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Patient Instructions

Your child has bronchiolitis, which causes swelling and mucus to buildup in the smallest air passages of the lungs. In the hospital, the doctors and nurses helped your child breathe better. They also made sure your child received enough liquids.

Most children will still have symptoms of bronchiolitis after they leave the hospital:

• Wheezing may last for up to 5 days.
• Coughing and stuffy nose will slowly get better over 7 to 14 days.
• Sleeping and eating may take up to 1 week to be normal.
• You may need to take time off work to care for your child.

Breathing moist (wet) air helps loosen the sticky mucus that may be choking your child. You can use a humidifier to make the air your child is breathing moist. Follow the directions that came with the humidifier.

Do not use steam vaporizers because they can cause burns.

If your child’s nose is blocked up, your child will not be able to drink or sleep easily. You can use warm tap water or saline nose drops to loosen the mucus. Both of these work better than any medicine you can buy. Follow these steps:

• Place 3 drops of warm water or saline in each nostril.
• Wait 1 minute, then use a soft rubber suction bulb to suck out the mucus from each nostril.
• Repeat several times until your child's breathing through the nose becomes quiet and easy.

Everyone who touches your child must wash their hands with warm water and soap or an alcohol-based hand cleaner before doing so. Try to keep other children away from your child.

Do not let anyone smoke in the house, car, or anywhere near your child.

It is very important for your child to drink enough.

• Offer breast milk or formula if your child is younger than 12 months.
• Offer regular milk if your child is older than 12 months.
• Offer warm lemonade or apple juice if your child is over 4 months old. These drinks may help relax the airway and loosen the mucus. They will also help your child get enough to drink.

Eating or drinking may make your child tired. Feed small amounts, but more often than usual.

If your child throws up because of coughing, feed your child again.

Some asthma medicines help children with bronchiolitis. Your health care provider may prescribe medicine for your child.

Do NOT give your child decongestant nose drops, antihistamines, or any other cold medicines unless your child’s doctor tells you to.

Call the doctor if:

• Breathing becomes labored or difficult.
• The wheezing gets more severe.
• Skin, nails, gums, or lips, or the area around the eyes are bluish or grayish in color, or looks dusky.
• Your child’s chest is pulling in with each breath.
• Your child’s body becomes limp.

Or, if your child:

• Is breathing faster than 60 breaths a minute (when not crying).
• Is very tired and is not moving around very much.
• Is breathing faster than usual.
• Has flaring nostrils.
• Is making a grunting noise.
• Has a loss of appetite.
• Is irritable.
• Has trouble sleeping.
• Is short of breath.

American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics. 2006 Oct;118(4):1774-93.

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.