Should I use this page, or get help now?
Use this page if a baby or toddler has a cold that has gone to the chest and you need home care versus 111. Skip it and call 999 if they are working hard to breathe, pausing between breaths, going blue or grey, or are floppy and will not wake. Trust your instincts if they look seriously unwell.
This page cannot measure oxygen. Croup is a barking cough; bronchiolitis is more a chesty, feeding problem.
What is bronchiolitis and who gets it?
Bronchiolitis is a viral infection of the smallest airways. It usually affects babies and children under 2, and is often more serious in younger babies. RSV is the usual cause. It is different from bronchitis in older children and adults. It often starts like a cold, then cough, faster or noisier breathing, and harder feeding.
NHS advice is that symptoms are usually worst between days 3 and 5, and the cough usually improves in about three weeks.
How should I look after them at home?
Offer smaller, more frequent feeds. Keep them upright when awake. Check them at night. Paracetamol or ibuprofen can ease discomfort if the pack says they are old enough — follow the pack. Do not smoke around them. Do not sponge them with cold water to bring a temperature down.
Find a GPhC-registered pharmacy on Pick My Pharmacy for age-appropriate medicine — not as a substitute for 111 if feeding or breathing is sliding.
When is it 111 or 999?
Call 999 if they are struggling to breathe, there are pauses in breathing, skin or lips look blue or grey, or they are floppy and will not wake. Use 111 if feeding has dropped, there has been a dry nappy for 12 hours, a baby under 3 months has a temperature of 38°C, or you are worried.
In England, Scotland and Wales call 111 (NHS 24 in Scotland). In Northern Ireland there is no general 111 — use GP out-of-hours on nidirect. See pharmacy, GP, 111 or A&E if you are stuck on the door.
Can it be prevented?
You cannot avoid every winter virus. Hand washing, cleaning toys, and keeping newborns away from colds help. An RSV vaccine in pregnancy from 28 weeks can protect the baby in the first months. Some high-risk children are offered extra winter antibodies. Ask your midwife or GP. Do not smoke around babies — smoke makes severe bronchiolitis more likely.
Antibiotics do not treat RSV. Pneumonia is a different, usually more unwell picture.
Will they need hospital — and can it be prevented?
Some babies need hospital monitoring for oxygen, help with feeding, or fluids. That does not mean you waited too long at home. Premature babies and those with heart, lung or immune problems are at higher risk. Ask the hospital or GP team about extra winter protection if that applies.
You cannot avoid every winter virus. Hand washing, cleaning toys, and keeping newborns away from colds help. An RSV vaccine in pregnancy from 28 weeks can protect the baby in the first months. Do not smoke around babies — smoke makes severe bronchiolitis more likely.
Do they need antibiotics for bronchiolitis?
Usually not. Bronchiolitis is almost always viral. Antibiotics do not treat RSV. They are only used if a clinician thinks a separate bacterial infection is present. Follow the course you are given if one is prescribed. Do not use leftover antibiotics from an ear infection.
Most babies recover fully. Some wheeze with later colds. Serious long-term lung damage is uncommon in otherwise healthy babies. A lingering cough in a child who is feeding and breathing comfortably can still be watched at home — 111 if they are getting worse.
Who should skip this page?
Skip this page if breathing is already hard or they will not wake — call 999. It is not a croup steam debate, not an asthma inhaler plan, and not a whooping-cough page for a cough lasting weeks in an older child. A baby with fever still needs the children’s fever pathway as well as chest-watch.
Common questions about bronchiolitis
- How long does bronchiolitis last?
- NHS advice is that symptoms are usually worst between days 3 and 5, and the cough usually gets better in 3 weeks. If they are getting worse rather than better, or you are worried, use 111 — do not wait for day 21. A lingering cough in a child who is feeding and breathing comfortably can still be watched at home.
- Can I treat bronchiolitis at home?
- Most children can. Offer smaller, more frequent feeds. Keep them upright when awake. Check them at night. Paracetamol or ibuprofen can ease discomfort if the pack says they are old enough — this page does not give milligram doses. Do not smoke around them. There is no routine medicine that cures bronchiolitis.
- Do babies with bronchiolitis need antibiotics?
- Usually not. Bronchiolitis is almost always viral. Antibiotics do not treat RSV. They are only used if a clinician thinks a separate bacterial infection is present. Follow the course you are given if one is prescribed. Do not use leftover antibiotics from an ear infection.
- Is bronchiolitis contagious?
- The viruses that cause it spread like colds, in coughs and sneezes. Wash hands, clean toys and surfaces, and keep newborn babies away from people with colds where you can. Almost all children catch RSV at least once before they are 2. Older children and adults usually just get a cold.
- Will bronchiolitis damage my baby's lungs?
- Most babies recover fully. Some wheeze with later colds. Serious long-term lung damage is uncommon in otherwise healthy babies. Premature babies and those with heart, lung or immune problems are at higher risk of a severe episode and may be offered extra winter protection — ask the hospital or GP team.
- Is there an RSV vaccine?
- Yes. An RSV vaccine is offered on the NHS in pregnancy from 28 weeks, to protect the baby in the first months of life, and to some older adults. Some high-risk children are offered antibody injections in winter. Ask your midwife or GP what applies. Vaccination does not make a 999 breathing emergency less urgent.