My Baby Has Bronchiolitis
The short answer
Bronchiolitis is inflammation of the small airways in the lungs, usually caused by RSV or other viruses. It's common in babies under 1 year and typically peaks around days 3-5 before improving. Most babies recover at home with supportive care, but watch for signs of breathing difficulty like fast breathing, chest retractions, or trouble feeding.
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By Age
What to expect by age
0-3 months
Young babies are most vulnerable to severe bronchiolitis. What starts as a runny nose can quickly progress to fast, difficult breathing and wheezing. Babies this age have tiny airways that swell easily. Contact your pediatrician at the first sign of cold symptoms, and seek immediate care if your baby is breathing fast, grunting, or feeding poorly.
3-6 months
Bronchiolitis usually starts with a few days of cold symptoms before breathing becomes more labored. You may hear wheezing or rattling in your baby's chest. The worst symptoms typically occur on days 3-5. Your baby may need smaller, more frequent feeds due to breathing difficulty. Most improve at home with rest, hydration, and close monitoring.
6-12 months
While still concerning, babies this age generally handle bronchiolitis better than younger infants. Expect 7-10 days of illness, with the cough often lasting 2-3 weeks. Use a cool mist humidifier, keep your baby upright, and offer frequent fluids. Call your doctor if breathing becomes labored, feeding drops significantly, or wet diapers decrease.
12-24 months
Bronchiolitis is less common after 1 year but can still occur. Your toddler may have significant coughing and wheezing but typically maintains better oxygen levels than younger babies. The illness may be labeled as a "wheezy bronchitis" or viral wheeze. Home care includes rest, fluids, and monitoring breathing effort.
2 years+
By age 2, most children have larger airways and are less likely to develop bronchiolitis. If wheezing occurs with viral illnesses, your pediatrician may consider other diagnoses like reactive airway disease or asthma. Treatment may include breathing treatments or inhalers, different from typical bronchiolitis management.
What Should You Do?
When to take action
- Your baby has been diagnosed with bronchiolitis and is being monitored at home by your pediatrician
- Your baby is breathing comfortably when calm, even if you hear congestion or mild wheezing
- Your baby is taking smaller feeds more frequently but is staying hydrated with regular wet diapers
- The illness is gradually improving after peaking around days 3-5
- Your baby has some energy and can smile or interact, even if more tired than usual
- Your baby's symptoms haven't improved by day 7-10
- Your baby is eating less than half of normal feeds for more than 24 hours
- The cough is still severe after 2 weeks
- Your baby has a fever that comes back after being gone for a day or more
- You're worried about your baby's breathing but unsure if it warrants emergency care
- Your baby is breathing very fast (over 60 breaths per minute for infants, over 50 for older babies when calm)
- Your baby's chest is pulling in sharply with each breath or nostrils are flaring
- Your baby's lips, tongue, or skin turn blue or very pale
- Your baby has pauses in breathing or very irregular breathing
- Your baby refuses to eat or drink for several hours and is having fewer wet diapers
- Your baby is extremely lethargic, difficult to wake, or unresponsive
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
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Adenoid Hypertrophy and Breathing
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How to Advocate for Your Child's Needs
You know your child better than anyone, and your observations matter. If you feel something is not right with your child's development or health, you have every right to ask questions, request evaluations, and seek second opinions. Advocating for your child is not being difficult - it is being a good parent.
Air Quality and Baby Health
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Altitude Sickness in Babies
Babies and toddlers can experience altitude sickness when traveling above 5,000-8,000 feet (1,500-2,500 meters). Symptoms are harder to recognize in infants because they cannot describe how they feel. Watch for unusual fussiness, poor feeding, disrupted sleep, vomiting, and fast breathing. Gradual ascent is the best prevention. Most pediatricians recommend avoiding sleeping at very high altitudes (above 8,000 feet) with infants when possible, and descending immediately if symptoms appear.