Key points about bronchiolitis

  • Bronchiolitis is a chest condition that causes breathing problems in babies.
  • It's caused by a virus – often respiratory syncytial virus (RSV) or rhinovirus.
  • Bronchiolitis is very easy to catch so wash your hands before and after handling your baby.
  • Breastfeeding and a smoke-free environment give the best protection against bronchiolitis.
  • Bronchiolitis is usually a mild illness but some sicker pēpi need to go to hospital.
  • There's no medicine that makes bronchiolitis better. If your baby with bronchiolitis is under 3 months old, you should always see a doctor.
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Bronchiolitis is a common illness usually caused by a virus. The most common are RSV (respiratory syncytial virus) and rhinovirus but there are many viruses that can cause bronchiolitis.

Bronchiolitis affects the smallest airways (called bronchioles) throughout the lungs.

Image of baby's lungs with inset of normal and inflamed bronchioles

Image credit: Asthma and Respiratory Foundation NZ

Yes, bronchiolitis is very easy to catch – it can spread easily. It is most common in winter and spring.

  • bronchiolitis usually affects pēpi under the age of 1 year
  • babies who are around people who smoke are more likely to get bronchiolitis
  • severe bronchiolitis is more common in premature pēpi or pēpi with heart or lung problems

A paediatrician may recommend a medicine to prevent serious illness caused by RSV in high-risk babies – RSV is a common cause of bronchiolitis.

Bronchiolitis often starts as a cold, with a runny nose.

Pēpi with bronchiolitis:

  • may have a fever
  • start to cough
  • breathe fast
  • put a lot of extra effort into breathing
  • have noisy breathing (wheeze).

The second or third day of the chesty part of the illness is usually the worst. Bronchiolitis can last for several days. The cough often lasts for 10–14 days but it may last as long as a month.

When do I need to get advice?

You should see your healthcare provider or go to an after-hours medical centre urgently if your baby:

  • is under 3 months old
  • is breathing fast, has noisy breathing and is having to use extra effort to breathe
  • looks pale and unwell
  • is taking less than half of their normal feeds
  • is vomiting
  • has not had a wet nappy for more than 6 hours.

You should also see a healthcare provider if you are worried about your baby.

Even if you've already seen your healthcare provider, if your baby's breathing difficulties get worse or you are worried, take your baby back to the doctor or nurse.

When should I dial 111?

Dial 111 within Aotearoa New Zealand (use the appropriate emergency number in other countries) and ask for urgent medical help if your baby:

  • has blue lips and tongue
  • has severe difficulty breathing
  • is becoming very sleepy and not easy to wake up
  • is very pale
  • is floppy
  • has breathing that is not regular, or pauses in breathing.

Most babies get better by themselves

Most pēpi with bronchiolitis get better by themselves without any special medical treatment.

  • Antibiotics do not help babies with bronchiolitis because it's caused by a virus.
  • Asthma puffers or inhalers don't help babies with bronchiolitis.
  • Using blue reliever asthma puffers or inhalers in babies less than 12 months of age may make their breathing worse.
  • Steroid medicine by mouth or inhaler doesn't help babies with bronchiolitis.
  • In babies over 12 months of age, it may be hard to tell if the problem is bronchiolitis or viral wheeze – your healthcare provider may try asthma puffers or inhalers.

Babies with more serious illness may need to go to hospital

Babies with more serious bronchiolitis may need to go to hospital. Sometimes babies need help with their breathing. This might include extra oxygen through small soft plastic tubes that fit into your baby's nose.

If your baby is not drinking enough, they may need feeding through a nasogastric tube (a tube through the nose into the stomach) or fluid through an intravenous drip (into a vein).

If your baby has bronchiolitis, keep them at home, away from other pēpi and tamariki, to stop bronchiolitis spreading.

Pēpi who can stay at home

  • Babies who are feeding well.
  • Babies who do not look sick.
  • Babies who are not working too hard with their breathing.

Tips for looking after your baby at home

  • Pēpi with bronchiolitis may not be able to feed for as long as usual. Offer smaller feeds more often.
  • Give them as much rest as possible.
  • Don't smoke in the house or around your baby.
  • Keep your baby's nose clear. If it's blocked or crusty you can use saline nose drops (from a pharmacy).
  • Keep your pēpi away from other pēpi and tamariki, and from childcare centres, to stop bronchiolitis spreading.
  • If your baby is miserable and upset, you can give paracetamol. You must follow the dosage instructions on the bottle. It is dangerous to give more than the recommended dose. Use our paracetamol dose calculator to work out how much to give your baby or child. 
  • Remember to sleep your baby on their back in their own bed and don't prop them up with pillows or blankets.


Breastfeeding your pēpi protects them from getting bronchiolitis by boosting their infection-fighting (immune) system. Breastfeeding beyond 4 months of age offers the best protection.

Smoke-free environment

Make sure your baby's environment is smoke-free. If you want to give up smoking:

A warm house

Keeping the house warm and well-insulated will also decrease your baby's risk of developing bronchiolitis.

Stay away from people with coughs and colds

It is sensible to keep young pēpi away from people who have colds and coughs.

Clean hands

Make sure everyone in your family washes their hands regularly and thoroughly and dries them well, including (but not only) before preparing food and eating. This can reduce the spread of infection.

Bronchiolitis is not the same as asthma. Most pēpi with bronchiolitis don't go on to have asthma. Asthma is more likely in tamariki if there are other family members with asthma.


Virus action plan (child)(external link) He Ako Hiringa, NZ, 2023 English(external link), te reo Māori(external link)Samoan(external link)Tongan(external link), Arabic [PDF, 214 KB], Hindi(external link), Chinese (simplified)(external link)


  1. Starship Children's Health Clinicians. Starship Children's Health clinical guideline – bronchiolitis(external link) Starship Children's Health, NZ, 2019
  2. PREDICT – Paediatric Research in Emergency Departments International Collaborative. Australasian bronchiolitis guideline(external link) 2017

Bronchiolitis statistics

Childhood bronchiolitis hospitalisation rates have increased by nearly a half since 2000. Pacific rates were 3.5 times higher than non-MPA, and Māori rates 3.2 times higher. The rate for the most deprived quintile was 3.9 times the rate of the least deprived quintile. The combined effect of ethnicity and deprivation meant that Māori and Pacific children in the most deprived quintile were at least five times as likely to be hospitalised as non-MPA children in the wealthiest quintile.

There were few deaths from childhood bronchiolitis, but all 7 deaths between 2006 and 2015 were in NZDep deciles 7-10; and all were Māori and/or Pacific children.

Source: The impact of respiratory disease in New Zealand – 2018 update(external link)


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Credits: Content shared between HealthInfo Canterbury, KidsHealth and Healthify He Puna Waiora NZ as part of a National Health Content Hub Collaborative. Healthify is brought to you by health Navigator Charitable Trust.

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