Solve the 10 major doubts of baby bronchiolitis and how to prevent it

Bronchiolitis takes its toll on the health system every season, most notably last fall, when infections rose sharply, leading to a large number of hospital admissions and visits.

This year, we will have a tool to prevent that: an antibody that will be given to babies under six months old to protect them. For parents who want to know more about this infection, the Andalusian Vaccination Program (Andavac) can address these questions:

What is Bronchiolitis?

Bronchiolitis, an inflammation of the smaller branches of the bronchi, can cause obstruction and difficulty breathing in infants. When you breathe, air flows through the airway, whether you inhale or exhale: the trachea divides into two bronchi, left and right, which continue to divide into narrower and narrower tubes until they reach smaller ones. bronchioles, and finally to the final destination – the alveoli.

In which part of life is bronchiolitis most common?

It is more common in younger children (under 2 years), especially those under 6 months.

Is bronchiolitis common?

This happens fairly frequently, especially during the first year of life, and the vast majority of babies eventually experience it, although with varying degrees of involvement. It is known that one in five boys and girls will end up in hospital with bronchiolitis sometime in the first year of life.

What is the cause of bronchiolitis?

The virus that most often causes bronchiolitis is respiratory syncytial virus (better known by its acronym RSV), which is more common in Spain during the colder months (November to March). It is known that 60-70% of bronchiolitis cases are caused by this virus.

There are other viruses that can also cause bronchiolitis, such as rhinovirus, metapneumovirus, adenovirus, bocavirus, etc.

What are the common symptoms of bronchiolitis?

Most bronchiolitis is mild, presenting as a cold or flu, and resolves within a few days. Other times, when a child has runny nose and cough for 3-4 days, he will start to have trouble breathing and chest “wheezing.” You may also develop low-grade or feverish fever, loss of appetite, vomiting mucus, or difficulty eating.

Bronchiolitis can be a serious condition in premature infants, infants younger than 3 months, and children with heart, respiratory, muscle, or immune system problems (compromised defenses).

How is Bronchiolitis Diagnosed?

Usually the diagnosis is clinical, that is, by recognizing the patient’s symptoms and signs, without the need for tests such as blood tests, mucus tests, or chest X-rays.

These supplemental tests and others are only done if complications are suspected, usually during admission to the hospital.

What is the treatment for bronchiolitis?

Most cases last about 7-10 days (although the cough may last longer), and as with almost all viral infections, treatment is symptomatic, ie aimed at reducing the most bothersome symptoms:

Rinse your nose with saline or a saline solution to remove mucus.

Place the baby in a semi-recumbent position with the headboard raised to help him breathe better.

Drink water frequently to avoid dehydration and to promote mucus flow and better drainage.

Your baby may have a poor appetite and be anorexic. Opportunities should be offered to you less and less. Therefore, if you breastfeed, you should breastfeed more often.

If you have a fever: Avoid overdressing your child. Paracetamol can be taken in the dose recommended by your doctor.

Antibiotics (which don’t work on viruses), cough syrup, mucolytics, or corticosteroids don’t help. Medications not prescribed by a doctor should not be used.

Can bronchiolitis get serious?

Fortunately, most children with bronchiolitis do not develop complications, although in most cases they may have bothersome symptoms for a week.

Sometimes, bronchiolitis can be complicated, eg: marked respiratory distress, hypoxia, difficulty eating, dehydration, pulmonary complications (bacterial pneumonia, atelectasis, pneumothorax…), bacterial infection in the blood, etc.

These complications usually lead to the admission of the patient to a hospital ward or to an intensive care unit, where oxygen, intravenous fluids, antibiotics, nasogastric tube feeding, etc. are given, depending on the case, by different more or less invasive techniques.

When should I see a doctor if I have bronchiolitis?

Monitoring and consultation with a doctor is recommended if your baby:

– He has trouble breathing: rib marks when breathing, swollen abdomen, loud chest (he has a “whistle”) and/or rapid breathing.

– He is pale and/or has bluish lips and nails.

– Apnea (stop breathing for a few seconds).

-He “moans” or is very agitated.

– He is depressed and doesn’t want to eat. Frequent vomiting.

-He has a high fever, which is difficult to control.

How to prevent bronchiolitis?

During the campaign period 2023-2024, in Andalusia, the monoclonal antibody Nirsevimab will be used systematically in children under six months and in some high-risk cases. RSV is highly contagious. It spreads through the saliva and mucus of an infected person:

-Aerosols or droplets produced when breathing, coughing, sneezing…

– Touching surfaces or objects on which RSV can stay for hours (pacifiers, toys…) and then touching the mouth, nose or eyes.

– The main common measures to reduce the risk of viral transmission are:

– Use disposable tissues

– Wash your hands frequently.

– Do not take children to day care when sick.

– Prevent adults with respiratory infections, even minor colds, from approaching children.

-Avoid smoking and crowded environments.

-Breastfeeding helps prevent viral infections such as bronchiolitis.

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