Acute Bronchiolitis in Newborns: A Parent’s Guide

What is Acute Bronchiolitis? Where does it come from? How often does it affect children? In this article, you will find out more about this common disease and what you can do if your child contracts it.

Acute Bronchiolitis is a lower respiratory tract infection – meaning it affects mainly the lungs. It is a common occurrence among babies younger than two years of age. In fact, it is the leading cause of hospitalization among infants and young kids.

What Causes Acute Bronchiolitis in Newborns?

Most of the time, Acute Bronchiolitis in Newborns is brought about by a virus. The most common virus that is behind Bronchiolitis is the Respiratory Sincytial Virus, or RSV.

RSV is such a common type of infection that virtually everyone will have been infected at least once by the age of three. Some people may get infected more than once in one season. Th peak seasons for RSV are usually winters or rainy seasons.

What increases your infant’s risk for RSV and Acute Bronchiolitis?

  • Having an underdeveloped immune system (which is why it is most common among young children)
  • Being born prematurely (the lungs are underdeveloped)
  • Having a heart or lung condition such as congenital heart disease or asthma
  • Exposure to tobacco smoke, such as if a parent or caregiver is a smoker
  • Formula feeding (breastfeeding babies receive some immune protection from breast milk)
  • Going outside in a crowded environment and increased contact with other children, such as in daycare
  • Spending time in other crowded areas especially enclosed crowded areas
  • Having older siblings who go to school or daycare who might bring home the viral infection

What are the Symptoms of Acute Bronchiolitis in Newborns?

Symptoms of Acute Bronchiolitis in Newborns are mainly respiratory. In the early days of the disease, it may present the following:

If the disease progresses, there will be more compromise to the airways. Other symptoms may appear such as:

  • Mild to moderate difficulty breathing
  • Fast breathing (beyond 60 breaths per minute)
  • Wheezing
  • Persistent coughing
  • Difficulty feeding due to the nasal congestion

If the condition gets worse, you will see these symptoms:

  • Severe difficulty in breathing, which may present as sucking of the skin in the throat and ribcage
  • Grunting sounds when breathing
  • Dehydration due to the difficulty in feeding
  • Apnea or stopping of the breath for more than 15 seconds, especially common in newborns or premature infants
  • Low Oxygen, which causes a bluish or pale color of the skin and nails

When should you worry?

When to take your baby to the doctor for acute bronchiolitis

The last set of symptoms are some of the most severe symptoms of the disease. If your child presents any of the last symptoms, he or she should already be confined and treated at the hospital.

Since you have a newborn, most pediatricians will take fevers seriously. So, at the onset of the first few symptoms (cough and colds accompanied by fever), you should already give your pediatrician, nurse, or family doctor a call.

You may have to take your baby to the clinic or hospital if the disease progresses to the second set of symptoms which include wheezing, difficulty breathing, and difficulty feeding.

How Is It Diagnosed?

When you get to the clinic or hospital, your healthcare provided will likely order a series of tests and examinations to determine exactly how severe your newborn’s acute bronchiolitis is. The tests include:

  • History taking
  • A thorough physical exam
  • Blood tests and x-rays (uncommon)
  • Tests that determine the type of virus that caused the infection

Treatment for Acute Bronchiolitis in Newborns

If the diagnosis of Bronchiolitis is made, your infant will most likely get hospitalized to adequately monitor his progress. If your child presents with some urgent symptoms such as grunting, wheezing, stops breathing, or turning blue, you should definitely seek emergency medical services by dialing 911.

When you get to the hospital, your healthcare provider will likelyorder the following:


The primary reason why your healthcare provider would want to admit your newborn for acute bronchiolitis is for monitoring purposes. It is very crucial to monitor the status of a newborn with bronchiolitis because they are very prone to complications since they have an underdeveloped system.

Your baby will be monitored for any sign of dehydration, inadequate oxygenation, breathing problems, or anything that may indicate worsening of the condition.

The best place for your baby to be if they have bronchiolitis is the hospital. There they will have round-the-clock observation, and the resources such as intravenous fluids and respirators are readily available should they be needed.

Fever control

Another thing your healthcare provider will do for your baby during their hospital stay is controlling their fever. A very high temperature, especially for newborns is very dangerous as it may cause seizures.

Acetaminophens may be administered orally, or through an IV line if your baby is not feeding well, to control the temperature and keep them comfortable.

Nasal drops or spray

A saline solution dropped or sprayed into the nose will help thin down the mucus so that it can be easily suctioned out with a bulb or a hospital suction.

Loosening the mucus in the nose and suctioning them out will help your baby breath better. Newborns and very young babies are natural nose-breathers, so it is important to clear their nose to make breathing easier.

Fluid intake

Baby getting IV fluid

At home, parents can encourage their baby to drink enough fluids. For newborns, it is important to breastfeed on demand at least 8 times during a 24-hour period. If you are formula-feeding, follow the correct recommendations of formula amounts for newborns.

If the condition worsens, your baby may have poor feeding. They may fuss at the breast or refuse to feed at all. If this happens, you will have to call your healthcare provider who will likely recommend your baby to get admitted so that they can administer fluids through an IV line.


Other possible treatment your child may receive are IV fluids, supplemental oxygen through an oxygen head box that is specially designed for infants.

Antibiotics can’t help the condition because since Acute Bronchiolitis in Newborns is caused by a virus, this type of medication won’t work because it mainly targets bacteria.

Cough suppressants and decongestants are also not advisable because they have not been proven to help with Bronchiolitis. In fact, they may even do more harm since they may mask the symptoms of low oxygen and breathing difficulty.

Can You Prevent Acute Bronchiolitis in Newborns? How?

Having your newborn hospitalized is not a good experience for any parent. That being said, there are a couple of things you could do so that your little one does not contract the disease.

Don’t smoke

Smoking is not just bad for your own health. It has terrible effects on a little baby with brand-new lungs. You can make your baby a good motivation to quit this bad habit.

If other family members are smoking, urge them to quit, prevent them from smoking in the house or holding your baby after smoking because smoke may cling to clothes and other parts of the body that may come in contact with the baby once they hold them.

Disinfect your hands thoroughly

Make it a habit to wash your hands as frequently as possible, especially if you’ve been in contact with other people outside your house. Wash with soap and water for a good 20 seconds and apply an alcohol-based hand rub to kill all the germs you may have touched.

Practice good hygiene

Having good hygiene makes you less prone to sickness since you are washing off the germs that may have clung to you the whole day. This is especially important if you frequently go outside. Have a quick shower first before cuddling with your little one.

Avoid people who are ill

If a coworker seems to have cough and colds, try to maintain a good distance from them for the meantime. You might catch the disease, or bring it with you at home to your newborn.

Similarly, when visiting or being visited, make sure that nobody around is sick. Germs can spread quickly, and a newborn’s underdeveloped immune system may not be able to adequately fight it off.

Follow vaccination schedules

It is advised that all individuals beyond 6 months of age be vaccinated annually for the flu. While your newborn still cannot have the vaccination, make sure not to miss it for yourself.

If you vaccinate yourself and other members of your household, you will be less likely to get sick and pass on the sickness to your little one.


While acute bronchiolitis in newborns may be very common, it’s completely understandable to be worried about your child, especially if your little one is just a newborn. Newborns are so susceptible and so fragile that it is a big risk for them to have such a disease, no matter how common it is.

What is important is that you know what it is, which signs to look out for when to call your doctor, what to expect, and most important of all, how to avoid it.

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Vanessa is a freelance writer and a two-time certified boy mom to a toddler and a preschooler. She believes that raising happy kids is a delicate balance between doing your best as a parent and seeking help when you need it.

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