More rarely, a child’s bronchitis can become chronic, meaning it lasts for about a month or more. Chronic bronchitis is often caused by bacteria and responds to treatment with antibiotics. You may not hear your doctor refer to such an illness as “acute bronchitis,” as physicians generally don’t use this term to describe the condition in children, Dr. Kopp says. Most of the time the child won’t need to see a doctor about acute bronchitis, because the infection that causes the cough usually goes away after two to three weeks, along with other symptoms. Many parents just refer to what is technically acute bronchitis as a chest cold, Kopp adds. Bronchitis is sometimes confused with the common childhood condition bronchiolitis, adds Dr. Fleece, so it’s important to understand the difference. Bronchiolitis affects the smaller airways, while bronchitis affects the larger airways; and bronchiolitis tends to affect younger infants and toddlers, while bronchitis typically affects older children. In either case, both bronchitis and bronchiolitis can present very similar symptoms, and both are best managed conservatively, with rest and fluids. Bronchiolitis affects many infants and young toddlers each winter and is similar to the common cold (with the addition of mucous and inflammation in the lower airways), and it can cause wheezing in the smaller lungs of this age group. Bronchiolitis is often caused by a respiratory syncytial virus (RSV) infection. (2) Other symptoms may include: (3,4)
Mild headacheLow-grade feverSore throatSoreness or tightness in the chestFeeling tiredBody achesWheezingShortness of breath
Parents may consider using some home remedies to alleviate their child’s symptoms. In addition to rest, Kopp recommends giving kids older than 1 year a teaspoon of dark honey to quell a cough — a remedy that the Mayo Clinic says has been shown to be at least as effective as over-the-counter cough suppressants. And good nasal care, such as blowing your nose when it feels full and flushing the nose with saline, can help with sinus drainage that contributes to cough. Kopp does not recommend cold and cough suppressants. “There’s not a lot of safe cold and cough suppressants for kids,” adds Kopp, especially for younger children. “These medicines can suppress natural protective reflexes and often have harmful side effects,” he says. He also cautions against using a humidifier or vaporizer. “They can become dirty and put bacteria into the air,” he says. They can also become moldy. If parents want to use a humidifier or vaporizer, Kopp suggests changing the water daily and ensuring these items are clean. One cause of a chronic cough in children is a condition called protracted bacterial bronchitis — meaning chronic bronchitis caused by bacteria — especially in kids younger than 6 years. (5) “Pediatric pulmonologists are still learning about the management and treatment steps for this condition and its natural history,” says Kopp. A child age 14 or younger diagnosed with protracted bacterial bronchitis should be treated with a two-week course of antibiotics, he says, citing guidelines established in 2017. (6) Doctors may consider extending to a four-week course if the patient isn’t responding fully to the initial treatment. Most bacterial bronchitis is caused by Streptococcus pneumoniae, Haemophilus influenza, and Moraxella catarrhalis, which are bacteria that usually respond to antibiotics, such as amoxicillin and clavulanate potassium (Augmentin) or cefdinir (Omnicef), says Kopp. Doctors also need to rule out other causes of chronic cough in children, such as asthma, before prescribing antibiotics, says Fleece. Other symptoms of concern that should be investigated further include blood in the sputum, poor appetite, and lack of fluid intake leading to dehydration, says Fleece. “Chronic cough is a fairly common problem in pediatrics,” says Fleece. The causes are numerous and varied, ranging from whooping cough, to inhaled foreign bodies, allergies, or serious conditions, such as chronic lung diseases or even cancer. “Luckily, in the vast majority of children with a chronic cough, the cause is either just slow recovery from a viral infection, or something treatable, like allergies, reflux, or sinus disease,” he says.
