels were never that bad…he was just working REALLY had to breathe. He is now 5.5 months old and caught a cold that resulted in more wheezing, congestion. His initial symptoms never completely cleared before he caught that cold. He is eating just fine and sleeping well, but has a pretty chronic stuffy nose, junky lungs, and cough. We are doing everything we were told: saline, suction, steam, humidifier, propped crib. I’m curious if you have experience babies continuing to have this congestion/coughing for up to 2 months after the initial onset of bronchiolitis. What is the expectation that it will completely clear up? When should we see a pulmonologist? Thanks!
It is very common for some of the symptoms of bronchiolitis to persist for weeks after the original infection. The congestion and cough are often the last to go away. Even though it may seem that his cough is “deep” (or in his lungs), the reality is that it is probably just congestion in the back of his nose that this causing all the trouble. Kids with this kind of thing down in their lungs, generally have low oxygen levels and lots of trouble breathing. Thus it is doubtful that this is a lung problem.
During the first of year of life many kids will get 10-12 “colds” This gives the appearance of being sick constantly when in reality it is many back to back illnesses. This is particularly true if your son is around any other kids and during the winter months. If you son is able to eat, sleep, gain weight, and meet his developmental milestones, I would not worry too much about it. You are doing all the right things and things will probably be better now that the winter season is over.