Bronchiolitis and Pneumonia in babies and children

For young children, bronchiolitis is a less severe form of pneumonia, but pneumonia can develop if it is left unchecked. Caused mainly by virus but secondary bacterial infection can occur.

Bronchiolitis is basically an infection of the bronchiolar tubes so it’s a respiratory infection. Babies and small children are susceptible to bronchiolitis because the airways are smaller and their immune systems are not mature enough to handle all the winter infections that come their way. Bronchiolitis is contagious and  it can be caught from others when they sneeze or cough or touching places where an infected person has touched with infected secretions in hands.

What are the most common symptoms of bronchiolitis?

A dry cough, runny and blocked nose initially like a common cold.

Headache, chills, fever and wheezing with tightness of chest follow later.

How will it be diagnosed?
If you suspect your child has bronchiolitis, take them to your Doctor,  who will examine the chest with a stethoscope to determine whether there is infection.
A further X-ray may be needed.


Bronchiolitis treatment

Treatment depends on the type of infection your child has. If it has been caused by a virus, antibiotics will not work and the doctor will probably advise you to take your child home, make sure they get plenty of rest, drink lots of fluids and give him lots of love. Nose has to be kept clear with saline spray. If your child’s bronchiolitis was caused by bacteria, antibiotics may be prescribed depending on the age of your child. Bronchiolitis is the leading cause of hospital admission in infants. Peak age of infection is 2 to 6 months of age. 1 in 10 children with bronchiolitis will need admission to hospital.

Warning signs for admissions

  • Children below 3 months
  • Rapid breathing
  • Difficulty in breathing
  • Poor feeding
  • High Fever
  • Blue lips and tongue

Because the symptoms are very similar to a cold (runny nose etc.), pneumonia in infants is often overlooked by parents. There are different types of pneumonia, bacterial and viral. Severe bacterial pneumonia can happen particularly when the immune system is lower than normal.

What are the most common symptoms of pneumonia?

  • High fever, chills
  • A bad cough
  • Rapid breathing


  • Cough
  • Wheeze
  • Mild fever

The difference with pneumonia is that these symptoms will not improve in time but steadily worsen. They can also follow other illnesses. If you notice your child has had these symptoms but is not getting any better even after a few days of rest, fluids and fever medicine, consult your doctor immediately.

If pneumonia is suspected your child may have to go to for a chest X-ray to check how serious the infection is. If the condition is severe the medical staff may take a sample of phlegm to grow under laboratory conditions in order to discover which type of pneumonia your child has got.

In addition to infants, children and elderly people with low immune systems also include vulnerable groups affected by pneumonia.

Recognize characteristics by rhythm breath counting

The easiest way to recognize if your child is stricken with possible pneumonia is to count his breath in a minute.

  1. Characteristics of children whose age is less than 2 months, when stricken with pneumonia is the breathing faster than 60 times per minute.
  2. If age 2-12 months, then his breathing faster than 50 times per minute.
  3. If age 1-5 years, breathing faster than 40 beats per minute.

Parents can do breath counting at home to determine whether the children has early rapid breathing or not, but it is advisable to seek medical advice as early as possible if you suspect pneumonia, as it can be fatal.

How can I help my child?

Make sure your child gets plenty of rest, fluids and keep their rooms cosy, warm and well ventilated. If he/she is old enough a pillow propped up behind him might help breathing a little easier.

Remember to keep your child’s vaccinations up to date as this helps to stop many of the illnesses that can lead to pneumonia, for instance measles and bacterial pneumonias caused by Hemophillus and Pneumococcus.

This article was supplied by Dr. P. Raghunathan (Paediatrician)