Bronchiolitis treatment

There is no cure for bronchiolitis. You can, however, help relieve your child’s symptoms while their body fights the virus and repairs itself. Determining the right bronchiolitis treatment^[22] depends on the severity of your child’s symptoms. Most children with bronchiolitis can be treated with supportive care at home. For children with mild bronchiolitis, it may be best to avoid unnecessary and painful procedures. If you are giving your child supportive at-home care, stay alert for any difficulty breathing. Contact your provider immediately if your child struggles to breathe, cannot speak or cry because of breathing difficulties, or makes grunting sounds with each breath.

Hospital care

A small percentage of children with bronchiolitis need hospital care to manage their condition. While hospitalized, they will have ready access to supplemental oxygen and suction equipment that can be delivered at measurable rates. Recommended treatments may include:

• Supplemental oxygen: Oxygen is administered to support children who have trouble breathing. Oxygen is usually administered through nasal tubes or a face mask. The oxygen may also be humidified. In severe cases, an oxygen tube may be inserted into the windpipe (trachea).
• Hydration: About 30% of patients who are hospitalized for bronchiolitis will need a degree of fluid supplementation. Fluids can be given intravenously (IV) or through a nasogastric route (nose tube)^[23].
• Nasal suctioning: Suctioning your child’s nose or mouth to remove mucus can make it easier for them to breathe and eat.

Your provider may also use the following treatments. There is little to no evidence to support their routine use for bronchiolitis, but they may be used in case the child has an illness that is actually not bronchiolitis:

• Bronchodilators^[24]: Bronchodilators, usually taken via an inhaler or nebulizer, are drugs that relax and open the airways. Your provider may try a bronchodilator to see if it helps the patient feel better. Some studies suggest that bronchodilators may provide modest short-term clinical improvement but do not affect the overall outcome, may have adverse effects and may increase the cost of care.
• Antibiotics**: Your provider may prescribe an antibiotic, depending upon the likelihood of a child with severe bronchiolitis to develop secondary bacterial infections (such as pneumonia or an ear infection). Antibiotics treat infections caused by bacteria—they are not effective against bronchiolitis itself, which is caused by viruses.

Before going home from the hospital, your child will be checked to make sure that they are well enough to no longer require medical supervision. A child hospitalized for bronchiolitis must meet the following criteria before being discharged:

• Appropriate respiratory rate
• Normal oxygenation without the need for supplementation
• Sufficient eating and drinking
• Parents who can confidently monitor their child with the hospital’s written guidelines

To get ready for an appointment with your child's healthcare provider, you can write down the symptoms that your child is experiencing. Also, write down key information regarding your child’s health, including whether your child has a lung problem and if your child was born prematurely. You should also ask your provider any questions that you might have, such as things you can do to make your child feel better, the possible causes for your child’s symptoms, and whether your child needs medication. In some cases, your healthcare provider may prescribe the following medications to provide symptomatic relief.

Home remedies for bronchiolitis

In most cases, home management^[25] of a child with bronchiolitis is all that is needed for a full recovery. You may not be able to shorten how long your child’s illness lasts. However, there are some things you can do to make your child feel more comfortable:

• Humidify the air: Coughing tends to worsen and become more painful when the air is dry. You can use a humidifier to ease your child’s congestion and coughing.
• Nose drops or spray: Saline nose drops or spray can help thin mucus and relieve congestion.
• Keep your child upright: Maintaining an upright position—especially during sleep—can help make breathing easier. Use a pillow or two to keep your child elevated in bed.
• Maintain a smoke-free environment: Cigarette smoke can worsen the symptoms of respiratory infections. If someone in your family smokes, they should do so outside (not in the house or car).

Be sure to watch your child’s condition closely in case their illness worsens or develops complications. Pay special attention to whether they are eating and drinking normally.

Bronchiolitis medicine

No vaccines exist for RSV and rhinovirus, the two most common causes of bronchiolitis. However, several vaccines are currently being evaluated in preclinical and clinical trials. There is also no medication for bronchiolitis^[26]. The treatment that is most often recommended by providers is hydration and oxygen. That being said, for patients with comorbidities that place them at a high risk of contracting RSV, the RSV prophylaxis medication palivizumab (generic Synagis) is sometimes used. This decision is typically made on a case-by-case basis by a provider. Providers may consider using palivizumab in infants who were delivered very prematurely, are immunocompromised, and have significant lung and heart impairments.