We usually post a blog about bronchiolitis in late October or early November. However, after it largely disappeared during the Covid lockdowns, with us all mixing again, bronchiolitis is on the rise much earlier in the Autumn than usual. We thought you'd appreciate a reminder as to what to look out for, and what to do if you suspect your little one has this common virus . . . over to Mini First Aid founder and director Kate Ball to explain how bronchiolitis affected her family:

It’s the time of year for streaming colds.  School & nursery children are merrily sharing their germs with each other and still needing reminding to ‘use a tissue’ and ‘cover your mouth’ and ‘don’t sniff like that’. Oh joy.

We all know how the common cold virus is spread - by coughs, sneezes transferred in the air and on our hands. That is why covering mouths when coughing and then washing hands  is so important. Whilst we know sometimes coming into contact with a cold is unavoidable, ask visitors to keep away if they have a cold, especially from babies.

Five of our babies have had bronchiolitis over the last few years. So what is it? What do you need to look out for? And why does the virus affect so many little ones?

Bronchiolitis is very common in the winter months. Bronchiolitis often starts with cold-like symptoms – a snuffly nose and slightly high temperature, and over the next few days will develop into a cough, wheezy chest and breathlessness. It is a viral infection and cannot be treated by antibiotics.

Bronchiolitis, most commonly the RSV (Respiratory Syncytial Virus) is an infection which affects infants lungs. Most children will have caught RSV by the time they are two. Most will have a cold-like illness and get better on their own.  However for some babies, the smallest air passages (bronchioles) in the lungs become moist and inflamed, leading to problems with breathing. Bronchiolitis is especially common in infants under one year of age. Your baby may struggle to keep any feeds down due to coughing and will need fluids, and sometimes-extra oxygen to help them breathe.  Something we are all too familiar with in our family.

What happens when you go to hospital?

We’d experienced bronchiolitis in our family before so when the baby twins were showing symptoms I called 111. They sent an ambulance to whisk us to children’s A & E. 

When you first arrive, we were ‘triaged’ which means you are allocated a level of need.

Triage identifies very sick children who need immediate medical review and intervention. This is why it can appear that other families are ‘jumping the queue’.  Your child’s level of need is based on a score given to heart rate, breathing, temperature and level of alertness – otherwise known as ‘observations’.

Medical professionals will do observations throughout your stay to indicate whether or not they need to be worried and escalate treatment.

Nurses will oversee your care; from making sure you are reviewed by the medical team at the right time, to getting hold of a breast pump or nappies. They provide invaluable emotional support and are a good listening ear during what can be an emotional journey.

You may be seen by a more Junior Doctor or highly skilled advanced Nurse Practitioner before being reviewed by the Registrar or Consultant.

ASK QUESTIONS. Don’t be scared to ask what staff mean if they use ridiculous words or if you think something hasn’t been clearly explained.

·      What do you think is going on?

·      Are you worried about them?

·      What is preventing us from going home?

The twins were admitted and given their milk by an NG (nasogastric) feeding tube, their oxygen levels and temperature monitored.  We were in hospital for 3 days before the girls were sent home to recover.

Most babies recover completely, although the cough can hang around for a few weeks. Adults and older children can get RSV as it is very contagious – however their symptoms are usually only a mild cough or cold.

What should I do if I suspect my child has bronchiolitis?

Whilst bronchiolitis is common in the winter months and very contagious, it is not deemed as life threatening.  However, young babies will always be treated with caution, so if you are concerned ring 111 for advice or if your baby is struggling to breathe or becomes unresponsive, call 999. Above all, trust your maternal instinct. Even if you have seen a doctor who tells you everything is OK, but you don’t feel satisfied or happy, then get a second opinion. You know your child best. Don’t settle unless you are 100% sure that they are ok to be at home. No one will ever tell you off for being over cautious.

Kate Ball, Founder and Director, Mini First Aid