The family way

7:00am Saturday 8th October 2011

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the organisers of a new campaign to educate parents about bronchiolitis discuss the lung infection, which affects a third of babies before their first birthday. Plus, advice on how to tell if your baby’s got more than just a cold.

by Lisa Salmon.

It’s all too easy to dismiss a high temperature and cough at this time of year as nothing more than a cold.

but when those symptoms are in a baby, together with fast breathing and a loss of appetite, the illness may be more than a cold – it could be bronchiolitis.

the respiratory condition affects one in three babies in the UK before their first birthday, yet only 5% of parents questioned in a GfK NOP survey about the illness knew that it was so common, and many failed to recognise all of its symptoms.

to improve parents’ knowledge of the illness, which often leads to babies being admitted to hospital, the first national Bronchiolitis Awareness Campaign has been launched.

the campaign, organised by the healthcare company Abbott, heralds the start of the bronchiolitis season, which runs from around October to March. Like colds, the illness commonly occurs in the winter months, because the RSV virus that normally causes it is the same virus that causes colds in older children and adults.

Bronchiolitis symptoms are similar to those of a common cold, and include: :: a distinctive, rasping cough :: Shallow, fast breaths :: a high temperature, along with cold-like symptoms such as a runny nose :: Inability to feed the illness occurs when the virus causes inflammation of the tiny air passages deep inside the lungs, the bronchioles, narrowing them and leading to breathing difficulties.

It’s often confused with bronchitis, which affects the main airways in the lungs, the bronchi, rather than the smaller bronchioles.

In the majority of cases, bronchiolitis isn’t a severe condition. however, every year, more than 20,000 children in the UK are admitted to hospital with an RSV infection.

the illness can’t be treated with drugs as it’s a virus, and babies are usually treated in hospital so they can be given oxygen, and help with feeding as they’re unable to breathe and suck at the same time.

In rare cases they are taken to intensive care so they can be put on a ventilator, and even more rarely, they can die from the illness.

Campaign spokesperson Dr Su Laurent, a consultant paediatrician at Barnet and Chase Farm Hospitals, London, says that in her experience parents have very little information about bronchiolitis.

“I’m very conscious that parents often don’t know a lot about it,” she says.

“It’s confusing, and parents need to know how to recognise the symptoms, when to seek help and how, if possible, to avoid their babies getting the illness.”

she explains that babies with bronchiolitis have “a very classic-sounding cough and wheeze”, warning: “Very often it will start off just like a cold, but then the parent will become worried about the child, because of their fast breathing.

“They may also be lethargic and floppy, as well as having this characteristic cough, and a decreased appetite and a temperature.

“All of those things on their own wouldn’t make you think, but all together it spells bronchiolitis.”

while she says the majority of babies will remain fairly “bright and perky”, a significant number are ill enough to need hospital treatment.

Although any baby can develop the illness, they’re more susceptible the younger they are, and it’s potentially far more serious in babies born prematurely, or those with underlying heart or lung conditions.

Laurent says babies will often be taken to hospital at a late stage of the illness because parents have initially dismissed it as just a cold – until their baby is floppy and wheezing.

“That’s when parents panic.” she says.

“If you think it may be bronchiolitis, get your GP to have a look at your baby.

“They can reassure you, or tell you when it’s a good time to go to hospital if the baby gets worse.

“It’s more than a cold. It’s looking at a baby and thinking they’re struggling to breathe. That’s what makes you worried.”

she advises parents of new babies to ask friends with colds not to visit, and try hard to avoid viruses where possible.

“A normal cold from an adult can give bronchiolitis to a baby. That’s the message. It can make them really sick.”

Babies who have a less severe form of bronchiolitis should have more frequent feeds, have their bed propped up slightly, and perhaps have more humidity in the air around them, maybe through a wet towel being placed on a radiator in their room.

Parents should keep a close eye on how alert they are and how wet their nappies are.

After having bronchiolitis, children may be more prone to chest problems, although it’s not known whether this is because the bronchiolitis weakens the chest, or because babies with weak chests are more likely to get bronchiolitis.

:: For more information about bronchiolitis, visit morethanacold.co.uk Ask the expert Q: “How can I assess whether the ‘expert’ parenting advice I read is right – or is it best to just ignore it all and follow my instincts?”

a: Sociology professor Frank Furedi, author of Paranoid Parenting: Why Ignoring the Experts may Be best for your Child (Continuum 2008, £12.99), says: “The very instability of parenting advice and the regularity with which yesterday’s authoritative recipe is dismissed as hopelessly inaccurate indicates that what’s going to be preached today will be rejected as irrelevant tomorrow.

“Such advice is based on the subjective opinion of individuals, rather than on science. Parenting experts know far less about your child than you do – so there’s no reason to defer to their views.

“Yes, we have to learn how to raise our children. but not everything that has to be learned can be taught. Reading other’s advice often distracts us from seeing what’s going on in front of our eyes.

“Instead of worrying about which opinion to choose, it makes sense to learn to make judgment calls on the basis of your own experience. It’s the experience of the unique interaction between parent and child that provides the insight through which we develop as competent mothers and fathers.

“Parents learn what’s right for their children through interacting with them and not from reading books. no one is likely to understand the situation of your child better than you do – so you might as well do what you think is best.”

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