The parents, leaning over the cradle, gnawed with worry, wonder if their child is not suffering from this bronchiolitis which we are talking about so much at the moment.
2 months old, the infant coughs, breathes badly and has just vomited his bottle.
The day before, the pediatrician said the child just had a cold.
But since then things have worsened.
Should we go to the emergency room immediately?
Make a new doctor's appointment?
Or wait to see if it goes by itself?
"We are in the midst of a bronchiolitis epidemic," explains Professor Christèle Gras-Le Guen, head of the pediatric emergency department at CHU Nantes.
The situation is currently explosive in pediatrics.
But fortunately, only 2% of children with bronchiolitis are hospitalized.
Parents need to know the criteria that should prompt them to have their baby examined by a doctor urgently.
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How to measure gravity?
Bronchiolitis is dangerous mainly for children under 3 months old, very premature babies or infants with chronic illness. To measure the seriousness of the situation, several criteria must be assessed. "We must see a doctor urgently, when the infant has a respiratory rate (one inspiration + one expiration) greater than sixty per minute or if he has difficulty breathing, for example with a flapping of the wings of the nose or the thorax which widens when he breathes, ”describes Doctor Bertrand Delaisi, pneumopediatrician in Paris.
You should also be concerned if he takes less than 50% of his bottle for three bottles in a row or if he is less than 6 weeks old.
"To summarize, we must see a doctor urgently when a child under 1 year presents an episode of wheezing during an epidemic, when he has a cold, a cough and, in addition, signs of distress respiratory;
if he does not manage to eat or if he is all limp, without tone, if he turns blue, if he pauses in breathing, ”summarizes Professor Gras-Le Guen.
Where does it come from?
Bronchiolitis is a viral disease caused in 80% of cases by the respiratory syncytial virus (RSV) which infects the bronchioles, that is to say the small bronchi.
This virus causes inflammation and secretions that obstruct the small bronchi, causing respiratory problems.
This disease, which affects infants under 2 years of age, begins with a simple cold for two or three days, but can progress to difficulty in breathing, with coughing and rapid wheezing.
Read alsoBronchiolitis: the Ministry of Health recommends avoiding exposing babies to kisses and family reunions
It is generally a mild disease, with forms which can be moderate or severe.
It is especially very young children and more particularly those under 3 months of age who may have serious symptoms requiring hospitalization, sometimes in intensive care.
The disease heals in eight to ten days, but a residual cough may persist for another fortnight.
"A child can have several episodes of bronchiolitis, because having had the disease once does not lead to total immunity," continues Professor Gras-Le Guen.
But it's like with gastro: the first episode of bronchiolitis can be severe, the following ones are usually less severe.
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What medication do we give?
There is no cure. And antibiotics usually don't help. "Several trials of antiviral drugs intended to treat bronchiolitis are being evaluated, but no molecule is on the market for the moment"
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adds Professor Bertrand Delaisi. It is therefore necessary to wait until the child's immune system itself develops antibodies that fight the virus for the disease to heal on its own in the end.
Some babies with severe forms need help to get through the most difficult times.
"Infants who need hospitalization in pediatrics or intensive care to overcome the disease benefit from an infusion to hydrate them, oxygen therapy to help them breathe and a gastric tube to feed them. , describes Professor Gras-Le Guen.
There are a few deaths each year in France from bronchiolitis, mainly in very premature babies or children with an underlying chronic disease.
Bronchiolitis heals without sequelae.
It is important to tell parents that just because a child has suffered from bronchiolitis does not mean that he will later have asthma.
They are two distinct diseases, with totally different mechanisms.
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