Bronchiolitis
Also known as: acute viral bronchiolitis, RSV bronchiolitis, infant bronchiolitis, viral lower respiratory tract infection
Bronchiolitis is an acute viral infection of the small airways that predominantly affects infants and young children. It commonly begins with upper-respiratory symptoms and may progress to cough, wheeze, increased work of breathing and feeding difficulty. Management is primarily supportive, with attention to oxygenation, hydration, feeding and minimal handling. TCM clinical decision support must never delay paediatric medical assessment and is generally inappropriate during acute respiratory distress.
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Lifestyle & Diet
- •Keep the infant or child well hydrated and seek medical advice when feeding falls significantly or wet nappies decrease. [1, 2, 3]
- •Offer smaller, more frequent feeds when medically safe and tolerated. [1, 3]
- •Use minimal handling during significant respiratory illness because distress can increase breathing effort. [1, 2]
- •Maintain a smoke-free and vape-free environment. [3]
- •Wash hands regularly and avoid close contact with vulnerable infants when household members are unwell. [3]
- •Follow current Australian advice regarding RSV prevention through the child's healthcare team. [6]
Cautions & Contraindications
- •Do not claim that acupuncture, acupressure or Chinese herbal medicine treats the viral cause, shortens bronchiolitis, prevents hospitalisation or replaces oxygen, hydration, feeding support or paediatric care. [1, 2, 5][,,]
- •Do not perform acupuncture during respiratory distress, hypoxaemia, apnoea, significant tachypnoea, dehydration, poor feeding or medical instability. [1, 2, 5][,,]
- •Do not needle infants unless the practitioner has specific paediatric competence, informed parental consent and a clear non-urgent indication; non-invasive support is preferred. [5][]
- •Avoid deep thoracic needling, strong stimulation, chest cupping and forceful gua sha. [5][]
- •Do not use moxibustion, smoke, incense, essential oils or inhaled herbal products around a child with acute lower-respiratory illness. [1, 2, 5][,,]
- •Do not routinely prescribe internal Chinese herbal medicines to infants with bronchiolitis. [1, 2][,]
- •Do not prescribe Má Huáng, Fù Zǐ, Cǎo Wū or Chuān Wū. [5][]
- •During pregnancy, avoid LI4, SP6, BL60, BL67, GB21, ST12 and strongly stimulating lower-abdominal or lumbosacral points unless specifically justified. [5][]
When to reassess or seek care again
- •Reassess breathing effort, respiratory rate, colour, alertness, feeding and hydration at every contact.
- •Immediately escalate apnoea, cyanosis, severe recession, grunting, exhaustion, reduced responsiveness or inability to feed.
- •Use complementary follow-up only during uncomplicated recovery, not as a substitute for paediatric review.
- •Discontinue adjunctive treatment if it causes distress, fatigue, prolonged crying or increased work of breathing.
- •Refer persistent wheeze, cough, poor weight gain or recurrent respiratory symptoms for medical reassessment.
Frequently Asked Questions
What is bronchiolitis?+
Bronchiolitis is an acute viral infection that inflames and narrows the small airways, mainly in infants and young children. [1, 2, 3]
How is bronchiolitis treated?+
Treatment is primarily supportive, focusing on oxygenation, hydration, feeding and minimal handling. [1, 2]
When is bronchiolitis an emergency?+
Pauses in breathing, blue or grey lips, severe recession, grunting, collapse, extreme drowsiness or inability to feed require urgent assessment. [1, 2, 3]
Can acupuncture treat acute bronchiolitis?+
No. Acupuncture must not be used to manage acute respiratory distress or replace paediatric care. [1, 2, 5]
Are Chinese herbs recommended for infants?+
Routine internal herbal prescribing is not recommended for infants with bronchiolitis. [1, 2]
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Sources & Further Reading
Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.
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- 2021
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Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.