Infant Bronchiolitis: How to Prevent, Diagnose and Treat It?

Bronchiolitis is a viral infection of the small airways, called bronchioles, located in the lungs. Several viruses can cause bronchiolitis, including rhinoviruses, but the most common is respiratory syncytial virus (RSV).

The bronchiolitis epidemic returns cyclically in France during the coldest period, generally between mid-October and mid-March. Each year, approximately 30% of children under the age of 2 are affected, and Public Health France estimates that by the age of 2, more than 90% of children will have contracted an infection due to this virus, most of the time without consequences.

2. What are the symptoms?

Symptoms of bronchiolitis can vary in severity, but the most common signs include:

Nasal congestion: The infant has a runny or stuffy nose.
Cough: The child develops a dry, persistent cough.
Fever: Inflammation can cause fever, sometimes high.
Wheezing: The infant has wheezing sounds due to inflammation of the bronchioles.
Breathing difficulty: Some infants may show signs of respiratory distress, rapid breathing, or "pulling"—a sinking of the chest during breathing, a sign of significant effort.
Vomiting: In some cases, fever and/or congestion can cause vomiting, with the associated risk of dehydration.

If you think your child has bronchiolitis, make an appointment with your doctor, who will be able to assess the severity of their symptoms.

And while it is important not to overcrowd hospitals , some cases still require rapid medical attention: if your child is less than six weeks old or is a premature baby less than three months old, if he already has an identified respiratory or cardiac illness, if he drinks less than half of his bottles for three meals or if he vomits them, but also if he sleeps constantly, or on the contrary, cries unusually and cannot fall asleep for long hours, consult immediately, by dialing 15, where a doctor will refer you either to the general practitioner or to the emergency room.

Finally, avoid contagion. Bronchiolitis is highly contagious, so limit your child's contact with others and wash your hands thoroughly to prevent the spread of the virus.

Most cases of bronchiolitis are mild and resolve spontaneously within a few days. Treatment of the disease in infants relies primarily on symptom management, as there is no specific antiviral medication. Furthermore, since the infection is viral, antibiotics are unnecessary.

The doctor may prescribe medication to lower fever, maintain hydration, limit vomiting, or dilate your child's bronchi. In some cases, respiratory physiotherapy sessions may be prescribed. Hospitalization is very rarely necessary.

Furthermore, if your child is sick, regularly clean their nose using saline pipettes to help them clear their secretions, at least six times a day, especially before meals or bottles. Also make sure they stay well hydrated, and divide their meals if necessary to help them eat. Ventilate living areas to circulate air and do not cover them too much. Caution: even in the event of breathing difficulties, it is not recommended to raise your child's mattress or have them sleep on their stomach.

In any case, avoid using over-the-counter medications, such as cough syrups , which are often useless or even dangerous.

Prevention is essential to contain the bronchiolitis epidemic in infants. While the disease primarily affects young children, older children and adults can unknowingly carry the virus. Therefore, several simple actions can significantly limit the risk of contagion. These actions apply to bronchiolitis, but also to other viruses, such as the flu or Covid .

As a first step, limit the exposure of babies under three months old to others as much as possible during the epidemic period. Restrict visits to the very close circle, ban kisses and hugs, and, where possible, suggest that your guests wear a mask around the infant.

On a daily basis, wash your hands before and after contact with your baby, and regularly wash your baby's toys and comforters. If you have a cold, cough, or fever, wear a mask when caring for your baby. If siblings have even mild symptoms of a viral infection, try to keep them away from your baby as much as possible during the acute phase of their infection.

Avoid crowded, enclosed places like supermarkets, restaurants, or public transport with your baby as much as possible.

Ventilate your baby's living space for at least 10 minutes a day, especially their room, and avoid smoking inside the home.

Finally, Public Health France advises avoiding entering a community setting (nurseries, MAM, daycare centers, etc.) as much as possible before the age of three months, even though maternity leave ends only two and a half months after the birth of the child.

Last August, a treatment for bronchiolitis, Beyfortus , received a favorable opinion for marketing from the French National Authority for Health. This preventive treatment is composed of a monoclonal antibody, which prevents the RSV virus that causes most cases of bronchiolitis from infecting the body. A single injection would be necessary to protect an infant for at least 5 months.

The government immediately ordered 200,000 doses from its manufacturer, Sanofi, for an unknown amount. But given the scale of demand, the treatment, which was initially intended to be available in pharmacies, was ultimately reserved for maternity wards, where it is administered drop by drop to the most fragile newborns. To date, approximately 100,000 doses have already been administered. The effectiveness of Beyfortus will only be truly measured at the end of winter, when the epidemic assessment is completed.