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. They 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 don' 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 liquid to use in a nebulizing machine (turns the medicine into a mist to breathe in) . Have your child use the medicine exactly at the times advised. Follow all instructions for giving these medicines to your child. Always use the correct techniques when giving the medicine.

  • 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's gone. You should not have any left over.

  • You may use over-the-counter medicine as directed by your child's healthcare provider, based on the child's age and weight for fever or discomfort and pain. If your child has chronic liver or kidney disease, always 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

    Note: 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, or even death. 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 clean, running 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 their 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 their 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 with an adult 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 get 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.

  • Trouble breathing that doesn’t get better in a few days.

  • Your child loses their appetite or feeds poorly.

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

  • The medicine doesn’t relieve wheezing.

Call 911

Call 911 if any of these occur:

  • Increasing trouble breathing or increasing wheezing or shortness of breath

  • Extreme drowsiness or trouble awakening

  • Confusion or unresponsive

  • Fainting or loss of consciousness

  • Skin or lips turn blue, purple, or gray

  • Unable to talk

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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