Bronchiolitis
(a cause of persistent cough, mild fever and feeding difficulties in infants) Advice for parents and carers of children younger than 1 year old
If your child has any of the following:
- Has blue lips
- Has pauses in their breathing (apnoeas) or has an irregular breathing pattern or starts grunting
- Severe difficulty in breathing - too breathless to feed
- Becomes pale, mottled and feels abnormally cold to touch
- Becomes extremely agitated, confused or very lethargic (difficult to wake)
- Is under 1 month of age with a temperature of 38°C / 100.4°F or above
You need urgent help.
go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
- Has laboured/rapid breathing or they are working hard to breath – drawing in of the muscles below their lower ribs, at their neck or between their ribs (recession).
- Seems dehydrated (sunken eyes, drowsy or not passed urine for more that 12 hours)
- Is becoming drowsy (excessively sleepy)
- Is between 1-3 months of age with a temperature of 38°C / 100°F or above; or 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations).
- Seems to be getting worse or if you are worried
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS Wales 111
If none of the features in the red or amber boxes above are present.
Self care
Using the advice overleaf you can look after your child at home
- If your child is not feeding as normal offer smaller feeds but more frequently. Offer.........ounces every..........hours
- Children with bronchiolitis may have some signs of distress and discomfort. You may wish to give either Paracetamol or liquid Ibuprofen to give some relief of symptoms (Paracetamol can be given from 2 months of age). Please read and follow the instructions on the medicine container.
- If your child is already taking medicines or inhalers, you should carry on using these. If you find it difficult to get your child to take them, ask your Pharmacist, Health Visitor or GP. Bronchiolitis is caused by a virus so antibiotics will not help.
- Make sure your child is not exposed to tobacco smoke. Passive smoking can seriously damage your child’s health. It makes breathing problems like bronchiolitis worse.
- Remember smoke remains on your clothes even if you smoke outside.
If you would like help to give up smoking you can get information / advice from your local GP surgery or by calling the National Stop Smoking Helpline Tel: 0800 169 0 169 from 7am to 11pm every day.
Bronchiolitis is an infection that causes the tiniest airways in your child’s lungs to become swollen. This can make it more difficult for your child to breathe:
- Bronchiolitis is caused by virus infections.
- It is common in winter months and usually only causes mild cold like symptoms.
- Most children get better on their own.
- Some children, especially very young ones, can have difficulty with breathing or feeding and may need to go to hospital.
- Your child may have a runny nose and sometimes a temperature and a cough.
- After a few days your child’s cough may become worse.
- Your child’s breathing may be faster than normal and it may become noisy.
- He or she may need to make more effort to breathe.
- Sometimes, in the very young babies, bronchiolitis may cause them to have brief pauses in their breathing.
- If you are concerned see the traffic light advice overleaf.
- As breathing becomes more difficult, your baby may not be able to take their usual amount of milk by breast or bottle.
- You may notice fewer wet nappies than usual.
- Your child may vomit after feeding and become miserable.
- Most children with bronchiolitis will seem to worsen during the first 1-3 days of the illness before beginning to improve over the next two weeks. The cough may go on for a few more weeks. Antibiotics are not required.
- Your child can go back to nursery or day care as soon as he or she is well enough (that is feeding normally and with no difficulty in breathing).
- There is usually no need to see your doctor if your child is recovering well. But if you are worried about your child’s progress discuss this with your Health Visitor, Practice Nurse or GP or contact NHS 111.
This guidance is adapted from the National Healthier Together programme with permission
NHS 111 Wales
Website: NHS 111 Wales
NHS 111 Wales (Option 2) telephone service is available 24/7 and can be used for urgent mental health advice and support.
Meic
Website: www.meiccymru.org
Meic is the helpline service for children and young people up to the age of 25 in Wales. Chat online, freephone 080880 23456, or text 84001.
C.A.L.L. Community Advice Listening Line
Website: www.callhelpline.org.uk
Provides a confidential mental health listening and emotional support line which is open 24/7. Call 0800 132 737 or text ‘help’ to 81066.
Shout
Website: www.giveusashout.org
Text ‘shout’ to 85258 anytime, day or night.
Childline
Website: www.childline.org.uk
If you’re under 19 you can confidentially call, chat online or email about any problem big or small.
Samaritans
Website: www.samaritans.org/wales/samaritans-cymru/
Call 116 123 free, anytime, day or night.
Papyrus
Website: www.papyrus-uk.org
Are you, or is a young person you know, not coping with life? For confidential suicide prevention advice contact HOPELINEUK. We are open 9am–midnight every day.
Campaign Against Living Miserably (CALM) for men
Website: www.thecalmzone.net
Need help? Call our helpline 5pm-midnight, 365 days a year on 0800 58 58 58.
DAN 24/7 - Wales Drug and Alcohol Helpline
Website: www.dan247.org.uk/
Freephone 0808 808 2234, or text DAN to 81066.
NHS 111 Wales
Website: NHS 111 Wales
NHS 111 Wales (Option 2) telephone service is available 24/7 and can be used for urgent mental health advice and support.
Meic
Website: www.meiccymru.org
Meic is the helpline service for children and young people up to the age of 25 in Wales. Chat online, freephone 080880 23456, or text 84001.
C.A.L.L. Community Advice Listening Line
Website: www.callhelpline.org.uk
Provides a confidential mental health listening and emotional support line which is open 24/7. Call 0800 132 737 or text ‘help’ to 81066.
Shout
Website: www.giveusashout.org
Text ‘shout’ to 85258 anytime, day or night.
Childline
Website: www.childline.org.uk
If you’re under 19 you can confidentially call, chat online or email about any problem big or small.
Samaritans
Website: www.samaritans.org/wales/samaritans-cymru/
Call 116 123 free, anytime, day or night.
Papyrus
Website: www.papyrus-uk.org
Are you, or is a young person you know, not coping with life? For confidential suicide prevention advice contact HOPELINEUK. We are open 9am–midnight every day.
Campaign Against Living Miserably (CALM) for men
Website: www.thecalmzone.net
Need help? Call our helpline 5pm-midnight, 365 days a year on 0800 58 58 58.
DAN 24/7 - Wales Drug and Alcohol Helpline
Website: www.dan247.org.uk/
Freephone 0808 808 2234, or text DAN to 81066.
- Try to stay calm.
- Tell them you are there for them and that you are not upset or angry.
- Tell them you are pleased they have told you they are having thoughts of harming themselves and that you are able to help them through this time.
- Listen to what they are saying even if they are venting anger or other negative emotions at you.
- Listen without interrupting.
- Validate their thoughts and feelings – they are real and important.
- Try to be emotionally available and present for your child.
- Once things appear to be settling please encourage your child to relax as the day/ evening progresses and make some suggestions for things you can do together to distract them from their thoughts (see below for some ideas).
- Try to proactively manage any potential conflicts or arguments within your immediate environment.
- Be mindful of excessive use of mobile devices but that young people really need to feel connected to others at times of distress.
If you are concerned that your child/ young person is at risk of harming themselves, please ensure the following:
- All medications (prescribed/ over the counter/ vitamins) are removed and/ or locked in a strong lockable medical box or locked cupboard. Medication needs to be stored in this way in all houses where the young person stays, including grandparents, foster carers, step parents and residential homes.
- All sharp objects, such as knives and razor blades, to be removed and/ or stored securely.
- Ensure the young person has not got a stock of medication or sharp objects in their room or amongst their property.
- Other environmental risks in your home should be considered, e.g. removing ropes, ties, dressing gown ties.
- Do not allow your child/ young person to go out alone or with friends during times of distress and when they are voicing thoughts of self-harm or suicide.
- Monitor your child/ young person’s mood and behaviour closely.
- Increase your presence and supervision of your child at home, if needed remaining awake or checking on them during the night.
- Ask them about thoughts of self-harm and suicide.
- ​​​​Look out for any warning signs in your child/ young person that they might be struggling.
- Distract yourself - watch a film or TV programme, play a computer game that absorbs your mind, or read a book you’re really interested in
- Get creative – drawing, mindful colouring, taking photos, listening to music, singing
- Get moving – walk, run, dance, do an exercise or yoga video
- Comfort yourself – have bubble bath or shower, eat something you like, stroke a pet, cuddle up tightly in a blanket, rock/ hug yourself, spray a favourite perfume
Alternatives to self-harm when the urge to harm is very strong:
- Hold ice in your hand for as long as you can
- Step under a cold shower briefly
- Run your hands under cold water
- Snap an elastic band against your wrist
- Hit a cushion against the wall or bed
- Punch a punch bag or pillow
- Go for a fast paced walk or run up and down the stairs several times
- Tear or scrunch up paper