Private bronchiolitis clinic in London, same-day paediatrics.

How the illness runs

Knowing that days three to five are usually the peak helps. A baby who is getting slowly better after that, even with a rattly cough, is doing what we expect. A baby who is getting worse after day five needs reviewing.

Why there is no medicine for it

Bronchiolitis is caused by a virus, most often RSV. Antibiotics do not work on viruses. Inhalers, steroids and cough medicines have all been tested in bronchiolitis and none of them shorten the illness or help the breathing — which is why your baby has not been given them. This is not because nothing is being done; it is because the treatments that exist do not work for this particular illness.

What helps is careful feeding, rest and close watching. Babies who need hospital care are admitted for help with feeding and oxygen while the illness runs its course, not for a drug that cures it.

Feeding and comfort at home

• Smaller feeds, more often. A blocked, breathless baby cannot manage a full feed. Half the usual amount twice as often is the aim.
• Do not stop feeding, even if your baby vomits after coughing. Vomiting a feed up after a coughing fit is common and does not mean feeds should be reduced — offer the next one as usual.
• Clear the nose before feeds. Saline nose drops from a pharmacy, a minute or two before a feed, make a real difference to a baby who cannot breathe and suck at the same time.
• Keep your baby fairly upright when awake and being fed. Follow normal safe sleep advice at night — on the back, in their own cot, on a flat firm mattress.
• Paracetamol may be given if your baby is distressed by a temperature, at the dose on the packet for their age. Ibuprofen is only suitable from three months of age and over 5kg.
• No smoking or vaping anywhere in the home. Smoke exposure makes bronchiolitis measurably worse.
• Rest. Expect your baby to sleep more and be less interested in play for a week or so.

Preventing it

• Wash hands before handling your baby, and ask visitors to do the same.
• Keep newborns away from anyone with a cold, and away from crowded indoor spaces in winter where you can.
• An RSV vaccine is offered during pregnancy, usually from around 28 weeks, and passes protection to the baby for their first months. If you are pregnant, ask your midwife or GP.
• Some babies at particularly high risk are offered a protective antibody injection. We can advise if this might apply to your child.

Book an appointment with us if

• your baby is feeding less well but is not showing the emergency signs above;
• the illness is dragging on beyond three weeks, or the cough is worsening rather than settling;
• your baby has repeated episodes of wheezing after this illness;
• you would simply like your baby examined and their breathing and oxygen levels checked.

We see children 7 days a week, usually the same day.