Bronchiolitis:Dara

For anyone whose child has been diagnosed with bronciolitis for the first time, it is a daunting diagnosis, but one apparently that shouldnt be a worry once they turn 18 months.  All of my children had a dose at some stage, but both Killian and Kate were on the older side when they first contracted it.  Kate unfortunately ended up being hospitalised for 2 nights when she was 20 months but recovered pretty quickly.  Therefore when Roisin (now 5 1/2 months) was diagnosed at the end of february I thought I was prepared and knew what to expect, what to look out for and not to worry because a dose of preventative antibiotics and some steroids would clear it in about a week.  Not so however, therefore I thought I would mention a few pointers I learned over the past month which might help some stressed parents out there deal with the unexpected.  I am not a doctor, and have no medical background whatsoever, so go to your doctor and have your little kiddie checked out but ask as many questions as you can.

1. Bronchiolitis is a virus and therefore antibiotics have no effect on it, but are however prescribed sometimes to prevent a secondary bacterial infection.  If your doctor does prescribe antibiotics ask about their necessity.  I am not saying they will not be in your situation (perhaps there is already a bacterial infection present), but it is worth clarifying.  If the child is old enough, natural yoghurt or a probiotic can restore the good bacteria in the stomach.  If your child does need to use them you will need to finish the course.  I have had one doctor prescribe them only for the next to say they were unnecessary and shouldnt have been prescribed.  Its worth clarifying. 
2. The virus reaches a peak after between 3-5 days.  I did not realise this until she was on her second bout of the illness in 3 weeks and we were in A&E panicking because with whatever medicine she received she was still getting worse.  She was at day 5 of the second virus.  If your child is feeding well, has no temperature, and their breathing is not distressed, and you have already visited your doctor recently, chances are that the virus may start to ease off after this.  However, if you are at all concerned, i.e. not feeding, breathing is distressed, wheezing, or has a temperature, use your gut instinct and contact someone.  At this stage our little one had stopped feeding and the breathing was quite distressed, but all it took was for the atrovent medication to be administered through a nebuliser as opposed to the inhaler, and additional steroids.  The following day she was much improved. 
3. The cough can last for up to a month after medication, and is also worse at night.  We were told on numerous occassions by doctors that Roisins cough was probably caused by a "little mucus plug" in her throat, and that some nasal spray may help. Teething was also blamed by another.  At one stage I got quite irrate with the doctor because we had been awake every night for a week and a half following antibiotics and steroid treatment with a 4 month old baby who was coughing so much that she could not catch her breath in between coughs and the only relief was usually to put her over my shoulder and slap her back.  I often spend well over an hour sitting up with her coughing.  In all respects it was like she was choking/drowning when she was coughing!  She had her matress raised, had the nasal spray, we had a warm mist vapouriser in the room, you name it and nothing helped.  Sure a cough can last, but again, use your gut instinct.  This kind of cough was not normal, and she required further treatment.  The kind of cough that remains is a soft cough that gradually fizzles out.
4. I mentioned that she requried further treatment, and this was in the form of a nebuliser.  At first i freaked out thinking that was it - I now have a chronic asthmatic because she needed a nebuliser.  Dont worry about it.  It uses saline (salt water) which in Ireland must be prescribed by your doctor but is harmless.  Its function is to soften and break down the mucus which makes it easier to cough up and reduces the post nasal drip at night.  She found relief at night almost immediately, and i would recommend anyone who is planning to have more than one child, that if you think you may need to use one at any stage, invest in one.  In Ireland you can receive one from the HSE on loan if you have a medical card, but need to purchase your own if you dont have a medical card.  They can cost anything from €85 - €120 but are worth it for young children who may have the potential for asthma or are too young to sit up at night to clear the mucus.  Alternatively, if you do not require it immediately start asking around now instead of when you need it, someone you know may have one you can borrow, and a paediatric mask only costs about €11 which you can then use with the borrowed devise.  
5. Nasal spray also works quite well if the symptoms arent very bad and uses saline similar to the nebuliser, but the nebuliser gets the saline right into the lungs which targets to affected bronchioli. 
6. Finally - you know your child.  Doctors see children with various illnesses everyday, and hear similar symptoms to yours all the time.  I said before I am not a doctor, but I knew that my baby was not getting better, and had to push hard and fight for doctors to listen to me.  If you are worried, ask as many questions as possible and take note of the symptoms, e.g. a diary so that you can make sure the doctor is making an informed decision and you are satisfied that the diagnosis is accurate.  

I have not researched any of the above in medical journals, nor have any references, just my own experience which was a frightening month with a steep learning curve and I hope that this will at least provide some pointers for parents who may face a similar scenario.