Bronchiolitis in infants is a viral illness that peaks around days three to five and usually settles within two weeks, though the cough can last longer. Established guidance from bodies including NICE and the AAP advises against routine salbutamol, adrenaline, corticosteroids, antibiotics and chest physiotherapy, because trials have not shown benefit.
Care rests on supporting feeding and hydration, giving oxygen when saturations fall below the local threshold, and gentle nasal suction when secretions obstruct feeding. Risk factors for severe disease include prematurity, age under three months, congenital heart disease and chronic lung disease.
- Avoid routine bronchodilators, steroids and antibiotics in typical bronchiolitis.
- Check feeding: intake below about half of normal is a common reason to admit.
- Give oxygen only when saturations fall below the local threshold, and wean it actively.
- Warn parents that symptoms often worsen before improving around days three to five.
Why it matters
Unhelpful treatments in bronchiolitis add side effects, cost and false reassurance.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for paediatrics, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free