Bronchiolitis and RSV

Bronchiolitis and RSV

Bronchiolitis is an infection that causes the small airways in your child’s lungs to
become swollen. This can make it more difficult for your child to breathe.

● Bronchiolitis affects children under the age of 2. It is caused by a virus, often
the Respiratory Syncytial Virus (RSV).
● The number of children with RSV and other viruses is usually highest in winter but bronchiolitis
can happen at any time of year. 
● Bronchiolitis usually causes cold like symptoms and mild breathing difficulty.
Breathing may be faster than normal as well as noisy and your child may not
be able to take their usual amount of milk by breast or bottle.
● Your child may get a little worse each day until the 3rd or 4th day of their
illness after which they are likely to start improving.
● Most children get better on their own. There are no medical treatments that
speed up recovery from bronchiolitis. Many children will continue to cough for
a few weeks afterwards.
Some children, especially those under 6 weeks of age or young children with heart
or lung problems, can develop worse breathing difficulty and may need to go to
hospital for help supporting their breathing and feeding.

Watch a  GP and health visitor talking about what they would look out for in a child with a cough and cold:

Many thanks to ASKSNIFF for providing the clips of abnormal signs.


If your child has any of the following:

● Breathing very fast or breathing that stops or pauses
● Makes a grunting noise every time they breathe out
● A harsh noise as they breathe in (stridor) present all of the time (even when
they are not upset)
● Becomes pale, blue, mottled and/or unusually cold to touch
● Difficult to wake up, very sleepy or confused
● Weak, high-pitched, continuous cry or can’t be settled
● Has a fit (seizure)
● Is under 3 months old with temperature more than 38°C or under 36°C
(unless fever in the 48 hours following vaccinations and no other red or amber
● Has a rash that does not go away with pressure (the ‘Glass Test’)

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

● Working hard to breathe, drawing in of the muscles below the ribs
● A harsh noise as they breathe in (stridor) only when upset
● Dry skin, lips or tongue
● Not had a wee or wet nappy in last 8 hours
● Poor feeding in babies (less than half of their usual amount)
● Irritable (Unable to settle them with toys, TV, food or hugs even after their
fever has come down)
● Is 3-6 months old with temperature 39 o C or above (unless fever in the 48
hours following vaccinations and no other red or amber features)
● Temperature of 38 o C or above for more than 5 days or shivering with
● Temperature less than 36°C in those over 3 months
● Getting worse or you are worried about them

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 Wales - dial 111

If symptoms persist  and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.

If your child has none of the above

● Watch them closely for any change and look out for any red or amber
● Additional advice is also available for families for help cope with crying in
otherwise well babies
● If your child has a long term condition or disability and you are worried please
contact your regular team or follow any plans that they have given you.

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 Wales – dial 111

What can you do? 

● Most babies and children can be safely cared for at home.

● Bronchiolitis can get worse before it starts to get better. Babies and children
are often most poorly on day 5 of the illness then start to get better.

● Keep a close eye on your baby's breathing and feeding. If you have any new
concerns, please look at our red/amber/green table again.

● If your child is not feeding as normal, offer smaller feeds more often.

● Children with bronchiolitis may have some distress and discomfort. You may
wish to give either Paracetamol or Ibuprofen to make them feel better
(Paracetamol can be given from 2 months of age). Please read and follow the
instructions on the medicine container.

● Bronchiolitis is caused by a virus so antibiotics generally don’t help.

● Although you should continue to place your baby on their back to sleep, you
can tilt the head of their cot upwards to help their breathing. You can do
this by raising the cot legs on blocks or putting a pillow under the mattress.
Remember never put a pillow or cushion under your baby's head as this is

● Avoid co-sleeping with your baby if they are unwell with bronchiolitis or a
respiratory tract infection. For more information, see our safe sleeping page.

● Avoid exposure to tobacco smoke which makes their breathing worse.
Remember that smoke stays on your clothes even if you smoke outside. 

● If you would like help to give up smoking you can get information and advice
from your local GP surgery or by calling the National Stop Smoking Helpline
Tel: 0300 123 1044 from 7am to 11pm every day.

How long does bronchiolitis last? 

Babies are usually unwell for 5 to 10 days. Most will get better within two weeks.
Babies may still have a cough for up to 4 weeks afterwards and this is completely
Your child can go back to nursery as soon as you feel they are well enough.
Bronchiolitis does not normally cause long term problems for your child

Improving the physical and emotional health and wellbeing of expectant mothers, infants, children and young people throughout Aneurin Bevan University Health Board Area.

(N.B: The Family and Therapies team at ABUHB is NOT responsible for the content on the webpage links that we refer to in our resource sections and linked information to external sites. All information was accurate and appropriate at the time the webpage was created.)

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