Bronchiolitis is a very common infection of infants and young children. A virus, most commonly respiratory syncytial virus or RSV, causes inflammation in the lining of the small bronchial tubes. It is almost impossible to make it to 2 years of age without at least one episode of bronchiolitis. It is most common in winter and early spring and in 3-6 month olds. Typically a runny nose comes first, followed a few days later by a tight deep sounding cough or a whistling wheeze, often with more rapid breathing.. Fever may be present. The cough or wheeze often lasts 5-10 days. The peak of the illness is usually between day 3 and 6. Mild symptoms are self limited and will go away with no treatment. If your child is taking fluids and has no signs of respiratory distress supportive care can be done at home. Fluids, Tylenol for fever, a cool mist humidifier, gentle nasal suctioning, and upright positioning may help the symptoms. In older children bronchiolitis often seems like a bad cold with cough or mild wheeze. In small babies, especially premature babies the illness can be more serious. Some babies will have difficulty feeding and start breathing very rapidly, pulling in between their ribs with each breath. They may become lethargic and have poor color. If any of those symptoms start to develop in your child medical care needs to be sought immediately. Read all about bronchiolitis here.
Croup is a viral infection common in young children that causes swelling in the voice box and windpipe. The main symptoms are a harsh, barky cough, sometimes with a raspy, hoarse voice, other cold symptoms and fever. A crowing noise called stridor is often heard when breathing in. It is different from wheezing which is a sound with expiration (breathing out). Croup is worse at night than in the day, sounds way more scary than it usually is and most often goes away on its own in 2-5 days. Many people describe the distinctive cough as a barking seal. The typical pattern is to have an attack, sound terrible, respond to symptomatic care, go back to sleep, then wake again throughout the night with repeated attacks. Home care usually works to ease the symptoms:
- Stay calm and comfort your child; crying makes the noisy breathing seem worse
- Moist air often helps. Try steaming up the bathroom and letting your child breath the moist air for 10 minutes, or hold your child directly over the vapor from a humidifier. Keep a humidifier running in the bedroom.
- The cold night air often helps. Dress your child warmly and go outside for 10 minutes or try putting your child’s face right up to an open freezer.
- Tylenol or Motrin if your child has a fever