Bronchitis or bronchiolitis? What do we do?

 

Between October and the end of March, coinciding with the cold months, a peak occurs in pediatrician consultations for respiratory pathologies. The two most common respiratory infections in young children are bronchiolitis and bronchitis. We are going to learn its characteristics and what we can do from home to improve the well-being of the little ones:

BRONCHIOLITIS:

It is an infection of the bronchioles (the thinnest and smallest branches or pathways of the lung), which causes inflammation and also fill with mucus, making it difficult for air to pass through.

Bronquitis
Bronchiolitis

It is an almost exclusive pathology of babies and children under 2 years of age, with a peak age of 3 to 6 months, especially during the winter months. Premature children are more at risk of developing this respiratory condition, also children with cardiorespiratory pathology, Down syndrome or cystic fibrosis.

One of the viruses that causes bronchiolitis is the Respiratory Syncytial Virus (RSV), although the same influenza virus can also cause it. Syncytial Virus, in adults or older children can give the symptoms of a cold, but it can cause serious problems in babies, and sometimes it is necessary to hospitalize the little one.

Bronchiolitis begins with a cold or mild upper respiratory infection. After 2 or 3 days the cold “gets complicated”, with the following symptoms appearing:

  • Decreased appetite.
  • Cough
  • Wheezing when breathing (noise: whistles or crackles).
  • Fever
  • Nasal flutter (nostrils flare when breathing).
  • Rib tirage (the muscles around the ribs sink when the child takes a breath).
  • Tiredness and irritability because it costs them more to sleep.
  • Fast breathing.
  • Sometimes the skin takes on a bluish tone (cyanosis) on the lips and fingertips, when respiratory distress is important.

 

BRONCHITIS:

It is the inflammation of the bronchi, the main airways of the respiratory system, which carry air to the lungs. The swelling narrows these pathways, causing shortness of breath. Unlike bronchiolitis, it can be suffered by children, but also by adults.

It is classified in:

  • Acute bronchitis: When symptoms are present for a short period of time.
  • Chronic bronchitis: It is a prolonged condition, with persistent cough with phlegm for a minimum of three months.
Bronquiotis
Inflamed bronchus

Like bronchiolitis, bronchitis also usually starts after a cold or flu process that begins in the upper respiratory tract. It is also mostly caused by viruses or non-infectious (allergic) inflammation.

It is characterized by a sudden or rapid onset of symptoms such as cough (often with phlegm that may be clear, yellow or green), tightness or pain in the chest, rapid and wheezing (with noise), fever, shortness of breath, tiredness or fatigue.

 

What can we do at home to relieve symptoms?

  • Preventive measures to avoid bronchitis or bronchiolitis: Most cases of bronchiolitis cannot be prevented, since the causative viruses are very common, but we can always try to avoid the spread of viruses with simple acts such as:
  • Wash your hands frequently, especially if we come from public settings.
  • If you are a child prone to colds, avoid contact with people with flu or cold.
  • Try to avoid the exchange of glasses, pacifiers or children's toys with a cold.
  • Avoid stuffy, unventilated or smoky spaces.
  • Promote breastfeeding.
  • Use disposable tissues.
  • Ventilate the house daily.
  • Teach from a young age to cover their mouths when coughing with the inside of the elbow and not with the hand.

 

  • Measures during bronchitis or bronchiolitis:
  • Do nasal washes (link link article), especially before eating or going to sleep.
  • Increase the fluid intake to help fluidize the mucus and hydrate the child because between the secretions and fever they lose a lot of fluid.
  • Place the mattress with a slight inclination (the highest head) to facilitate breathing and thus rest better.
  • Ventilate the different rooms of the house, avoid stuffy spaces with tobacco smoke, since they worsen the pathology.
  • If we are with the flu or very cold, we can use a mask and avoid (as far as possible) kiss them on the face and hands.
  • Letting the baby or toddler rest seems obvious, but they need more than ever not to tire so as not to make respiratory distress more evident.
  • Respiratory physiotherapy applied to infants and young children, it is very useful to help treat bronchiolitis and bronchitis. Its purpose is through non-invasive techniques:
    • Achieve the optimal state of pulmonary ventilation, permeabilizing the airways.
    • Reduce the amount of medications you must take.
    • Achieve faster improvement or avoid complications, hospitalizations or possible relapses.
    • Improve the sleep and rest of the baby and the family.
    • Facilitate food intake.

Hitting the back with the hand in a concave position (making a hole) is completely contraindicated why it can cause bronchospasm (closing of the bronchi) rapidly) and would decrease oxygen saturation, that is, make less oxygen in the blood. There are still medical personnel who recommend it, but it is a technique not recommended by pediatricians, nurses, and physical therapists for these two types of pathology.

USE OF HUMIDIFIERS:

Humidified air relieves cold and flu symptoms, helping to dissolve mucus and decongesting the airways by fluidizing secretions, especially in children. This

bronquitis
Laia Masseras Salvadó - Pediatric Physiotherapist. Col. 7098

It helps us breathe better by facilitating the child's sleep.

The aspects that we must take into account when using a humidifier:

  • Place the humidifier about 2 meters from the child's bed, or within reach.
  • Graduate the degree of humidity well so that the room is not damp or that it facilitates the appearance of bacteria or fungi. Normally the comfort zone is between 30-50%, but it depends on the temperature, the use of heating and the time of year.
  • They have to be emptied and cleaned daily.
  • Until now, it has been recommended to use cold air humidifiers with children to avoid possible burns, but there are already brands that use warm humidified air to improve comfort (especially in winter), thus eliminating the sensation of cold in the environment, in addition to kill most bacteria.

It is important to go to the pediatrician whenever we see that the cold is lengthening, that it worsens in a few hours or if they have respiratory difficulties, especially with children under 2 years of age, who are the most vulnerable.

The doctor will be the one who, through an auscultation and evaluation, will see what type of respiratory affection is involved and will advise us on the best treatment for the specific case of our little one, with the aim of alleviating respiratory distress and "noise" when breathing. Antibiotics are not usually prescribed because they are viral infections, and they usually disappear within a week.

Bibliography:

 

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1 Comment

  1. My bichilla just passed casia when she was 4 years old for her first bronchitis and we were in panic for the possible contagion to the child. Luckily it seems that the worrying period has passed, because with her not a single bronchiolitis we have lived and this poor man has all the ballots to go catching all the bugs that his sister brings home. We are thinking about the humidifier, because we have never had it, but this girl's coughs last forever.

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