CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Cough - acute with chest signs in children - Management
How do I manage an infant with bronchiolitis?
- Infants with bronchiolitis and any high risk features — admit immediately.
- Infants with bronchiolitis at intermediate risk — consider hospital assessment. The threshold for arranging this should be low. Arrange hospital assessment if:
- The infant was born prematurely, or has any significant health problems such as chronic respiratory disease or congenital heart disease.
- The carers are not able to cope with the ill child.
- There is any deterioration in the child's condition.
- Infants with bronchiolitis at low risk can be managed at home.
- For children managed at home, antibiotics and bronchodilators are not recommended. Advise carers that bronchiolitis is a self-limiting condition but occasionally children deteriorate. Advise checking on the child regularly, including through the night, and to call a doctor if they are unable to cope or if the child deteriorates, in particular if:
- Breathing rate increases, or if there are any episodes of apnoea or signs of increased effort of breathing.
- A baby takes less than 50% of its normal feeds, there are signs of dehydration such as dry mouth or infrequent passage of urine.
- A baby becomes less responsive or difficult to rouse.
- There is persistent worsening of fever.
In depth
© NHS Institute for Innovation and Improvement