Beware of bronchiolitis in babies

As the season of the sniffles begins, parents should keep a close eye on what may seem like the common cold in their little ones, but which could quickly develop into bronchiolitis. 

“Bronchiolitis is a common, acute viral infection of the small lower airways and typically affects infants younger than 24 months,” says Dr Palesa Monyake, a paediatric intensivist practising at Netcare Waterfall City Hospital. “This differs from bronchitis, which affects the larger airways of the lungs and normally occurs in older children and adults. While bronchiolitis can be mild, it often leads to difficulties in breathing and may require hospitalisation.

“This infection causes the lower airways to swell and become inflamed. Mucus then collects in these airways, making it difficult for air to flow freely into and out of the lungs. This usually results in coughing and a high pitched or musical sound known as wheezing. The illness may or may not be accompanied by fever. 

“If left untreated, bronchiolitis can cause a baby to become lethargic and dehydrated. The lack of oxygen can result in a blueish tinge to the skin and they may lose consciousness. An infant with suspected bronchiolitis should be taken to the doctor immediately if their breathing becomes fast or laboured, or if they struggle to breathe. It is also advised to seek medical help if the child has a chronic medical condition or is under the age of six months,” she adds.

RSV a common cause

According to Dr Monyake, respiratory syncytial virus (RSV) is an extremely common virus that can appear as a cold, but is a leading cause of bronchiolitis among children. Other viruses that cause the condition include rhinovirus, influenza virus, para-influenza virus and adenovirus. 

“Given how common RSV is, it can be difficult to avoid, particularly among young children. However, parents of babies can take steps to reduce exposure to the virus, which most commonly spreads through coughing and sneezing via airborne respiratory droplets.

“It can also spread through direct contact and via saliva on water bottles and shared utensils, for example. Bronchiolitis can recur, even in an infant who was infected with RSV previously, so prevention practices are highly recommended,” she points out. 

Dr Monyake suggests taking the following steps to prevent the spread of RSV and other illnesses to your baby:

• Wash your hands regularly. 

• Avoid contact with anyone in the family who may be ill with the common cold.

• Wear a mask around young children if you have the common cold.

• Breastfeed, as breastfed babies have a lower risk of developing RSV.

• Cover your mouth and nose when you cough or sneeze.

• Disinfect surfaces with sanitiser.

• Avoid sharing utensils. 

“Infants at high risk of contracting RSV, such as those born prematurely or with a heart or lung condition and those with decreased immunity, may be prescribed appropriate medication to reduce the risk of contracting RSV infections and bronchiolitis. Adults with high-risk infants at home are strongly advised to have the annual flu vaccine as a further precaution,” she says. 

When in doubt, seek help

Treatment for RSV is almost always symptomatic and may simply include an over-the-counter nasal spray for a blocked nose; however, it is important to watch closely for other symptoms and to consult your doctor if you suspect that your baby’s condition is worsening, notes Dr Monyake.

“While we hope it does not reach this stage, hospitalisation is not uncommon and it can be helpful to know what to expect. Should your child require hospitalisation, they will likely be put into an intensive-care or high-care unit where their breathing will be carefully monitored. 

“Depending on the level of respiratory distress, the appropriate respiratory therapy will be provided, which will often include a high-flow nasal cannula – this is proven to decrease the need for ventilation while supporting your child’s respiration.

“Once your infant has achieved a normal respiratory rate, is feeding well, no longer requires oxygen and their fever has subsided, they will be ready for discharge from hospital,” she concludes.

Looking for a medical appointment? Netcare appointmed™ will make appointments for YOU with specialists practising at Netcare hospitals, GPs and dentists at Medicross medical and dental centres, and specialists at Akeso mental health facilities. Simply request an appointment online or phone Netcare appointmed™  on 0860 555 565, Mondays to Fridays between 08h00 and 17h00.

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