When Your Child Has Acute Bronchitis

Acute bronchitis occurs when the bronchial tubes (airways in the lungs) become infected or inflamed. Normally, air moves in and out of these airways easily. When a child has acute bronchitis, the tubes become narrowed, making it harder for air to flow in and out of the lungs. This causes shortness of breath and coughing or wheezing. Acute bronchitis usually goes away without treatment in a few days to a few weeks.

Cross section of bronchiole showing open airway.

Cross section of bronchiole showing airway mostly blocked by mucus, inflammation, and muscle constriction.

A healthy airway allows a clear passage for air.

An inflamed airway blocks airflow.

What causes acute bronchitis?

  • A cold or the flu (most cases)

  • A bacterial infection

  • Exposure to irritants such as tobacco smoke, smog, and household cleaners

  • Other respiratory problems, such as asthma

What are the symptoms of acute bronchitis?

Acute bronchitis usually comes on suddenly, often after a cold or flu. Symptoms include:

  • Noisy breathing or wheezing

  • Mucus buildup in the airways and lungs

  • Slight fever and chills

  • Chest retractions (sucking in of the skin around the ribs when your child inhales, a sign of difficult breathing)

  • Coughing up yellowish-gray or green mucus

How is acute bronchitis diagnosed?

Your child’s health history, a physical exam, and certain tests can help your child’s healthcare provider diagnose bronchitis. During the exam, the provider will listen to your child’s chest and check his or her ears, nose, and throat. One or more of these tests may also be done:

  • Sputum culture: Fluid from your child’s lungs may be checked for bacteria. Not routinely done because it is hard to get in children.

  • Chest X-ray: Your child may have a chest X-ray to look for pneumonia (bacterial infection in the lungs).

  • Other tests: Your child’s healthcare provider may order other tests to check for underlying problems such as allergies or asthma. Your child may be referred to a specialist for these tests.

How is acute bronchitis treated?

The best treatment for acute bronchitis is to ease symptoms. Antibiotics are usually not helpful because viruses cause most cases of acute bronchitis. To help your child feel more comfortable:

  • Give your child plenty of fluids, such as water, juice, or warm soup. Fluids loosen mucus, helping your child breathe more easily. They also prevent dehydration.

  • Make sure your child gets plenty of rest.

  • Keep your house smoke-free.

  • Use “children’s strength” medicine for symptoms. Discuss all over-the-counter products with the doctor before using them, including cough syrup. The U.S. Food and Drug Administration (FDA) does not recommend using cough or cold medicine in children under 4 years of age. Use caution when giving these medicines to kids between the ages of 4 and 11 years.

  • Never give a child under age 18 aspirin to treat a fever unless your healthcare provider says it’s OK. (It could cause a rare but serious condition called Reye’s syndrome.)

  • Never give ibuprofen to an infant 6 months of age or younger.

If antibiotics are prescribed

Your child’s healthcare provider will prescribe antibiotics only if your child has a bacterial infection. In that case:

  • Make sure your child takes ALL the medicine, even if he or she feels better. Otherwise, the infection may come back.

  • Be sure that your child takes the medicine as directed. For example, some antibiotics should be taken with food.

  • Ask your child’s healthcare provider or pharmacist what side effects the medicine may cause and what to do about them.

Preventing future infections

To help your child stay healthy:

  • Teach children to wash their hands often. It’s the best way to prevent most infections.

  • Don’t let anyone smoke in your house or around your child.

  • Consider having children ages 6 months to 18 years get a flu shot each year. The shot is recommended for young children because they are especially at risk of flu, which can lead to bronchitis.

Tips for proper handwashing

Use warm water and plenty of soap. Work up a good lather.

  • Clean the whole hand, under the nails, between fingers, and up the wrists.

  • Wash for at least 20 seconds (as long as it takes to say the ABCs or sing “Happy Birthday”). Don’t just wipe—scrub well.

  • Rinse well. Let the water run down the fingers, not up the wrists.

  • In a public restroom, use a paper towel to turn off the faucet and open the door.

When to seek medical care 

Call the healthcare provider if your otherwise healthy child has:

  • Symptoms that get worse, or new symptoms

  • Trouble breathing

  • Retractions (skin sucking in around the ribs when your child inhales)

  • Symptoms that don’t start to improve within a week, or within 3 days of taking antibiotics

  • Recurring bronchial infections

Unless advised otherwise by your child’s healthcare provider, call the provider right away if:

  • Your child is of any age and has repeated fevers above 104°F (40°C).

  • Your child is younger than 2 years of age and a fever of 100.4°F (38°C) continues for more than 1 day.

  • Your child is 2 years old or older and a fever of 100.4°F (38°C) continues for more than 3 days.