How Do You Know if Your Baby has Bronchitis?

Acute bronchitis, which is sometimes called a chest cold, can develop after your baby has a cold or upper respiratory infection.

Acute bronchitis, which is sometimes called a chest cold, can develop after your baby has a cold or upper respiratory infection. Bronchitis occurs when the bronchi, the airways that carry air to the lungs, become irritated and inflamed. When they are inflamed, they produce excess mucus and cause your baby to cough. Acute bronchitis will usually get better on its own but can develop into pneumonia.  

Bronchitis affects the airways leading to the lungs, while pneumonia affects the air sacs in the lungs, called alveoli. Pneumonia is much worse than bronchitis and needs immediate treatment. Pneumonia symptoms are similar to bronchitis symptoms but generally more severe.  Chronic bronchitis is a long-term condition compared to acute bronchitis. It is caused by irritation of the airways, usually from smoking or other exposure to irritants such as toxic gasses.

Bronchiolitis is more common in babies. It affects the smaller airways that branch off of the main bronchi, called bronchial tubes. Bronchiolitis only affects children and is most common in children under 12 months old. Bronchiolitis is normally no worse than a cold, but there is a risk it could cause breathing difficulties. This risk is greater in babies who were born prematurely.

Acute bronchitis usually starts with an upper respiratory infection, and your baby may have any of the following symptoms: 

• Coughing that may produce mucus
• Runny nose
• Sore throat
• Vomiting or gagging from mucus
• Tiredness or irritability
• Low-grade fever
• Wheezing
• Difficulty eating or drinking

Symptoms of bronchiolitis are similar but usually include breathing changes such as:

• Fast breathing
• Noisy breathing
• Working hard to breath

The most common cause of acute bronchitis is a viral infection, such as those that cause influenza and the common cold. These are easily spread among children. Occasionally, acute bronchitis is caused by a bacterial infection. In either case, bronchitis occurs when the bronchi become inflamed and start producing mucus. Acute bronchitis is contagious because it's caused by a viral or bacterial infection. You should take precautions to avoid your child spreading it to others. Your child may also be more prone to developing acute bronchitis if they have the following:

• Enlarged tonsils and adenoids
• Asthma
• Allergies
• Chronic sinusitis
• Exposure to second-hand smoke

Bronchiolitis is usually caused by the respiratory syncytial virus (RSV). RSV is a very common virus and most children have been exposed to it by the time they are 2 years old. In older children and adults, it just causes a cold, but in babies, it can cause bronchiolitis. 

Most cases of acute bronchitis can be treated at home. Antibiotics do not usually help bronchitis. However, you should take your child to the pediatrician for any of the following symptoms: 

• Cough that lasts longer than three weeks
• Wheezing or shortness of breath
• Coughing up blood
• Coughing up discolored mucus
• Coughing that keeps your child awake
• High fever
• Repeated episodes of acute bronchitis

Additionally, if your baby has symptoms of bronchiolitis, you should take them to the doctor if they:

• Were born prematurely
• Are under 10 weeks old
• Have underlying lung problems

Your baby's doctor will probably be able to diagnose acute bronchitis or bronchiolitis by listening to their symptoms and doing a physical exam. If your baby has a fever, the doctor may order a chest x-ray to make sure your child doesn't have pneumonia. A pulse oximetry, which measures the amount of oxygen in the blood, can be used to diagnose bronchitis. Additionally, the pediatrician may test a sample of sputum, the mucus that your baby coughs up, to see if there is another type of infection. 

Acute bronchitis will likely improve without medication so most treatment focuses on relieving the symptoms. You can help your child feel better by: 

• Ensuring they get lots of rest
• Offering the breast or bottle more frequently
• Using saline nasal sprays
• Using a humidifier or inhaling steam from a shower

Talk to your child's pediatrician before you give them any over-the-counter cough or cold medicines. These are not recommended for children under 4 and only under a doctor's recommendation for children ages 4 to 6. Don't give antihistamines with bronchitis unless the pediatrician recommends it because they dry up mucus and can make a cough worse. Don't give children under 19 any form of aspirin, as it can cause Reye Syndrome, a serious disorder. Do not give ibuprofen if your baby is under 6 months without discussing it with your pediatrician.