BRONCHITIS

Bronchitis is an infection of the main air passages in the upper lungs. It can be caused by a cold virus or bacteria, so it doesn’t necessarily need antibiotics. It almost never requires an urgent after-hours call to your doctor.

How can I tell if my child has bronchitis?
Parents often come into the office so the doctor can check if their child has bronchitis because there is a misconception that bronchitis is a severe illness in kids and must be treated with antibiotics. Parents can actually determine on their own if a child has bronchitis. Here is how:

• Junky sounding cough
• Child coughs up and spits up thick green or yellow mucus
• Younger kids won’t cough up and spit out mucus. Instead, they cough it up into the throat and swallow it.
• Child complains of chest pains during coughing
• Rattling breathing sounds that come and go.

When are antibiotics needed for bronchitis?
If your child has fever over 101 for more than 3 days, chest pains with coughing, a junky sounding cough, and rattling sounds with breathing, then this may be bacterial bronchitis and an antibiotic may be needed after your doctor examines your child. Your doctor will also listen to the chest to see if a more severe infection is present.

Should I page my doctor after-hours or go to the ER to get antibiotics?
No. Most cases of bronchitis are caused by a cold virus. Therefore antibiotics usually aren’t needed, and an after hours call to your doctor or ER visit is almost never needed. If your child has fever for a few days, but is acting fairly well with no rapid labored breathing, then this can usually wait until your doctor’s office opens. Following the treatment plan below will usually keep your child stable until the doctor’s office opens next.

When to go to the ER.
If your child has rapid labored breathing with the above symptoms of bronchitis, you should probably go to an ER or urgent care center. Most doctors won’t just prescribe antibiotics over the phone if a child is extremely ill, so an after-hours page to your doctor may not be helpful.

Treating bronchitis at home.
Here is what you can do at home to help clear the mucus out of your child’s chest, whether or not your child is taking antibiotics:

• Steam – make your bathroom steamy by running a hot shower and closing the door. Sit in the steam 4 times daily for 20 minutes.
• Chest pounding – firmly pound on the chest, sides, and upper back for several minutes while steaming.
• Give expectorant medication (guaifenesin) three times daily. This makes the mucus runnier so your child can cough it up better.
• Don’t give cough suppressant medication during the day. Your child needs to cough the junk out of the chest.
• It’s ok to give cough suppressants at night if your child’s cough keeps him awake.
• Have your child sleep slightly upright if possible.

My child won’t spit out the mucus. I’m worried she won’t get better.
Don’t worry. Your child is probably coughing the mucus out of the lungs up into the throat and then swallowing it. This is harmless. Your child may end up coughing then vomiting up the mucus. This too is harmless. All that matters is getting the mucus out of the lungs.