Bronchiolitis

A runny nose that turns into a cough, fast breathing and a baby who won’t feed. Bronchiolitis is very common in the first year of life. Most babies get through it at home; the job is to keep them feeding and watch their breathing.

What it is: a viral infection of the small airways in the lungs, usually caused by respiratory syncytial virus (RSV). Almost all children catch RSV before age 2. It’s most common in winter but can happen any time.

Who gets it: babies under 12 months, and sometimes toddlers up to 2. Babies under 10 weeks, those born early, and babies with heart or lung conditions or smoke exposure are more likely to get very sick.

How it goes: it starts like a cold, then over a few days comes a cough, faster breathing, wheezing or crackles, and trouble feeding. It’s usually worst around days 2 to 5 and settles over 7 to 10 days. The cough can last up to 3 weeks.

Why feeding matters: a blocked nose and fast breathing make it hard for babies to suck and breathe at the same time. Feeding less than half the usual amount is one of the main reasons babies need hospital.

The bronchiolitis ladder

There’s no medicine that cures bronchiolitis. Treatment is support: feeding, watching breathing, and oxygen or tube feeds in hospital if needed. Prevention now works very well.

1. Step 1 · PreventionRSV vaccine in pregnancy or an antibody injectionAn RSV vaccine in pregnancy passes protection to the baby. Babies whose mothers didn’t have it (or had it less than 2 weeks before birth) can have an antibody injection called nirsevimab.

   Works

   The antibody injection cuts the chance of a baby needing hospital care for RSV by more than 80%. It protects for about 5 to 6 months

   Cost

   Free in Australia: the pregnancy vaccine is on the National Immunisation Program and nirsevimab is free for eligible babies through state programs

   How long

   One dose, before or at the start of RSV season

   Watch for

   Ask your midwife or GP which option fits your pregnancy or baby.

   The best bronchiolitis is the one that never turns up.

2. Step 2 · Self-careSmall, frequent feeds and close watchingOffer smaller feeds more often. Saline nose drops before feeds can help. Keep your baby away from smoke, and check on them regularly, including overnight.

   Works

   Supportive care is the treatment; most babies recover at home

   Cost

   Free, plus a few dollars for saline drops

   How long

   7 to 10 days, with a cough for up to 3 weeks

   Watch for

   Count wet nappies. Fewer than usual can mean your baby isn’t getting enough fluid.

   Little and often beats big and battle.

3. Step 3 · PharmacyParacetamol or ibuprofen for discomfortOnly if your baby is uncomfortable or feverish. Paracetamol is for babies over 2 months; ibuprofen for over 3 months. Don’t give both at the same time.

   Works

   Helps comfort, not the infection itself

   Cost

   A few dollars

   How long

   As needed

   Watch for

   Use the dose for your baby’s age and weight, and never give aspirin to children.

   Comfort counts, even when it doesn’t cure.

4. Step 4 · HospitalOxygen and feeding supportBabies who can’t feed well get fluids through a thin tube into the stomach or a drip. Oxygen is added if oxygen levels stay below 92%. Some babies need high-flow oxygen through the nose.

   Works

   Supports babies through the worst few days while their body clears the virus

   Cost

   Free in Australian public hospitals

   How long

   Usually a few days

   Watch for

   Babies under 8 weeks are more likely to need to come back after going home.

   Hospital buys time. Time does the healing.

Costs are rough Australian prices in November 2026 and vary by pharmacy and provider. PBS co-payment: $25, or $7.70 with a concession card. Results are typical figures from trials, not promises.

Save your money

Popular, heavily marketed or often asked about, but the evidence is weak or says no.

• Asthma puffers (salbutamol)Not recommended for bronchiolitis, even in babies with eczema or a family history of asthma. They don’t help.
• SteroidsNot recommended in any form: oral, inhaled or by injection.
• AntibioticsBronchiolitis is caused by a virus. Antibiotics, including azithromycin, don’t help.
• Salty nebulisers, chest physio and routine X-rays or blood testsNone of these are recommended for routine care.

What you can do

• Feed little and often, and track wet nappies.
• Use saline nose drops before feeds if a blocked nose gets in the way.
• Keep your baby away from cigarette smoke and vapes.
• Wash hands often, and keep newborns away from people with colds.
• If you’re pregnant, ask about the RSV vaccine.
• For fevers, see our fever in children fact sheet.

See your GP if

• Your baby has a cold that is getting worse, with a cough or fast breathing
• Your baby is under 3 months, was born early, or has a heart or lung condition
• You are worried, even if you can’t say exactly why

See a doctor urgently if

• Feeding less than half the usual amount, or no wet nappy for 12 hours
• Breathing fast or working hard to breathe, with the skin between the ribs sucking in
• A baby under 3 months with a temperature of 38°C or more
• Your baby is very tired, irritable or not themselves

Call 000 (Australia) or your local emergency number if your baby is struggling to breathe or grunting, has pauses in their breathing, has blue or grey lips, skin or tongue, or is floppy and can’t stay awake.

Helpful resources

• NHS: BronchiolitisSymptoms, home care and warning signs. Free, UK.
• NSW Health: RSV protection for babiesWho can get nirsevimab, for parents. Free, Australia.
• Fever in children fact sheetWhen a temperature needs a doctor. Free, from us.

Evidence and more information

• PREDICT: Australasian bronchiolitis guideline (bedside version)
• NHS: Bronchiolitis
• NSW Health 2026: Nirsevimab for parents and carers

Reviewed 4 November 2026. General education, not personal medical advice. Treatment depends on your situation, so talk to your GP, physio or pharmacist.

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