Table 7 Parent behaviour: caring for an infant with bronchiolitis

How parents can protect their babies from bronchiolitis

• Exclusive breastfeeding for at least six months should be encouraged to decrease the morbidity of respiratory infections

• Frequent handwashing and decontamination of hands using alcohol solutions by parents or caregivers and other household contacts

• Use the face mask in case of a cold when approaching the baby. If you have a cold, refrain from kissing the baby and avoid touching his/her face.

• Visitors and contacts, especially with subjects suffering from respiratory infection symptoms, should be avoided or limited.

• Exposure to tobacco smoke must be strongly discouraged

• Ask the pediatrician for monoclonal antibodies use for the prevention of RSV infections, if indicated

When to ask for primary care paediatricians

• Respiratory distress suggested by cough; dyspnea; polypnea; increased respiratory effort manifested as nasal flaring, grunting, use of accessory muscles or intercostal and/or subcostal chest wall retractions; apnea; skin colour changes.

• Feeding difficulties: intake of fluids and feeds < 50% than usual; and signs of dehydration: dry mouth, fewer wet diapers, crying without producing tears.

• Poor responsiveness, lethargy and generally toxic appearance, especially in infants younger than 3 months of age

Which supportive therapies to administer

• A gentle, superficial and reasonably frequent nasal aspiration, especially before feeding

• Fractionated and frequent (2–3 hourly) meals