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When Your Child Has Acute Bronchitis

Cross section of bronchiole showing open airway.
A healthy airway allows a clear passage for air.

Acute bronchitis occurs when the bronchial tubes (airways in the lungs) become infected or inflamed. Normally, air moves in and out of these airways easily. When a child has acute bronchitis, the tubes become narrowed, making it harder for air to flow in and out of the lungs. This causes shortness of breath and coughing or wheezing. Acute bronchitis often goes away without treatment in a few days to a few weeks.

What causes acute bronchitis?

  • A cold or the flu (most cases)

  • A bacterial infection

  • Exposure to irritants such as tobacco smoke, smog, paint, and household cleaners

  • Other respiratory problems, such as asthma

What are the symptoms of acute bronchitis?

An inflamed airway blocks airflow.
An inflamed airway blocks airflow.

Acute bronchitis often comes on suddenly, often after a cold or flu. Symptoms include:

  • Noisy breathing or wheezing

  • Mucus buildup in the airways and lungs

  • Slight fever and chills

  • Sucking in of the skin around the ribs when your child inhales (chest retractions), a sign of difficult breathing)

  • Coughing up yellowish-gray or green mucus

How is acute bronchitis diagnosed?

Your child’s health history, a physical exam, and certain tests can help your child’s healthcare provider diagnose bronchitis. During the exam, the provider will listen to your child’s chest and check his or her ears, nose, and throat. One or more of these tests may also be done:

  • Sputum culture. Fluid from your child’s lungs may be checked for bacteria. Based on your child's age, this test may optional because it is hard to get in younger children.

  • Chest X-ray. Your child may have a chest X-ray to look for a bacterial infection in the lungs (pneumonia).

  • Other tests. Your child may have other tests to check for underlying problems such as allergies or asthma. Your child may be referred to a specialist for these tests.

How is acute bronchitis treated?

The best treatment for acute bronchitis is to ease symptoms. Antibiotics are often not helpful because viruses cause most cases of acute bronchitis. To help your child feel more comfortable:

  • Give your child plenty of fluids, such as water, juice, or warm soup. Fluids loosen mucus, helping your child breathe more easily. They also prevent dehydration.

  • Make sure your child gets plenty of rest.

  • Keep your house smoke-free.

  • Use “children’s strength” medicine for symptoms. Talk about all over-the-counter products with the healthcare provider before using them, including cough syrup. The U.S. Food and Drug Administration (FDA) does not advise using cough or cold medicine in children under 4 years of age. Use caution when giving these medicines to kids between the ages 4 and 11.

  • Don’t give aspirin (or medicine that contains aspirin) to a child younger than age 19 unless directed by your child’s provider. Taking aspirin can put your child at risk for Reye syndrome. This is a rare but very serious disorder. It most often affects the brain and the liver.

  • Never give ibuprofen to an infant 6 months old or younger.

If antibiotics are prescribed

Your child’s healthcare provider will prescribe antibiotics only if your child has a bacterial infection. In that case:

  • Make sure your child takes all the medicine, even if he or she feels better. Otherwise, the infection may come back.

  • Be sure that your child takes the medicine as directed. For example, some antibiotics should be taken with food.

  • Ask your child’s healthcare provider or pharmacist what side effects the medicine may cause and what to do about them.

Preventing future infections

To help your child stay healthy:

  • Teach children to wash their hands often. It’s the best way to prevent most infections.

  • Don’t let anyone smoke in your house or around your child.

  • Think about having children ages 6 months to 18 years get a flu shot each year. The shot is advised for young children because they are especially at risk of flu, which can lead to bronchitis.

Tips for correct handwashing

Use clean, running water and plenty of soap. Work up a good lather.

  • Clean the whole hand, under the nails, between fingers, and up the wrists.

  • Wash for at least 20 seconds (as long as it takes to say the ABCs or sing “Happy Birthday”). Don’t just wipe—scrub well.

  • Rinse well. Let the water run down the fingers, not up the wrists.

  • In a public restroom, use a paper towel to turn off the faucet and open the door.

When to get medical care 

Call the healthcare provider if your otherwise healthy child has:

  • Fever (see "Fever and children" below)

  • Symptoms that get worse, or new symptoms

  • Symptoms that don’t start to get better in a week, or within 3 days of taking antibiotics

  • Bronchial infections that keep coming back

Call 911

Call 911 if your child has any of these:

  • Trouble breathing

  • Skin sucking in around the ribs when your child breathes in (retractions)

  • Trouble breathing or can't talk

  • Blue purple or gray skin color, especially lips

  • Trouble talking or swallowing

  • Loss of consciousness or dizziness

  • Seizure-like activity

  • Shortness of breath or wheezing

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds of digital thermometers. They include ones for the mouth, ear, forehead (temporal), rectum, or armpit. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Use a rectal thermometer with care. It may accidentally poke a hole in the rectum. It may pass on germs from the stool. Follow the product maker’s directions for correct use. If you don’t feel OK using a rectal thermometer, use another type. When you talk to your child’s healthcare provider, tell him or her which type you used.

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

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

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

  • 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

Online Medical Reviewer: Daphne Pierce-Smith RN MSN CCRC
Online Medical Reviewer: Liora C Adler MD
Online Medical Reviewer: Marianne Fraser MSN RN
Date Last Reviewed: 1/1/2020
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