How to Recognize Bronchitis in Kids and How It’s Treated

If you were just up all night with your coughing child, bronchitis may be to blame. Bronchitis is a chest cold that occurs when the airways to the lungs become inflamed and start producing mucus. These large airways are known as the bronchi. If you child has been experiencing a wet cough for more than a week, it’s likely that they are experiencing bronchitis. 

Acute bronchitis usually comes on quickly and can last for three to four weeks, while chronic bronchitis, which is rare in children, is a persistent disease that comes on slowly over time. It is often attributed to smoking or even secondhand smoke. 

Acute bronchitis can be classified as viral or bacterial. Viral bronchitis makes up the majority of cases in children and requires time and rest to heal. Bacterial bronchitis is caused by a bacterial infection and usually requires a trip to the pediatrician and antibiotic therapy. 

Causes of Bronchitis in Kids

The most common causes of bronchitis in kids are viruses and bacteria. A bacterial infection is caused by bacteria in your child’s bronchi. Other causes of acute bronchitis include irritants such as dust, tobacco, strong fumes, and allergens. 

Viral infections are a common cause of bronchitis in kids and usually start out as an upper respiratory infection, such as a cold. Children can catch viral bronchitis by having direct contact with another infected person. This is common for kids in school or daycare since they spend time together in close quarters.  

Symptoms

A common sign of bronchitis in kids is a persistent cough that lasts for more than a week. The cough may be dry or wet.

A wet cough means your child is coughing up mucus. This is their body’s attempt to remove the mucus from their airways. Infants and young children may gag or vomit due to the mucus. 

Other symptoms to watch for include:

• Tiredness and crankiness
• Chest soreness
• Sore throat
• Headache 
• Body aches
• Runny nose
• Mild fever
• Chills
• Wheezing 

Risk Factors

Some children may be more at risk of getting bronchitis than others. Common risk factors include:

• Allergies
• Asthma
• Chronic sinusitis
• Enlarged tonsils
• Exposure to secondhand smoke

Diagnosis

Bronchitis is a common respiratory illness in children which can often be diagnosed by history and physical exam. Bronchitis can sometimes be confused with pneumonia or bronchiolitis. Bronchitis shares many similar symptoms with bronchiolitis; your healthcare provider will help you determine what your child is experiencing.

Bronchitis affects the larger airways to the lungs, the bronchi. Bronchiolitis affects the smaller airways known as the bronchioles. During bronchiolitis, the bronchioles constrict, making breathing more difficult. Bronchiolitis is more common in young children, while bronchitis usually affects older children and teens. 

Bronchiolitis is usually caused by a virus, such as the influenza (flu) virus or respiratory syncytial virus (RSV). Like bronchitis, bronchiolitis can cause a cough and slight fever. Young children with bronchiolitis may also develop rapid, shallow breathing and wheezing. 

Your healthcare provider will ask when your child’s symptoms started and if they have worsened. They will examine your child and listen to their lungs.

If your healthcare provider suspects bronchiolitis, they may check your child’s pulse oximetry, which measures the amount of oxygen in the blood. If your healthcare provider suspects pneumonia, they may order a chest X-ray. Occasionally, a mucus sample is ordered as well. 

Treatment

The treatment for bronchitis depends on your child’s symptoms and the cause of their condition.

Viral Bronchitis

Viral bronchitis usually resolves on its own within a few weeks. Antibiotics should never be used to treat viral infections since they will not help and may contribute to future antibiotic resistance. 

Instead, your pediatrician will recommend that your child rest as much as possible. This means staying home from school or daycare until their symptoms improve. 

To help ease your child’s symptoms, try administering a saline nasal spray or drops. The saline mixture will help hydrate their tissues while breaking up mucus.

Other ways you can help your child’s body break up mucus include using a humidifier, breathing in steam, and drinking plenty of liquids like water or broth. Once the mucus starts to come loose in their bronchi, it will be easier to cough it up and remove it. 

Most children start feeling better after 10 days, with full recovery sometimes taking two to three weeks. 

Bacterial Bronchitis

Bacterial bronchitis usually requires antibiotic therapy. If your child has had a wet cough for more than 10 days, see your healthcare provider to find out if they have developed a bacterial infection.

Amoxicillin is generally considered the first-line treatment for bronchitis in kids. The medication is usually taken twice daily, and the number of days needed will depend on your child’s symptom severity. 

If your child is prescribed liquid amoxicillin, you can mix it into their food or drink. Amoxicillin capsules should never be opened or crushed. Most kids begin feeling better after three days of antibiotic therapy.

Be sure to help your child finish their full prescription even once they start feeling better. When an antibiotic is stopped early, the infection can linger, and the bacteria may become resistant to antibiotic treatment. 

Common side effects of antibiotics include nausea, vomiting, and diarrhea. Try giving the medication with food to prevent an upset stomach. Giving your child a pediatric probiotic supplement may help as well. 

Complications

The majority of children with bronchitis will get better on their own. Rarely, untreated cases of viral or bacterial bronchitis can lead to pneumonia.

Pneumonia is a lung infection that can cause the air sacs in the lungs to become inflamed and fill with fluid. When these sacs, also known as alveoli, fill with fluid, the child’s cough will worsen as a means to remove some of the liquid.

Pneumonia can be diagnosed by a chest X-ray and may be treated with prescriptions or over-the-counter medication, in addition to rest. In rare cases, some children who develop pneumonia may require hospitalization for oxygen therapy. 

A Word From Verywell 

It is difficult to see your child uncomfortable, and you most likely want to do whatever you can to help them feel better right away. It’s helpful to remember that most cases of bronchitis in kids resolve on their own without the need for antibiotics or other prescription drugs. 

Once your child is diagnosed with bronchitis, encourage them to rest as much as possible. Set up a cool mist humidifier in your home, and offer them water and fluids throughout the day.

It may take weeks for your child to fully recover, but most kids start feeling more like themselves after about 10 days. See your pediatrician right away if your child develops a high fever, bloody mucus, or has difficulty breathing.