Bronchiolitis in Babies: Symptoms, Right Steps and Warning Signs

For two days, baby just had a cold. Tonight, they are coughing more, their breathing speeds up and makes a little whistle, and they drop the bottle after a few sips. This is often how bronchiolitis starts: a virus that travels down from the nose into the smallest airways, the bronchioles.

The infection is very common in infants, frightening to watch, and most often managed at home. It still calls for close watching, especially in the first days and in the youngest babies. Here is how to recognise it, what really helps, and the signs that must never wait.

What is bronchiolitis, and who gets it?

It is an acute viral infection of the bronchioles. Their lining becomes inflamed and secretions clog them, which gets in the way of airflow. The main culprit is the respiratory syncytial virus, or RSV. It affects children under 2, and comes back every year as an epidemic, in autumn and winter.

Not all babies have the same risk of a severe form. French authorities call for extra vigilance:

• before 2 months (corrected age for a premature baby), because of the risk of pauses in breathing;
• for babies born before 36 weeks of pregnancy;
• in the case of heart or lung disease, immune deficiency or neuromuscular disease;
• when baby is exposed to tobacco, during pregnancy or at home;
• when the breathing difficulty (cough, fast or wheezy breathing) began less than 48 hours ago: this is the period when any infant can get worse.

How do you recognise it?

It all starts like a cold, sometimes with a mild fever. Then comes a dry cough, and the breathing changes: faster, wheezy, noisy on breathing out. Baby may struggle to feed and sleep, because breathing takes more effort.

Two signs should catch your eye:

• the breathing rate: count their breaths for one minute, with baby calm, watching their tummy rise. Above 60 a minute, France’s Haute Autorité de santé (HAS) considers the bronchiolitis to be at least moderate;
• the chest indrawing: the skin sinks in between or under the ribs with each breath in, and the nostrils flare. It is a sign that baby is making an effort to breathe.

The acute phase lasts about ten days on average. The first two days after the breathing difficulty appears, not after the cold starts, are when symptoms can worsen; after that, they ease gradually. A small leftover cough can last two to four weeks.

The right steps at home

Most mild cases of bronchiolitis are managed at home. The HAS advice to parents comes down to a few steps:

1. Rinse the nose with saline, baby lying down, head turned to the side, before meals and bedtime. This is the first care: our article on nasal rinsing details it step by step. A nasal aspirator can complement it, gently, at the entrance of the nostril; deep suctioning is not recommended.
2. Split feeds: smaller, more frequent breast or bottle feeds. Keep breastfeeding; if baby struggles to latch, express your milk to give it another way.
3. Lay baby on their back, flat, with no pillow or wedge, as the rules of safe sleep require.
4. Keep the room at around 19 °C, aired, without overheating.
5. Ban tobacco from the house and car.
6. Keep baby at home: nursery is not desirable during the acute phase.

For fever, if there is any, the rules are the same as for any infant; our guide to baby colds also lists the syrups and remedies to avoid.

From the shop

What you need to care for and monitor at home

No product treats bronchiolitis. These are for the basic steps: clearing the nose before feeds, protecting irritated skin and taking the temperature with a reliable thermometer.

• −48 %GifrerIsotonic seawater nasal spray, 100 ml – Gifrer29 DHinstead of 56 DHView product
• −41 %BelvitalManual baby nasal aspirator, from birth – Belvital41 DHinstead of 70 DHView product
• −48 %Safety 1stArctic newborn baby care kit, 8 pieces – Safety 1st156 DHinstead of 300 DHView product
• −9 %BabymoovTravel baby care kit – Babymoov346 DHinstead of 380 DHView product
• −48 %Laboratoires GilbertGilbert Cold Cream, 50 ml24 DHinstead of 46 DHView product
• The whole aisle · Baby nasal aspirators1 products online, delivered anywhere in Morocco.Open the aisle

Products sold by La Maison du Bébé, publisher of this magazine. Prices as of 12 October 2026; please check the product page.

What is useless, or no longer used

The 2019 French guidelines cleared out the treatments for bronchiolitis. For a first episode in an infant under 12 months, the HAS does not recommend:

• chest physiotherapy in outpatient care, for lack of data showing a benefit. “Clapping”, vibration and postural drainage techniques are even contraindicated;
• cough syrups and mucus thinners, contraindicated;
• antibiotics, even with a fever, unless there is an associated bacterial infection;
• bronchodilators, corticosteroids and nebulised adrenaline or hypertonic saline.

This does not mean nothing is done: you help baby breathe and drink while their body clears the virus. If physiotherapy is offered to you, ask your paediatrician; it can be discussed for certain fragile children.

When is hospital admission needed?

Sometimes bronchiolitis becomes severe. The HAS recommends hospital in severe forms, and considers it in moderate ones, in particular when baby needs oxygen, when they drink less than half of their intake over three consecutive feeds, or when they are under 2 months old.

In hospital, the care is mainly supportive: oxygen if needed, nasal rinses, help with feeding when baby can no longer drink enough.

Preventing bronchiolitis: everyday precautions and new protections

Everyday habits remain the foundation, until the child is 2 and throughout the epidemic season:

• wash hands for 30 seconds before and after every contact with baby;
• wear a mask if you have a cold or are coughing;
• avoid crowded, enclosed public places, and if possible nursery before 3 months;
• avoid kisses on baby’s face and hands, including from brothers and sisters;
• air the home every day and do not smoke indoors.

In Morocco, the first weeks are also those of visits and the sbou3 (the baby-naming celebration on the seventh day). In the cold season, kindly asking everyone to wash their hands and to avoid kissing baby’s face and hands is not impolite at all.

Two medical protections now exist. The first is a vaccine for pregnant women, given in France between 32 and 36 weeks of pregnancy: its antibodies pass to the baby and protect them until about 6 months (see our article on vaccines during pregnancy). The second is a monoclonal antibody, nirsevimab (Beyfortus), injected into the newborn in a single dose, protective for at least 5 months. In a study cited by the French health insurance service, involving 1,270 infants, it cut hospital admissions for RSV bronchiolitis by 85%. Another antibody of the same type, clesrovimab, is also authorised in France. These strategies are recommended in France; their availability and cost in Morocco should be checked with your gynaecologist or paediatrician.