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Bronchiolitis & RSV

Bronchiolitis · Bronchiolitida a RSV

What it is

The commonest reason babies go to hospital in winter.

Symptoms & signs

  • Runny nose then wheeze and fast breathing
  • poor feeding
  • chest recession
  • apnoea in the very young

🚩 Get help if…

  • call 112 / 911 now Pauses in breathing, or lips or tongue turning blue
  • call 112 / 911 now Grunting, ribs sucking in or very fast breathing
  • see a doctor soon Taking less than half the usual feeds or no wet nappy for 12 hours
  • see a doctor soon A baby under 3 months with fever, or getting worse after day 3

Where it strikes

Medical treatment

  • Oxygen and feeding support trials support
  • Suction mixed evidence
  • Antibiotics, steroids and salbutamol — none of them work in bronchiolitis not confirmed in trials
  • Nirsevimab or palivizumab for high-risk babies trials support
  • Nirsevimab for all infants in their first RSV season — approved (EMA 2022, FDA 2023)
  • Maternal RSV vaccination (Abrysvo) — approved 2023; given at 32–36 weeks in the US because of a possible preterm-birth signal

Natural & lifestyle

  • Small frequent feeds
  • nasal saline
  • smoke-free home
  • hand hygiene

Emerging & experimental

  • Intranasal live-attenuated RSV vaccines for infants (in trials)

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Nebulised hypertonic saline — trials disagree mixed evidence
  • Steam — traditional; can scald anecdotal / traditional

ICD codes