Bronchiolitis is a clinical diagnosis in infants with coryza, cough and crackles or wheeze, usually from respiratory syncytial virus. Treatment is supportive.
What helps: oxygen when saturations stay below about 90 to 92%, nasogastric or intravenous fluids when feeding falls below half the usual intake, and nasal suction before feeds in some infants. High-flow nasal cannula is a rescue option for those failing standard oxygen.
What does not help in routine cases: salbutamol, adrenaline nebulisers, steroids, antibiotics and chest physiotherapy. Chest X-rays and blood tests rarely change management.
Admit infants with apnoea, severe recession, poor feeding or saturations persistently low, and take extra care under three months, in preterm babies and those with heart or lung disease.
- Give oxygen only when saturations stay below about 90 to 92%
- Support feeding with nasogastric fluids when intake falls below half
- Avoid routine salbutamol, steroids, antibiotics and X-rays
- Admit young, preterm or comorbid infants with a lower threshold
Why it matters
Unnecessary treatment in bronchiolitis adds side effects and antibiotic pressure without helping the child.
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