Bronchitis with Wheezing (Child)

Front view of infant showing respiratory system. Inset shows bronchiole and alveoli.

Bronchitis is inflammation and swelling of the lining of the lungs. This is often caused by an infection. Symptoms include a dry, hacking cough that is worse at night. The cough may bring up yellow-green mucus. Your child may also breathe fast or seem short of breath. He or she may have a fever. Other symptoms may include tiredness, chest discomfort, and chills. Inflammation may limit how much air can flow through the airways. This can cause wheezing and trouble breathing, even in children who don’t have asthma. Wheezing is a whistling sound caused by breathing through narrowed airways.

Bronchitis is most often caused by a virus of the upper respiratory tract. Symptoms can last up to 2 weeks, although the cough may last much longer. Medicines may be given to help relieve symptoms, including wheezing. Antibiotics will be prescribed only if your child’s healthcare provider thinks your child has a bacterial infection. Antibiotics do not cure a viral infection.

Home care

Follow these guidelines when caring for your child at home:

  • Your child’s healthcare provider may prescribe medicine for cough, pain, or fever. You may be told to use saltwater (saline) nose drops to help with breathing. Use these before your child eats or sleeps. Your child may be prescribed bronchodilator medicine. This is to help with breathing. It may come as a spray, inhaler, or pill to take by mouth. Have your child use the medicine exactly at the times advised. Follow all instructions for giving these medicines to your child.

  • The provider may also prescribe an oral antibiotic for your child. This is to help stop a bacterial infection. Follow all instructions for giving this medicine to your child. Have your child take the medicine every day until it is gone. You should not have any left over.

  • You may use over-the-counter medicine as directed based on age and weight for fever or discomfort. If your child has chronic liver or kidney disease, talk with your child's healthcare provider before using these medicines. Also talk with the provider if your child has had a stomach ulcer or digestive bleeding Never give aspirin to anyone younger than 18 years of age who is ill with a viral infection or fever. It may cause severe liver or brain damage. Don’t give your child any other medicine without first asking the healthcare provider.

  • Don’t give a child under age 6 cough or cold medicine unless the provider tells you to do so. These don't help young children, and they may cause serious side effects.

  • Wash your hands well with soap and warm water before and after caring for your child. This is to help prevent spreading infection.

  • Give your child plenty of time to rest. Trouble sleeping is common with this illness.

    • Have your toddler or older child (older than 1 year) sleep in a slightly upright position. This is to help make breathing easier. If possible, raise the head of the bed slightly. Or raise your older child’s head and upper body up with an extra pillows. Talk with your healthcare provider about how far to raise your child's head.

    •  Never use pillows with a baby younger than 12 months. Also never put your baby younger than 12 months to sleep on their stomach or side. Babies younger than 12 months should sleep on a flat surface on their back. Don't use car seats, strollers, swings, baby carriers, and baby slings for sleep. If your baby falls asleep in one of these, move them to a flat, firm surface as soon as you can.

  • Help your older child blow his or her nose correctly. Your child’s healthcare provider may recommend saline nose drops to help thin and remove nasal secretions. Saline nose drops are available without a prescription. You can also use 1/4 teaspoon of table salt mixed well in 1 cup of water. You may put 2 to 3 drops of saline drops in each nostril before having your child blow his or her nose. Always wash your hands after touching used tissues.

  • For younger children, suction mucus from the nose with saline nose drops and a small bulb syringe. Talk with your child’s healthcare provider or pharmacist if you don’t know how to use a bulb syringe. Always wash your hands after using a bulb syringe or touching used tissues.

  • To prevent dehydration and help loosen lung secretions in toddlers and older children, have your child drink plenty of liquids. Children may prefer cold drinks, frozen desserts, or ice pops. They may also like warm soup or drinks with lemon and honey. Don’t give honey to a child younger than 1 year old.

  • To prevent dehydration and help loosen lung secretions in infants under 1 year old, have your child drink plenty of liquids. Use a medicine dropper, if needed, to give small amounts of breastmilk, formula, or oral rehydration solution to your baby. Give 1 to 2 teaspoons every 10 to 15 minutes. A baby may only be able to feed for short amounts of time. If you are breastfeeding, pump and store milk to use later. Give your child oral rehydration solution between feedings. This is available from grocery stores and drugstores without a prescription.

  • To make breathing easier during sleep, use a cool-mist humidifier in your child’s bedroom. Clean and dry the humidifier daily to prevent bacteria and mold growth. Don’t use a hot-water vaporizer. It can cause burns. Your child may also feel more comfortable sitting in a steamy bathroom for up to 10 minutes.

  • Keep your child away from cigarette smoke. Tobacco smoke can make your child’s symptoms worse.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

When to seek medical advice

For a usually healthy child, call your child's healthcare provider right away if any of these occur:

  • Fever (see Fever and children, below)

  • Symptoms don’t get better in 1 to 2 weeks, or get worse.

  • Breathing difficulty doesn’t get better in several days.

  • Your child loses his or her appetite or feeds poorly.

  • Your child shows signs of dehydration, such as dry mouth, crying with no tears, or urinating less than normal.

  • The medicine doesn’t relieve wheezing.

Call 911

Call 911 if any of these occur:

  • Increasing trouble breathing or increasing wheezing

  • Extreme drowsiness or trouble awakening

  • Confusion

  • Fainting or loss of consciousness

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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