Bronchitis in Children
Content reviewed against published AAP, CDC, NIH guidelines
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Acute bronchitis is an inflammation of the bronchial tubes (large airways) in the lungs, causing a persistent cough that may produce mucus. In children, it is almost always caused by viruses and typically follows a cold or upper respiratory infection. Unlike pneumonia, bronchitis does not affect the small airways or air sacs. It is important to distinguish bronchitis from bronchiolitis (which affects infants) and asthma. Antibiotics are not indicated for acute bronchitis in otherwise healthy children.
Key takeaways
- Acute bronchitis is an inflammation of the bronchial tubes (large airways) in the lungs, causing a persistent cough that may produce mucus.
- Duration: Cough typically lasts 10-21 days. In some children, a dry cough can persist for 4-6 weeks after the infection resolves (post-viral cough). Other symptoms (fever, malaise) resolve in 3-5 days.
- Go to ER if: Difficulty breathing or rapid breathing (tachypnea)
- No vaccine currently available
Symptoms
How It Presents by Age
0-12 months
The diagnosis of "bronchitis" is rarely used in this age group — bronchiolitis or viral-induced wheeze is more appropriate. Infants with cough and wheeze should be evaluated for bronchiolitis, RSV, or other lower respiratory infections.
Risk level: Moderate — needs evaluation to rule out bronchiolitis
1-5 years
Persistent cough following a cold. May wheeze, especially if they have a history of viral-induced wheeze. Cough can last 2-3 weeks. Often misdiagnosed as needing antibiotics.
Risk level: Low
5-12 years
Classic presentation with cough lasting 10-14 days after a cold. May describe chest soreness from coughing. Usually afebrile by this stage. Green mucus does NOT indicate need for antibiotics.
Risk level: Low
12+ years
Similar to adult presentation. Persistent cough with possible sputum production. Chest tightness and fatigue. Cough can last 3-4 weeks.
Risk level: Low
Treatment
Supportive care
Rest, adequate fluids, and time. Acute bronchitis is self-limiting. No specific treatment shortens the course. Honey (over 1 year) may reduce cough severity.
No antibiotics
Antibiotics are NOT recommended for acute bronchitis in children. Multiple studies confirm no benefit. Green or yellow sputum does not indicate bacterial infection.
Cough management
OTC cough medications are NOT recommended for children under 6. Honey (1 tsp for ages 1-5, 2 tsp for 6+) at bedtime has evidence for reducing nighttime cough. Humidified air may help.
Bronchodilators
Generally not indicated unless the child has known asthma or demonstrates reversible airway obstruction. May be trialed if significant wheezing is present.
Home Care
- Honey at bedtime for children over 1 year (1-2 teaspoons)
- Run a cool-mist humidifier in the bedroom
- Encourage extra fluids to thin secretions
- Elevate the head of the bed slightly
- Use saline nasal drops for associated congestion
- Avoid exposure to secondhand smoke and irritants
- Allow rest but child does not need strict bed rest
- Warm clear liquids (for children old enough) may soothe throat
When to Worry
Go to the ER if:
- Difficulty breathing or rapid breathing (tachypnea)
- Chest retractions (skin pulling in between ribs with breathing)
- Blue or gray color around lips
- Unable to speak in full sentences due to breathlessness
- Very high fever with chest pain
- Child appears very ill or exhausted from coughing
Call your doctor if:
- Cough persisting more than 3 weeks without improvement
- Fever returning after initial improvement
- Wheezing or noisy breathing
- Cough significantly disrupting sleep for more than a week
- Child under 1 year with persistent cough
- History of asthma with worsening symptoms
Keep an eye on:
- Cough lasting more than 3-4 weeks (may suggest asthma or pertussis)
- Difficulty breathing or rapid breathing
- High fever (over 102°F) developing after initial improvement
- Chest pain that is persistent or worsening
- Wheezing that is increasing or does not resolve
- Blood-tinged sputum
Prevention
- Annual influenza vaccine
- Frequent handwashing
- Avoid exposure to secondhand smoke
- Teach proper cough and sneeze hygiene
- Keep sick children home during acute illness
- Maintain good overall health with adequate nutrition and sleep
- Avoid close contact with people who have respiratory infections
Contagion & Incubation
Incubation
2-7 days depending on the virus (typically follows a cold by 3-5 days as infection spreads from upper to lower airways)
Contagious for
Most contagious during the first 3-5 days of cold symptoms. May continue shedding virus for 1-2 weeks. The prolonged cough phase is generally less contagious.
Duration
Cough typically lasts 10-21 days. In some children, a dry cough can persist for 4-6 weeks after the infection resolves (post-viral cough). Other symptoms (fever, malaise) resolve in 3-5 days.
Frequently asked questions
How long does bronchitis in children last?
How does acute bronchitis spread?
When should I take my baby to the ER?
Can acute bronchitis be prevented?
When can my child return to daycare?
Sources
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Illnesses
Bottom line
Bronchitis in Children is a viral illness that typically resolves on its own. Seek emergency care if difficulty breathing or rapid breathing (tachypnea).
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.