Time Of Bronchiolitis…

By Jorge De Diego, MD
Pediatrician and Medical Director
Doral Medicine Associates

Now, that school started and infants are returning to their respective Day Care Centers their association with other sick children may bring about a series of common respiratory problems for children and, one of them is Bronchiolitis. This condition mainly occurs during the winter and early spring, and it affectes the entire respiratory tract, including the bronchioles for which is named after.

Bronchiolitis usually begins as a cold often with symptoms of fever, runny nose and nasal stuffiness as well as poor appetite or we may see some difficulty with sucking in some infants. After 2 to 4 days, the virus spreads to the bronchioles, causing irritation and narrowing of the air passages. This results in a whistling sound (wheeze) when breathing out. Bronchiolitis usually goes away by itself.

Bronchiliolitis is usually mild and the child gets better after 3 to 4 days. However, sometimes the infection is more serious and admission to the hospital is required. There maybe several different viruses that causes colds and flu-like illnesses but, the RSV is the most frequent one being followed by the parainfluenza viruses.

Young children catch these viruses during close contact with older children, as well as family members and others who are infected, but often have mild illnesses. The virus is spread directly to the mucus membranes whan an infected person sneezes or coughs into anothers face. It can be spread indirectly by the hands that touch contaminated toys or tabletops (known as fomites) and subsequently touching their eyes or noses. The illness begins in approximately 3 to 7 days later..

Because the virus causing bronchiolitis can be spread to others and if the child is hospitalized due to deteriorating conditions an isolation sign shall be posted to remind others of precautions. The same precautions shall be utilized at the house if  a diagnosis is made to your child.

The following shall be followed:

1. Strict handwashing techniques by everyone in the family and the sharing of toys and objects shall be prohibited

2. If the child is hospitalized it is in the best interest and in part is a reuirement to wear gloves and gowns to prevent direct contact of the skin and clothing with respiratory secretions and contaminated surfaces. It may not be a bad idea to follow the same isolation precautions at home so as to avoid propagation of the disease.

As far as feeding, most babies are offered a regular formula or breast milk. Liquids and fluids are one of the most important things needed by a baby with bronchiolitis. We all need to gauge the breathing of the child and make sure that they are breathing comfortably. When babies have bronchiolitis, the nose often gets plugged. This can make it hard to breathe while eating. Often the nose of an infant with bronchiolitis will be suctioned before being fed. Sometimes it is hard to suction mucus from the nose because it is very thick. When this happens, a little bit of saltwater such as saline nose drops re dropped into the nose before suctioning. Learn how to use a bulb suction to obtain the result desired.

Some children with brionchiolitis may need to be hospitalized and be followed closely with their respiratory status and some may require the use of oxygen and be followed by the respiratory therapists and be assesed by a machine called pulsioximeter for his oxigenation status. As we stated before bronchiolitis usually goes away by itself. If the child may present with fever a non aspirin fever reducer may be used, Medicines such as bronchodilators may be tried and may work on a baby with bronchiolitis.

Even if the baby was hospitalized and discharged, it maybe normal for the child to have the symptoms for a few days, the whistling sound or wheezes usually gets better in 2-5 days. But, the stuffy nose and cough may last for 1 to 2 weeks. Sleeping and eating routines may not return to normal for 4 to 7 days.

  1. Let us make sure that no one smokes in the house this could b detrimental for a child with bronchiolitis.
  1. Also, be sure to wash your hands frequently specially when handling the infant. Use saltwater nose drops and suction your baby’s nose if stuffy and if plugged up before feedings or putting your baby down to sleep. You can buy saltwater nose drops at any drug store and follow the instructions.
  2. Do not give decongestant nose drops or any antihistamines or other cold medicines unless told by your Pediatrician. Always consult with your health care provider for any question or questions that you may have in reference to your child’s health.

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