Bronchiolitis is a viral illness that peaks around days three to five and then settles. Treatment is supportive: oxygen when saturation is persistently low, help with feeding or fluids, and gentle nasal suction where blockage interferes with feeding.
Salbutamol, nebulised adrenaline, corticosteroids and antibiotics do not change the course in typical bronchiolitis and expose the infant to side effects. Chest X-ray and routine blood tests rarely alter management. Parents mainly need to know when to return.
- Give oxygen only when saturation is persistently below your unit's threshold.
- Support hydration by smaller, more frequent feeds, or nasogastric or intravenous fluids if intake falls.
- Avoid bronchodilators, steroids and antibiotics in typical bronchiolitis.
- Tell parents the cough may last two to three weeks and give clear signs that need review.
Why it matters
Unhelpful drugs in bronchiolitis are among the commonest low-value treatments in paediatrics.
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