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Parent’s Guide

Parent’s Guide: Bronchiolitis & RSV

Diagnosis: Bronchiolitis is an infection of the smallest air passages in the lungs (bronchioles). Cause: It is usually caused by a virus called RSV (Respiratory Syncytial Virus). Who gets it: It is most common in children under 2 years old (peak age is 6 months).

1

🔎What Does It Look Like? (Symptoms)

Bronchiolitis often starts like a common cold (runny nose, mild fever) but moves into the chest after a few days.

  • Wheezing: A high-pitched whistling or purring sound usually heard when your child breathes out.
  • Rapid Breathing: Breathing faster than 30 breaths per minute in toddler/older child, or greater than 40 breaths per minute in infant
  • The “Work” of Breathing: Your child looks like they are exercising just to breathe.
  • Wet Cough: A deep cough, often bringing up sticky mucus.
2

 🚨 When to Get Help

Breathing trouble can change quickly. Use this checklist to know when to act.

Call 911 Now

  • Severe Struggle: Child is struggling for every breath, or can barely speak/cry.
  • Color Change: Lips or face turn blue or gray when not coughing.
  • Consciousness: Child has passed out or stops breathing.
  • State: You think this is a life-threatening emergency.

Call Doctor Now or Go to ER

  • Retractions: Ribs represent pulling in with each breath.
  • Stridor: You hear a new harsh/raspy sound when breathing in.
  • Worsening: Wheezing is tighter, or breathing is faster than when you last saw the doctor.
  • Dehydration: No wet diaper in 8 hours, dark urine, or dry mouth/no tears.
  • Age/Fever:
    • Baby is less than 12 weeks old with a fever (>100.4°F / 38°C).
    • Baby is less than 6 months old and acting sick.
  • High Fever: Fever over 104° F (40° C) in any age.

Contact in 24hrs

  • Fever lasts more than 3 days.
  • Earache or ear drainage develops.
  • Feeding is becoming difficult (drinking less than half of normal).
3

🏠 Home Care Advice

If your child is breathing comfortably enough to be at home, the goal is to keep the airways clear and the child hydrated.

1. The “Snot” Strategy (Suctioning) Babies are “nose breathers.” If their nose is clogged with RSV mucus, they cannot eat or sleep well.

  • Saline: Use saline (salt water) drops to loosen the sticky mucus. (2-3 drops per nostril).
  • Suction: Use a bulb syringe or nasal aspirator after the saline.
  • When: Do this before feedings and before sleep. Limit to 4-5 times a day to avoid irritating the nose.

2. Feeding Strategy Babies with RSV tire easily.

  • Smaller Meals: Offer small amounts more frequently. A full stomach can push on the lungs and make breathing harder.
  • Fluids: Keep them hydrated to thin the mucus.

3. Soothe the Cough

  • Steam: Run a hot shower in the bathroom with the door closed. Sit in the steam with your child for 10-15 minutes to loosen tight airways.
  • Honey (Age 1+ Only): ½ to 1 teaspoon of honey can thin mucus and calm the cough. Never give honey to a baby under 1 year.
  • Humidifier: Use a cool-mist humidifier in the bedroom.

4. Medication Reality Check

  • No Cough Syrup: Do not use OTC cough meds for young children. They don’t help RSV and can be dangerous.
  • Asthma Meds: Sometimes doctors prescribe Albuterol. Only continue using it if it actually helps the wheezing. If it doesn’t help, stop using it.
  • Antibiotics: Since RSV is a virus, antibiotics will not cure it.
4

What to Expect (The Timeline)

RSV/Bronchiolitis can be a long illness.

  • The Peak: Symptoms (wheezing/breathing) are usually at their worst on Day 3 to 5.
  • Improvement: Wheezing usually improves after a week.
  • The Tail: The cough can last up to 3-4 weeks.
  • Contagious: Your child is contagious for about 7 days after the cough starts.

Medically Reviewed by Dr Michael Villadelgado
Disclaimer: This information is for educational purposes only. You assume full responsibility for how you use it. If you are unsure, always call your doctor.