Bronchitis In Children: Causes, Symptoms and Treatment

Eight-year-old Rahul has been suffering recurrent bouts of cough and cold. His mother, Seema, is worried as the little boy keeps complaining of tightness in the chest and a sore throat. A visit to the doctor confirms that Rahul is having acute bronchitis (inflammation of the main airways in the lungs). He assures Seema not to worry as bronchitis in children is quite common and the symptoms can be managed without antibiotics. However, this is not the first time that Rahul has been diagnosed with the ailment. During his growing up years, he suffered from recurrent bronchitis almost two to three times in a year.

What is bronchitis?

Bronchitis is an infection in the large airway passages, which connect the windpipe to the lungs. In this condition, there is an inflammation of the mucous membrane lining the medium and the large breathing tubes (bronchus). It starts with a common cold, sinusitis or flu and develops into bronchitis.

Types of bronchitis

There are two types of bronchitis - acute and chronic.

• Acute bronchitis: Symptoms only last for a few weeks and go away without needing antibiotics. In most cases, the disease is caused by the cold virus. Other reasons for acute bronchitis are smoke or dust inhalation.
• Chronic bronchitis: The condition is termed chronic when the cough symptoms with mucus production persists for more than three months. It also should have been recurrent over a period of two years.

Symptoms of bronchitis in kids

The symptoms include fever and dry cough during early illness, and discharge of sputum when a bacterial infection sets in. The child can also have chest pain, breathlessness, chest tightness associated with wheezing, lethargy, poor intake and irritability as the illness progresses. These symptoms occur more often in the night. Bronchitis can start as an acute illness or sometimes become chronic, lasting more than a few weeks or months, depending on the child's immunity and response to treatment.

Causes of bronchitis in babies

The most common cause of bronchitis in babies is a viral respiratory infection but can also be caused by a bacterial infection with prolonged illness. Sometimes, children less than two years of age can suffer from acute airway injury called bronchiolitis. The symptoms of bronchitis or bronchiolitis can mimic a common cold or flu; hence, there can be a delay in the diagnosis.

Many of these symptoms overlap with early childhood asthma but are mistakenly treated as bronchitis or bronchiolitis with repeated courses of antibiotics. Parents should be aware of these symptoms and consult a child specialist to get a correct diagnosis and initiate proper treatment.

Immunity in children

As the present generation of children get vaccinated early in life, their immunity is much less developed than in children, who suffer from natural infections in early childhood. This could be one of the reasons for why children suffer from prolonged bouts of bronchitis following a viral or bacterial respiratory infection.

Childhood bronchitis is usually self-limiting, lasting 5-7 days, but may occasionally last for anything between 10 days and four weeks, if there is a prolonged illness or a bacterial infection. The delay in recovery may be due to undetected reactive airway disease (a condition where the airway is obstructed because of external factors), an allergy, a foreign body trapped in the airways, or other medical conditions such as cystic fibrosis, bronchiectasis and ciliary dyskinesia.

The non-infectious causes of bronchitis include repeated exposure to irritants like dust, smoke, indoor and outdoor pollution, tobacco smoke and allergens.

So, why does Rahul get bronchitis almost twice every year? Apart from a respiratory infection, the child could be suffering from repeated episodes of bronchitis (allergic bronchitis) due to newer strains of viruses each year. The treating physician should recognise the condition and treat with appropriate medications, so that the suffering is not prolonged.

Treatment for bronchitis in toddlers

• The treatment for acute bronchitis in children includes complete bed rest, good hydration, medication to control fever, cold, cough and use of antibiotics to treat the associated bacterial infection.
• If your child is suffering from breathlessness or wheeze, nebulisation with bronchodilators (medication to remove the block in the airways) may be needed to improve the condition. If your child's bronchitis is chronic, he may be prescribed regular nebulisation or inhalers. To control bacterial infection, the doctor may prescribe systemic steroids apart from antibiotics.
• If a foreign body is detected, the child may need a procedure called bronchoscopy to remove the foreign body and to clear the trapped secretion or mucus, for faster recovery.
• Bronchitis is not a contagious disease. As your child grows up and the immunity improves, the frequency of the illness comes down. If the child has an allergy, the symptoms may continue into adolescence, or even adulthood.
• The recurrent episodes of bronchitis may be prevented with seasonal influenza vaccination and pneumococcal vaccination to some extent.

Home remedies for bronchitis in toddlers

• Natural cough syrup: Honey and lemon in warm water is one of the popular home remedies for cough and cold. Honey helps to reduce cough frequency and severity and will help soothe your baby's throat. According to a study by Cohen et al, titled 'Effect of honey on nocturnal cough and sleep quality: a double-blind, randomized, placebo-controlled study' published in Pediatrics (2012), honey can be considered an effective and safe treatment of children greater than 1 year of age.
• Drink warm fluids: According to research, drinking warm liquids help relieve cough and cold symptoms. Hot fluids can loosen up the mucus in the chest and sinuses and make it easier to expel. It is also important to stay hydrated during an illness.
• Salt-water gargle: Give your toddler slightly warm water mixed with salt. Ask him to swish the mixture around the throat for some time before spitting it out and not to swallow. Salt water can soothe throat inflammation and reduce the mucus in the back of the throat.
• Steam inhalation: You can expect mild relief of symptoms of bronchitis from steam inhalation. Warm steam works by loosening the mucus in the nasal passages, sinuses and lungs. This helps to reduce the frequent bouts of cough and improves breathing.

Look out for worrying signals when your child falls ill. Discuss with your child's paediatrician about the measures to be taken to control the recurrent episodes. This will save your child from prolonged illness.

About the expert

Written by Dr Ramesh B R on 16 July 2018; updated on 23 September 2019

Dr Ramesh B R is an experienced, skilled and awarded pulmonologist with over 30 years of experience.

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