Bronchiolitis

• Bronchiolitis starts like a simple cold. Your baby may have a runny nose and sometimes a fever (high temperature) and a cough
• After a few days your baby’s cough may become worse. Your baby’s breathing may be faster than normal, and it may become noisy. Your baby may need to make more effort to breathe
• In very young babies' bronchiolitis can sometimes cause them to have brief pauses in their breathing (we call these apnoeas)
• If your baby is working harder to breathe it can make it harder for your baby to feed. They may take less milk than normal from the breast or bottle. Your baby may have fewer wet nappies than usual.

• If your baby is finding it hard to feed, try breastfeeding more often or giving smaller bottle feeds more often
• If your baby has a fever, you can give them paracetamol (such as Calpol). Follow the instructions that come with the paracetamol carefully.
• Your local pharmacist can help you know when to give your baby paracetamol and how much paracetamol to give. Do not give paracetamol to babies under 3 months of age unless your doctor or a health professional has told you to
• Too much paracetamol can be harmful. If you think your baby has had too much paracetamol call NHS 111
• You should carry on giving any medicines or inhalers that your baby usually takes. If you find it hard to get your baby to take them, ask your doctor for advice
• Bronchiolitis is caused by a virus. Antibiotics will not help a viral infection. Most children with bronchiolitis do not need antibiotics.
• Occasionally children with bronchiolitis can become unwell with another illness. Get medical advice if your child was getting better but has a new fever or is getting worse
• Call your GP or NHS 111 to get medical advice

Make sure your baby is not exposed to tobacco smoke. Passive smoking can seriously damage your baby’s health. It makes breathing problems like bronchiolitis worse.

If you would like help to give up smoking you can get information / advice from your local pharmacist, GP surgery or by calling the Quit Your Way Scotland helpline on 0800 84 84 84 Mon-Fri 0800-2200 and Sat-Sun 0900-1700.

• Most children with bronchiolitis will seem to get worse during the first 1-3 days of the illness. They often begin to improve over the next two weeks. The cough may go on for a few more weeks.
• Your child can go back to nursery or day care as soon as he or she is well enough (feeding as normal and with no difficulty in breathing)
• If you are worried your child is unwell or is not getting better see your doctor

The chart above show how long bronchiolitis lasts in children. The faces represent 10 children who have bronchiolitis. Green faces are those children who have recovered within that time period.
Diagram taken from www.whenshouldiworry.com

Use the table below to know when and where to get help for your child.

If your child has any of the following signs: Your child has blue lips Your child has pauses in their breathing, your child has an irregular breathing pattern or your child starts grunting Your child is finding it very hard to breathe – your child is too breathless to feed Your child is pale, mottled (blotchy skin) or feels cold to touch Your child is hard to wake up or your child has difficulty staying awake Your child is very distressed, and you cannot settle them Your child is taking less than 50% of their feeds (milk). See the feeding advice for more detail Your child is under 3 months of age with a new temperature of 38°C (100.4°F) or above (unless within 48 hours of vaccinations)

You need help now. Go to the nearest Hospital Emergency Department or phone 999

If your child has any of the following signs: Your child has fast breathing, or your child is working hard to breathe – sucking in their tummy, at their neck or between their ribs (recession). Your child has signs of dehydration including: your child has sunken eyes, no tears when crying, a sunken soft spot or your child has not had a wet nappy for more than 12 hours Your child is drowsy (very sleepy) Your child is only taking 50-75% of their feeds. See the feeding advice information for more detail Your child was getting better but has a new fever (temperature above 38°C) within the same illness Your child has a fever that has gone on for more than 5 days Your child is getting worse or if you are worried

You need to speak to a doctor or nurse today. Phone your GP surgery or call NHS 111 - dial 111

If your child has none of the above signs	Self care You can keep looking after your child at home. Phone NHS 24- dial 111 if you are concerned.

Content adapted with permission from the what0-18.nhs.uk resource produced by the Healthier Together initiative