Feb 10, 09 | Posted by: Kristin Bencik Boudreau, D.O.

Bronchiolitis- No, it is NOT Bronchitis

Bronchiolitis is here – and no, it is not the same as bronchitis! If you imagine the tubes in your airway as a tree, the trunk of the tree is the bronchus, and the tiny tubes are the bronchioles.  Adults and adolescents get bronchitis, or an inflammation of the main trunk of the airway. Bronchiolitis is an inflammation of the twigs or bronchioles, and because the bronchioles are tiny in infants, they swell and get clogged with mucus and essentially become clogged.  Young children, especially infants, will present with a very wet cough, copious nasal secretions, and wheezing.  In addition, they can run a fever, they never eat because they can’t breathe, and they are really fussy.   Bronchiolitis is classically caused by a virus called RSV, or respiratory synctial virus, although other viruses can also do it.  Adults and older kids can get RSV, but in them it is just a bad cold.

Bronchiolitis is a pediatrician’s nemesis, because although the kids are so sick, there really is not much we can do to help.  It is a virus, so antibiotics do not help.  The mainstay of treatment is trying to manually clear the secretions with the bulb suction and saline.  Yes, your baby will hate it and cry but it really does help.  Infants are unable to blow their noses and clear the secretions.  The other things that help are keeping their heads elevated and running a humidifier.  Babies like to breathe through their noses, so eating is a real challenge with bronchiolitis.  Small frequent feeds are the best, and giving extra fluid with Pedialyte is also very helpful.  Tylenol may be given depending upon the age of the infant, talk with your doctor first.  At your visit, we will often try a nebulizer, because it helps about half the time.

Bronchiolitis is bad not only because kids are miserable for weeks, but they can also get sick enough to end up in the hospital.  Most at risk for serious bronchiolitis are premature infants, although healthy infants can also become quite ill.  Symptoms to look for to bring your infant in immediately are any signs of respiratory distress- respiratory rate greater than sixty times per minute, nasal flaring, or retractions of the ribs.  Symptoms of dehydration such as no wet diapers for greater than eight hours or very sunken eyes should also be seen.  Finally, if you have an infant under the age of eight months, they should always be seen with any illness.  Please always err on the safe side and call you doctor with any questions on bronchiolitis.

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