An Overview of Bronchitis in Kids

Bronchitis in kids occurs when a chest cold leads to inflammation of the large airways to the lungs called the bronchi. If your child has been coughing for more than a week, they could have bronchitis.

Acute bronchitis usually comes on quickly due to a viral or bacterial infection. Apart from a cough, symptoms of bronchitis in children may include a sore throat, body aches, and fatigue (feeling tired). These can last for up to three weeks. 

This article explains the signs of bronchitis in kids, how viral and bacterial bronchitis are treated, and when you may need to have your child see their healthcare provider. It also discusses serious complications that can arise in children with bronchitis, such as pneumonia.

Symptoms and Signs of Bronchitis in a Child

Bronchitis in kids is often diagnosed when a child has a persistent cough that lasts for more than a week. The condition often begins with a dry cough that gradually turns wet or productive.

A productive cough means your child is coughing up mucus. The cough 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 

Bronchitis symptoms may last for up to three weeks.

Causes of Bronchitis in Kids

The most common causes of bronchitis in kids are viruses and bacteria. It usually starts out as an upper respiratory infection, such as a cold.

Children can catch viral or bacterial respiratory infections by having direct contact with another infected person, which commonly occurs in schools and daycares.

Other causes of acute bronchitis in kids include irritants like:

• Dust
• Secondhand smoke
• Strong fumes
• Allergens

Chronic Bronchitis in Children

It is rare for children to be diagnosed with chronic bronchitis. This is a persistent disease that comes on slowly over time and is often attributed to secondhand smoke exposure.

Underlying conditions such as cystic fibrosis can lead to thick mucus production and chronic bronchitis in kids as well.

Risk Factors

Some children may be more at risk of getting bronchitis than others. In addition to irritant exposure, common risk factors include:

• Allergies
• Asthma
• Chronic sinusitis
• Enlarged tonsils

Does My Child Have Bronchitis?

You may assume your child has bronchitis based on their symptoms. However, it's best to let a healthcare provider make that call. That's because bronchitis can sometimes be confused with pneumonia or bronchiolitis.

A healthcare provider will conduct a physical exam, which will include listening to your child's lungs. If that's not enough to confirm bronchitis, additional testing will be ordered.

Ruling Out Bronchiolitis

Bronchiolitis affects the smaller airways known as the bronchioles, rather than the larger ones. These airways constrict, making breathing more difficult.

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

This condition is the leading cause of hospitalization among infants and young children.

If your healthcare provider suspects bronchiolitis, they may check your child’s pulse oximetry, which measures the amount of oxygen in the blood.

Ruling Out Pneumonia

Pneumonia is a lung infection that can cause the alveoli, the air sacs in the lungs, to become inflamed and fill with fluid. It can be viral or bacterial and cause symptoms similar to those of bronchitis.

Most cases of bronchitis resolve on their own, but the condition can sometimes turn into pneumonia. This is why it is important to make sure your child gets plenty of fluids and rest while they are sick.

If the bronchitis is bacterial, taking the entire course of antibiotics prescribed by your child's healthcare provider can help prevent the infection from progressing to pneumonia.

If your child's healthcare provider suspects that this has already occurred, they may order a chest X-ray. Occasionally, they may also collect a mucus sample to be evaluated by a lab. 

Note that even if pneumonia is ruled out when your child is first evaluated, there is always the possibility it can develop as the result of bronchitis.

How Do You Treat Bronchitis in Children?

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

While medication can help resolve a bacterial infection, viral infections simply have to run their course. In the meantime, symptomatic treatment can be given for comfort.

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 child's healthcare provider will recommend that they rest as much as possible. This means staying home from school or daycare until their symptoms improve. 

Once mucus starts to come loose in their bronchi, it will be easier to cough it up and remove it. To help this along and ease discomfort, try:

• Administering a saline nasal spray or drops
• Using a cool-mist humidifier
• Having your child breathe in steam (e.g., have them sit in the bathroom with the shower running)
• Providing them plenty of liquids, like water or broth

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 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 depends on your child’s symptom severity. 

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. 

Try giving the medication with food to prevent nausea, vomiting, and diarrhea—all common side effects of antibiotics. Giving your child a pediatric probiotic supplement may help as well. 

Pneumonia Caused by Bronchitis

If bronchitis results in pneumonia, it may be treated with prescriptions or over-the-counter medication. Your child will also require lots of rest.

In rare cases, some children who develop pneumonia may require hospitalization for oxygen therapy. 

Preventing Bronchitis

There are steps you can take to prevent bronchitis in kids, some of which you will need to rely on your child to follow through on.

Take the time to explain, in simple terms, the reason they need to follow each of these measures and repeat this message as often as is needed for these suggestions to become habits:

• Make sure your child knows how best to cover their mouth and nose when coughing or sneezing.
• If they wear a face mask to school, make sure their masks are properly cleaned daily.
• Encourage your child to wash their hands frequently. Proper handwashing technique at the right times, such as right before meals or after blowing their nose, can reduce the chances of spreading illness.
• Stay in contact with your child's healthcare provider about their vaccination schedule and stay up-to-date on recommended shots to keep them healthy.

Summary

Most cases of bronchitis in kids resolve on their own without the need for antibiotics or other prescription drugs, though some may require treatment. It's best to let a healthcare provider evaluate your child and make that decision.

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.