Discharge Instructions for Bronchiolitis (Child)

Your child has been diagnosed with bronchiolitis. This is inflammation in the small airways (bronchioles) in the lungs. It's caused by a virus. It is not the same as bronchitis, which is an infection of the larger airways. Bronchiolitis is most common in children under 2 years old. It often starts as a cold and then gets worse. Some children with bronchiolitis need to be in the hospital. This is because they need oxygen to help them breathe. Or they may be dehydrated and need more fluids. Here is how to care for your child at home.

Home care

• Make sure your child drinks plenty of fluids. This is to prevent too much fluid loss (dehydration). Ask your child’s healthcare provider how much to give.

• Try keeping your child's head raised (elevated) to make it easier to breathe. Don't use pillows for a baby.

• Use a rubber suction bulb to remove mucus from your child’s nose. Ask your child’s healthcare provider to show you how to suction the nose if you're not sure how to do it.

• Wash your hands with soap and water or with alcohol-based hand cleaner before and after touching your child. Your child, if old enough, should also learn to wash their hands often.

• Don’t smoke near your child. Don't let anyone else smoke near your child or in your home.

• Keep in mind that wheezing and coughing from bronchiolitis can last for weeks after your child is sent home from the hospital. Listen to your child’s breathing for signs that it's getting better or worse.

• Give all medicines to your child exactly as directed. Your child may still have a fever. Ask your child's healthcare provider if and when to give children's acetaminophen or ibuprofen. Ibuprofen can only be given to children who are older than 6 months. Never give a child aspirin. Antibiotics are usually not prescribed. This is because bronchiolitis is caused by viruses that are not cured by antibiotics.

Follow-up care

Make a follow-up appointment as advised.

Call 911

Call 911 right away if your child has any of these symptoms:

• Less alert

• Not able to be awake or aware

• Blue, purple, or gray color of skin, fingertips, or lips

• Trouble breathing

• Unable to talk

• Wheezing that doesn't get better with treatment

When to call your child's healthcare provider

Call the healthcare provider right away if your child has any of these symptoms:

• Breathing faster than normal

• Pale skin color

• Vomiting

• Fever (see Fever and children below)

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

• Rectal, forehead, or ear: 102°F (38.9°C) or higher

• Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

• Repeated temperature of 104°F (40°C) or higher in a child of any age

• Fever of 100.4° (38°C) or higher in baby younger than 3 months

• Fever that lasts more than 24 hours in a child under age 2

• Fever that lasts for 3 days in a child age 2 or older