You should seek emergency medical advice, call 999, or go straight to A&E if:
Your baby has long pauses in breathing (apnoea)
Your baby’s skin, lips or tongue turns pale or blue. brown or darker skin tones this may be easier to see on lips, tongues and gums, under nails, around your baby’s eyes, on the palms of the hands and on the soles of the feet
Your baby is feeding poorly, and their nappies are less wet than usual
Your baby is finding it difficult to breathe. You may notice this if your baby grunts or you may be able to see the muscles under their chest sucking in
Do not delay getting help if you have concerns. You know your baby best.
What will happen if my baby has to go to hospital?
Some babies with bronchiolitis need to be admitted to hospital. If this happens, your baby may firstly be admitted to the paediatric ward (a section of the hospital for treating children).
Doctors or nurses will measure how much oxygen is in your baby’s blood (oxygen saturation). If your baby’s oxygen saturation levels are lower than expected (usually less than 92%), your baby may need extra oxygen to help with their breathing. They may also need some support with tube feeding if they are too breathless to feed normally.
If your baby’s symptoms get worse, they may be admitted to the paediatric intensive care unit (PICU). Some of the treatments your baby might need in hospital are listed below. If you are unsure about any part of your baby’s treatment or care, speak to the doctors and nurses looking after your baby.
Breathing (respiratory) support: oxygen and CPAP
Some babies will need to be given oxygen to help improve the low levels of oxygen in their blood.
There are different ways of providing breathing support to babies:
Conventional oxygen therapy
High-flow nasal oxygen therapy (including Optiflow and Vapotherm), where a warmed mix of oxygen and air is given at a higher flow
In these cases, oxygen is usually given through nasal cannulas, which are small soft tubes that are placed in your baby’s nostrils.
Continuous positive airway pressure (often shortened to CPAP) is another type of respiratory support. It passes air with or without oxygen (depending on what your baby needs) through two thin tubes in your baby’s nose, or through a small mask that fits over their nose. CPAP slightly raises the pressure of the air and oxygen given, which helps keep your baby’s lungs inflated. This makes it easier for them to breathe.
During oxygen support and CPAP, your baby breathes on their own.
Mechanical ventilation
Mechanical ventilators are machines that do the breathing for your baby if they are unable to breathe on their own. They blow air, with or without oxygen (depending on what your baby needs), gently into your baby’s lungs. This is done through a tube that is passed through your baby’s nose or mouth (called an endotracheal tube) into their trachea (windpipe).
Feeding support
If your baby is unable to feed by mouth, doctors may pass a tube into your baby’s nose or mouth to their stomach so they are able to feed. This is called tube feeding. Some babies will also need fluids given through a vein (intravenously).
If your baby is showing signs of distress – for example increased breathlessness, vomiting or changes to their skin colour – or if they are struggling to suck and swallow or having further breathing difficulties, the medical team may decide to pause the feeds until their oxygen levels have stabilised and they can breathe more easily.
After treatment
When your baby’s breathing improves and they are feeding well, they will be able to go home. Staff on the unit will talk to you about any symptoms you should be aware of at home and how to get help. See our section for parents and carers of babies discharged from the unit for more information.
Short-term: You may notice that your baby continues to wheeze and cough for a few months after they have had bronchiolitis. This is common.
Longer-term: They may cough and wheeze more with new viral infections, be at increased risk of recurrent wheeze, including viral-induced wheeze, and later asthma.
If your baby has had treatment in hospital for bronchiolitis, they may have follow-up appointments to monitor their progress.
It is possible for your baby to get bronchiolitis again after they have already had it once. You can reduce the risk of this happening by following the steps above to prevent infection.
Having an unwell baby can be a stressful experience. We have some information about how you might be feeling and the different types of support available.
If you are unsure about any part of your baby’s diagnosis, treatment or care, the staff on the ward will help you in any way they can. It is okay to ask again if you need information repeated or made clearer. The team will understand and want to support you.
If you are not in hospital, meet with your baby’s GP or health visitor to talk through your concerns. If your baby has had recurring instances of bronchiolitis that have required hospital treatment, ask about being referred to a respiratory specialist.
In an emergency situation, where your baby is struggling to breathe, dial 999 or go straight to A&E.
If you need someone to talk to, you can contact us on [email protected] or arrange a video call with one of our volunteers. Other organisations who can provide information and support include:
Asthma + Lung UK provides support to anyone affected by a lung condition, through online and printed information, support groups, a web community, and a helpline.
NHS provides more information about bronchiolitis, symptoms, treatment and prevention.
