In plain words
Bronchiolitis is an infection of the smallest airways in the lungs, the bronchioles. It is most common in babies under one year, and it peaks in winter. The most frequent cause is respiratory syncytial virus, known as RSV. Babies with bronchiolitis may have a runny nose, a cough, fast or noisy breathing, and trouble feeding. Some babies need hospital care for oxygen or fluids. Most recover at home over one to three weeks. Parents often find the wheezing and fast breathing frightening. Signs that breathing is hard, such as the ribs pulling in with each breath, or that a baby is not feeding or wetting diapers, need prompt medical attention. Antibiotics do not work against this virus.
The deeper version
Bronchiolitis is a lower respiratory tract infection, typically in children under two, with inflammation and obstruction of the small airways. Respiratory syncytial virus accounts for most cases, with human metapneumovirus, rhinovirus, and others also implicated. Seasonal peaks follow local RSV circulation, usually in winter. The AAP clinical practice guideline (Ralston and colleagues, Pediatrics, 2014) recommends clinical assessment and supportive care, and advises against routine chest radiography, bronchodilators, corticosteroids, and antibiotics in uncomplicated cases. Since 2023, CDC and ACIP have recommended a monoclonal antibody for infants in their first RSV season, with eligibility set by the recommendations. Hospitalization is most common in infants under six months and in those with prematurity or chronic lung disease.
Where it comes up
- Newborn breathing, congestion, and the noseBaby Basics
- When to call the pediatrician (and when to go in)Baby Basics
- Fever in a newborn is an emergencyBaby Basics
- Vaccines: the baby's schedule and who around the babyBaby Basics
- Pediatrician visits in the first weeksBaby Basics
What mothers here say about bronchiolitis
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Sources
- Ralston SL and colleagues, American Academy of Pediatrics — Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis. Pediatrics, 2014
- Centers for Disease Control and Prevention — RSV in infants: prevention and treatment information for families