Bronchiolitis

[TwigletFiend]

Hi all, think I'm just looming for reassurance because my very highly strung DP is freaking out over every squeak DS makes.

We got home this pm from a 2 night stay in hospital. DS, 7 weeks, been diagnosed with RSV/bronchiolitis. We took him to A & E because he has audible chest crackles, and fairly significant retractions with intermittent tracheal tug, nostril flaring and head bobbing. He was monitored but O2 levels stayed good throughout, no fever and he's eating and peeing normally so not dehydrated. They wanted to send us home yesterday but because DP was so anxious, we agreed to do another night in.

Those of you who have had little people with bronchiolitis, did your little person get sent home/stay at home while still having retractions etc? I have said they wouldn't have sent us home if they weren't confident he didn't need help, but interested in others' experiences too.

In my experience (nursing) it would be unusual to discharge a baby with signs of respiratory distress like that, even if their oxygen saturations were maintained. Head bobbing in particular was something we were told to never ignore. With that said it was rare to see babies with that degree of respiratory distress in the absence of reduced feeding / reduced 02 levels.

Did they run a blood gas (heel prick blood test into a tiny clear tube?). That can give an insight into how well they are coping.

We routinely discharge if the sats are good and the feeding okay. Here's the national guideline on when to discharge:

Hm, ok. We saw multiple paediatric doctors both junior and consultant, and all three said he was fine to go home despite the retractions etc. The head bobbing was intermittent, and no sign of it this evening. No nostril flare at the moment either, but still retracting. Might be another night of staying awake to monitor him, then. Thank you for sharing your experience.

We had an 18 day stay with my 3 week old who needed nasal high flow then intubation. He got pneumonia as a secondary infection.
I don’t remember him bobbing, flaring or retracting when we got discharged. I do remember the noise of his breathing though. I couldn’t sleep for it.
such a worrying time for you all and I hope your baby is ok x

If you’ve seen multiple doctors at different levels of seniority then I would be reassured that they feel he is safe to be at home. Bronchiolitis is their bread and butter at this time of year and they will be well used to picking out the babies who need admission / extra help. And it is reassuring that the head bob, nasal flare etc has now resolved. The fact that feeding hasnt been affected is reassuring too as that is usually the first thing to be impacted.

Be vigilant but certainly don’t feel you need to stay awake all night - you must be knackered.

So do we.

As long as they've had a good sleep in air. When I qualified 20 years ago, they had to go 24 hours in air. Now it's down to 'a good sleep'

Yep, we've also moved to the "good sleep" test.

Thanks all, my inclination was also that they must see it loads at the moment (borne out by the number of babies on the ward with it) and if all 3 concurred he was fine to go home at different times in our stay, he is probably fine to be home. I'll monitor for the return of the head bopping and/or nostril flare etc and call the PAU again if it looks worse, as they gave us a direct number we can use for the next 72 hours.

@TwigletFiend we are in this exact predicament now, just waiting to be discharged. Was everything ok or did you need to return at any point?

Everything was OK - it was amazing, he hit day 7 and in the morning he was still poorly, then by afternoon it was like he'd never been ill. Hope you had a reasonable night and your little one is also on the mend <3

thats so good to hear, glad he recovered well! We have been home 2 days and whilst she has still got the cough she is so much better. Thank you 🥰 what a relief all round x