Bronchiolitis is respiratory tract infection which causes inflammation and blockage in the bronchioles.This condition is a common cause of shortness of breath in baby and kids age 2 years and under.
Bronchioles are the smallest respiratory passages in the lungs. When bronchiolitis occurs, the bronchioles experience swelling and inflammation. It also causes excess mucus production in the respiratory tract.
Given the small size of the bronchioles, especially in children, bronchiolitis easily causes airway obstruction and obstruction of airflow in the lungs. Therefore, this condition often causes shortness of breath.
Causes of Bronchiolitis
Bronchiolitis is generally caused by: respiratory syncytial virus (RSV). This virus usually infects children aged 2 years and under, especially in the rainy season. Apart from RSV, influenza virus (virus that causes flu) and rhinovirus (the virus that causes coughs and colds) can also cause bronchiolitis.
The virus that causes bronchiolitis is highly contagious. Children can catch this virus if they accidentally inhale splashes of saliva from people who sneeze or cough because of the flu or coughing cold. Transmission can also occur if the child touches the mouth or nose with hands contaminated with the virus from the items around him.
The following are some conditions that can increase a child's risk of developing bronchiolitis:
- Have a weak immune system
- Born prematurely
- Less than three months old
- Never get breast milk
- Living in a crowded environment
- Suffering from lung or heart disease, such as congenital heart disease
- Frequent exposure to cigarette smoke
- Frequent contact with other children, for example at daycare
Symptoms of Bronchiolitis
Early symptoms of bronchiolitis are cough, runny or stuffy nose, and low-grade fever. A few days later, further complaints will appear, in the form of:
- Shortness of breath or seems difficult to breathe
- Wheezing
- Difficulty feeding or swallowing
- Movement looks sluggish or limp
- Continuous cough
- Vomiting due to cough
- Ear pain or discharge from the ear
When to go to the doctor
Bronchiolitis can last up to 2–3 weeks. Therefore, immediately consult your child to the doctor when he experiences:
- Difficulty breathing, for example breathing seems shorter and faster
- Breath sounds (wheezing)
- Difficulty breastfeeding
This is especially so if your child is under 12 weeks of age or has risk factors for bronchiolitis.
Do not delay taking your child to the doctor if there are signs of lack of oxygen or dehydration, for example:
- Blue nails and lips
- dry mouth
- Urinating less or less often
- Cry without shedding tears
Bronchiolitis Diagnosis
The doctor will ask about your child's complaints and medical history. The doctor will also ask if the child has previously interacted with other children or adults who are sick.
Next, the doctor will perform a physical examination by listening to the child's breathing rate using a stethoscope. An oximeter will also be used to measure the oxygen level in the child's blood.
If needed, the doctor can run additional tests, such as:
- Scan with X-Ray or CT scan, to detect signs of inflammation in the lungs
- Blood test, to measure white blood cell levels
- Sampling of mucus with a swab, to determine the type of virus that causes infection
Bronchiolitis Treatment
If your child has bronchiolitis that is not severe, the doctor will usually recommend home treatments, such as:
- Give enough breast milk or formula, if your child is under 1 year old
- Provide adequate fluid intake to children, can be by drinking water or electrolyte fluids
- Maintain the humidity of the children's room air, for example by installing humidifier
- Keep children away from air pollution, especially cigarette smoke
- Give nasal drops (saline water) to relieve nasal congestion and help the child remove mucus from the nose
- Give paracetamol or ibuprofen to relieve fever (if any) with the instructions for use according to the doctor's directions
Avoid using aspirin or cough and cold medicines that can be purchased at pharmacies, because these medicines are not recommended for children younger than 12 years.
If the child has severe shortness of breath or cannot eat and drink for 1 full day, treatment should be given to the hospital. During hospitalization, the child will receive the following therapies:
- Provision of nutrition and body fluids through infusion
- Giving oxygen to help the child breathe
Complications of Bronchiolitis
Bronchiolitis generally resolves with home treatment. However, bronchiolitis whose symptoms are quite severe can cause complications, such as:
- Dehydration
- Lack of oxygen in the blood (hypoxia)
- Blue lips and skin (cyanosis) due to lack of oxygen
- Shortness of breath (apnea) which generally occurs in infants with bronchiolitis who are born prematurely or are less than 2 months old
- Breathing failure
Bronchiolitis Prevention
As previously explained, bronchiolitis is a highly contagious disease. Therefore, the best way to prevent this disease is to minimize the risk of transmission. The methods include:
- Keep your baby or child away from people who are sick, especially if the child was born prematurely or is under 2 months old
- Wash your hands and your child regularly
- Asking others to wash their hands first before coming into contact with your child
- Keeping children at home if they are sick until they are completely healed
- Clean frequently touched objects, such as toys and children's chairs, regularly
- Avoid sharing your and your child's eating and drinking utensils with others
- Receive the influenza vaccine as directed by the doctor
- Keep children away from exposure to cigarette smoke