New advice issued on caring for children with bronchiolitis

The National Institute for Health and Care Excellence (NICE) has issued draft recommendations to provide best practice advice on the care of babies and young children with lung infection bronchiolitis.The guideline recommends treatment with supportive therapies such as oxygen, airway suctioning or tube feeding for some children with bronchiolitis. It does not recommend the use of a range of other therapies such as antibiotics, bronchodilators or corticosteroids.Professor Mark Baker, director of clinical practice at NICE, said: €œWith this new draft guideline our aim is to assist clinicians, alongside parents and carers, in making decisions about how to thoroughly assess babies and young children with bronchiolitis and what the most appropriate treatments are to use, to ensure they are well looked after.€Bronchiolitis is the most common disease that affects the lower respiratory tract and around 1 in 3 babies will develop the condition in their first year of life.It is caused by a viral infection where small airways in the lungs, known as bronchioles, become inflamed. This reduces the amount of air entering the lungs and causes breathing difficulties. Symptoms usually start as a cough with forced breathing. It often results in difficulty feeding.

Professor Baker added: €œBronchiolitis may often be confused with a common cold in infants who present to primary care. In the majority of cases, symptoms are mild and will only last a few days, but in some cases the disease can lead to serious illness. It is very important that children with bronchiolitis are correctly diagnosed and their symptoms closely monitored. So parents and carers, as well as doctors, nurses and health visitors need to know when to seek help from specialist care.€ Most children with bronchiolitis can be managed at home and the draft guideline has key safety information for parents and carers. This includes red flag symptoms to look out for such as increasing difficulty breathing or exhaustion, and when to arrange a follow up or get immediate help.A small number (2-3%) of infants with bronchiolitis will require hospitalisation. The guideline sets out recommendations for people working in primary care on when to consider referral to specialist care, such as if a child has rapid breathing (a respiratory rate of over 60 breaths/minute), difficulty breastfeeding or clinical dehydration.It also sets out the symptoms which require immediate referral to emergency care, usually by calling 999. Urgent symptoms include stopping breathing, looking seriously unwell or beginning to turn blue.