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12 things every parent needs to know about bronchiolitis

Though usually mild, the lung infection can lead to hospitalisation. Lisa Salmon points out the symptoms when 'it's more than a cold'

As well as being the peak season for coughs and colds, this time of year is when babies and young children often succumb to the common - but potentially more serious - lung infection bronchiolitis.

During their first year of life, around a third of children in the UK will develop bronchiolitis - in which a virus causes inflammation of the small airways in the lungs (bronchioles). And with initial symptoms like a blocked or runny nose, cough and slightly high temperature, the illness is often mistaken for a cold.

But it is 'more than a cold' - also the name of a bronchiolitis information campaign - and although the illness is mild in most cases, it can sometimes cause life-threatening lung infections in young children.

Dr Su Laurent, a consultant paediatrician at Barnet Hospital, points out that it leads to around 45,000 paediatric hospital admissions in England alone every year, of which up to 6% will end up in intensive care.

She says: "Bronchiolitis infections can occur any time of year, but the lead up to Christmas is a particularly bad period. Last December, I saw a lot of babies coming in to hospital for treatment and we've already treated a large number of babies this autumn.

"Coughs and sniffles are really common around the festive period - so it's important for parents of babies to be mindful of the symptoms of bronchiolitis".

Here are 12 things every parent of young children should know about bronchiolitis:

1. Distressing symptoms

Initial symptoms of bronchiolitis are a runny nose and a cough, and further symptoms which usually develop over the next few days include a slightly high temperature, dry and persistent cough, rapid or noisy breathing (wheezing), brief pauses in breathing, difficulty feeding, having fewer wet nappies, vomiting after feeding and being irritable or floppy.

"When a child is unwell, it's understandable that parents will be worried. Although symptoms can be distressing to witness, they are usually mild and bronchiolitis can generally be managed at home," says Dr Laurent.

2. Highly contagious virus

The main cause of bronchiolitis is the very contagious respiratory syncytial virus (RSV), and Dr Laurent warns: "It's important to remember that bronchiolitis is caused by a viral infection so in the majority of cases antibiotics aren't needed."

3. Restricted air

When the bronchioles become inflamed as a result of the RSV, they restrict the amount of air that can enter the lungs, making it more difficult for children to breathe.

4. Rapid breathing

In some cases, bronchiolitis can become severe and cause children to struggle to breathe - their breathing rate can increase to 50-60 breaths a minute or they may develop a temperature of 38°C (100.4F) or higher. If these symptoms occur, medical attention should be sought.

5. Widespread infection

Bronchiolitis most commonly affects babies between three and six months of age, but by the age of two, almost all infants will have been infected with RSV and up to half will have had bronchiolitis.

6. Worse in winter

The illness is most widespread during the winter (from November to March), and the annual peak around the end of November and beginning of December is when the temperature's low and the relative humidity is high.

7. Repeat infection

It's possible for a child to get bronchiolitis more than once during the same season.

8. Prematurity risk

Babies are at greater risk of developing severe bronchiolitis if they were born prematurely (at less than 37 weeks), are under 12 weeks old or were born with a heart or lung condition.

9. Get medical advice

The NHS advises parents to call a doctor or dial 111 if they're worried about their child, if he/she has taken less than half their usual amount during the last two or three feeds, if they've had a dry nappy for 12 hours or more, if they have a persistent high temperature of 38C or above, or if they seem very tired or irritable.

10. It's an emergency...

Dial 999 if your baby is having difficulty breathing, his/her tongue or lips are blue, or there are long pauses in your baby's breathing.

11. Home care

There's no medication to kill RSV, but the infection usually clears within two weeks without treatment, and most children can be cared for at home in the same way that you'd treat a cold - so by drinking plenty of fluids, and taking children's paracetamol or ibuprofen to bring down their temperature.

12. Good hygiene

To prevent the spread of RSV, parents and carers need to adhere to basic hygiene rules and should wash their hands regularly with soap and water. Everyone, including older children, should cover their nose and mouth when they cough or sneeze near the baby and babies should be kept away from other people who show signs of a cough or cold, while toys should be washed or wiped regularly to prevent the spread of germs.

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