Treatment for bronchiolitis at home focuses on simple steps that help ease symptoms in babies and young children. These measures generally include rest, plenty of fluids, nasal cleaning, and medications recommended by the pediatrician when needed. Most cases are mild and can be safely managed at home.
Because bronchiolitis is caused by a virus, antibiotics are not usually helpful. There are also no antiviral medications that cure the infection itself, since the virus is naturally cleared by the immune system. Supportive care is the main approach to help the child stay comfortable and recover. Read more about bronchiolitis and the symptoms it presents with.
Bronchiolitis typically starts to improve within 3 to 7 days. Still, parents should watch for signs of trouble breathing, such as strong chest retractions or bluish lips or fingertips. If these symptoms appear, or breathing becomes very difficult, medical care in an emergency setting is recommended.
Home care
Complementary care for bronchiolitis that can be done at home includes:
1. Rest
Rest is important to help the baby or child recover and allow the body to fight off the virus.
It is best to avoid going out with the baby or sending the child to daycare or school during this time.
2. Offer plenty of fluids
Offering extra fluids helps prevent dehydration and supports the body in clearing the virus.
Babies who are exclusively breastfed should be offered breast milk or formula on demand.
Children who already eat solid foods can also have water offered regularly.
3. Avoid dusty places
Keeping the child away from dusty or smoky environments helps prevent irritation and inflammation in the lungs.
The baby’s room should be kept clean, well-ventilated, and free from dust, mold, or objects that collect dust, such as carpets, curtains, cushions, or stuffed animals. Bedding should be washed frequently.
Babies should not be exposed to cigarette smoke.
4. Keep the air humidified
Using a cool-mist vaporizer, humidifier, or even placing a bowl of water out of the baby’s reach in the room can help keep the air moist.
Humidified air helps thin mucus and relieve nasal congestion and coughing.
5. Clean the child’s nose
Regularly cleaning the child’s nose with saline drops helps thin mucus, making it easier to remove and easing nasal congestion.
Saline drops (0.9% saline solution) can be used before feedings to make breathing easier and whenever the nose is blocked. They should be applied with the baby sitting on the caregiver’s lap, with the head slightly tilted back, and never while lying flat.
For babies under 6 months of age, a bulb syringe is recommended. Check out other ways to help a congested baby.
6. Elevate the head of the crib
Raising the head of the crib slightly with a wedge or crib elevator may help keep the airways more open and make breathing easier.
This should only be done with guidance from a pediatrician. Babies over 12 months may use a thin, low pillow up to 3 cm thick. Babies under 1 year should not use pillows.
7. Keep the baby seated
If breathing becomes more difficult, such as during feedings, keeping the baby in a more upright or seated position can help. Lying flat can make breathing harder.
These home measures can be continued until symptoms fully resolve, which may take up to 3 weeks. However, if symptoms do not start to improve within 3 days, another pediatric evaluation is recommended.
Medications for bronchiolitis
Most children do not need medication for bronchiolitis, as the body is usually able to manage the infection on its own.
If symptoms cause significant discomfort or if the fever is very high, a pediatrician may recommend acetaminophen or ibuprofen, with doses based on the child’s weight and age.
Aspirin (acetylsalicylic acid) should never be given to babies or children, according to the American Academy of Pediatrics, because it is associated with Reye’s syndrome.
In some cases, the pediatrician may recommend bronchodilators to help open the airways and improve breathing. These are used with pressurized inhalers and a spacer device.
What cough syrup is prescribed for bronchiolitis?
Using cough syrups to relieve coughing or wheezing in bronchiolitis is generally discouraged by doctors. These products do not help with recovery and are not safe for babies.
How to know if bronchiolitis is improving
Signs that bronchiolitis is getting better usually appear within 3 to 7 days after starting care. These include reducing fever, improved appetite, and easier breathing. However, coughing may continue for several days or even months.
When to go to the doctor
Even when symptoms seem mild, it’s important to seek medical care if they do not improve after 3 days or if any of the following are present:
-
Severe difficulty breathing
-
Very slow breathing or breathing pauses
-
Rapid or labored breathing
-
Bluish lips or fingertips
-
Chest retractions
-
Refusal to feed
-
High fever
These situations are less common but may require hospital care, where medications can be given intravenously and oxygen support may be used.
Hospital treatment
Hospital treatment may include intravenous fluids to maintain hydration or treat dehydration, as well as respiratory support such as humidified oxygen or nebulized hypertonic saline.
Vital signs and oxygen saturation levels are monitored closely.
In more severe cases, intensive respiratory support may be needed, including mechanical ventilation or non-invasive ventilation.
-
Most cases of bronchiolitis improve with simple home care, including rest, extra fluids, and regular nasal cleaning.
-
Antibiotics and cough syrups are not recommended, but acetaminophen or ibuprofen may help with fever or discomfort when advised by a pediatrician.
-
Seek medical care if breathing becomes difficult, symptoms worsen after 3 days, or signs like chest retractions or bluish lips appear.