What is bronchitis?
Bronchitis can be defined as a clinical syndrome, in which inflammation occurs in the lining of the trachea and bronchi. This can be acute or chronic, depending on its duration and characteristics.
Acute bronchitis, is an inflammation of the mucous membrane of the bronchus, is usually self-limited and its duration does not extend for more than 2 weeks with proper treatment and care.
As for chronic bronchitis, inflammation also occurs, but having a prolonged and recurrent duration, causes a secondary deterioration to the airway with more severe symptoms.
Causes of bronchitis in babies
Bronchitis in babies have multiple causes, in which infectious or non-infectious processes can intervene, these initiate changes in the epithelium, in response to the stimulus, so that inflammation occurs in the trachea and bronchi.
This entire process induces bronchial hyperreactivity, with an increase in mucus production, leading to the development of bronchitis in the baby. The most frequent triggers of this disease are detailed below.
In babies and children the most common causes of acute bronchitis are infections, with viruses being the most frequent infectious agents up to 90%, these are; the flu virus, adenovirus, parainfluenza, respiratory syncytial virus, among others.
Bronchitis caused by bacterial infections are less common, being present in 10% of cases .
The bacteria most likely to trigger acute or chronic bronchitis in children under 6 years of age are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Mycoplasma pneumoniae and Chlamydia pneumoniae.
Cystic fibrosis is a multisystemic and hereditary disease, whose evolution is chronic, progressive and lethal, in which chronic obstructive pulmonary disease, also known as COPD, predominates.
Being a disease that affects the respiratory tract, it weakens the defense mechanisms that prevent the replication of infectious microorganisms, before they can establish an infection.
Of these conditions, cystic fibrosis can be associated with chronic bronchitis that subsequently worsens over the years until it triggers bronchiectasis or severe pneumonia.
Cultures of bronchial secretions show persistence of Staphylococcus aureus, one of the most common microorganisms among recurrent infections in these patients.
Bronchitis is not exclusively of infectious origin, as mentioned above, it can be triggered by allergic reactions to antigens to which the baby is exposed or comes into contact.
Consequently, an asthmatic syndrome called allergic bronchitis is generated, characterized by bronchospasms that generate persistent cough.
Many people mistakenly assume that infants or newborns cannot experience emotional stress or trauma. Even if they don’t know the meaning of the word, infants can be affected by these events, just like any adult.
Traumatic events before 3 years of age, can truncate the development of the infant, such as mobility, language, emotions, motor and social skills. Basic functions that every infant must fully develop.
Sudden and extreme noises, the separation of the baby from one of his caregivers or any problem that affects his caregivers, can generate overwhelming feelings of fear or stress.
Stress can raise circulating cortisol levels, which is toxic to a baby’s developing immune system. In this sense, this elevation of cortisol can even affect the baby during his adulthood.
Symptoms of bronchitis in babies
The symptoms of bronchitis in the newborn and the infant are very non-specific, although chronic cough and wheezing are the most common symptoms that cause parents to take their children to the doctor.
Next, we will provide you with the most relevant information about your symptoms.
persistent dry cough
A chronic cough is defined as any cough that lasts more than four weeks. The word dry refers to the fact that the patient does not expel mucus or any secretion when coughing. This phenomenon is also known as non-productive cough.
Also known as dyspnea. It is produced by the obstruction of the bronchial airways due to the accumulation of mucus and inflammation of the walls, a direct result of the infection that is occurring.
In adults, chest pain is often caused by heart problems. In children, this is rarer and respiratory or musculoskeletal causes are more common.
Your baby may experience chest pain, especially when inhaling air or coughing. The pains can be found not only in the chest, but in other parts of the body, which causes the feeling of weakness that the baby experiences.
wheezing in the chest
Wheezes are breath sounds that occur, either during inspiration or expiration, at a relatively high pitch. They are produced by an obstruction in the lower airways.
In the context of bronchitis, mucus and inflammation decrease the cross-sectional diameter of the bronchi, causing less air to flow inside. This difficulty originates the sound phenomenon.
Nasal obstructions or congestions, along with an abundant secretion of mucus (known as rhinorrhea), can be the first symptoms that appear, even before coughing.
Why? Rhinosinusitis (causing nasal congestion) is caused by a virus, which weakens the defense mechanisms of the upper airways (such as type A antibodies found in the nasal mucosa).
This facilitates the invasion of the lower airways by other infectious agents (bacteria or viruses), triggering an even more persistent infection.
weakness and tiredness
The weakness produced by the infection is due to increased body metabolism.
As the infant’s body fights the infection, they require more nutrients as they are metabolically active. A greater consumption of fuel means that the infant feels exhausted or without energy.
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In summary, immune cells, upon detecting the pathogen, release proinflammatory cytokines that also produce pyretic (pro-fever) effects at the level of the hypothalamus , the temperature regulating center.
The purpose? Raise the temperature to create a hostile environment for the infectious agent. If your baby has a dry or mucus cough, fever and wheezing, it is a strong indicator of a respiratory infection.
loss of appetite
Lack of appetite is the baby’s lack of desire to eat. It is a secondary effect of the infection, related to the tiredness and weakness that he suffers, where his desire to eat is also inhibited.
Treatment of bronchitis in babies
Bronchitis is generally a self-limiting disease. The main treatment is sufficient rest for the infant and, in addition, antibiotics may also be prescribed, if necessary. Next, we will show you the most common treatments.
In chronic bronchitis, bronchodilators should be considered and used among the first pharmacological measures. A bronchodilator is a medication that acts on the smooth muscle of the bronchial wall, causing it to relax.
When relaxing, the wall expands and allows a greater flow of air, decreasing shortness of breath and wheezing. Among the most used for pediatric patients, we have beta-adrenergic agonists, such as albuterol and terbutaline.
Antibiotics should not be part of the first measures against bronchitis, whether chronic or acute. Studies have been unable to demonstrate significant improvement in bronchitis in pediatric patients by using antibiotics.
However, if the infant presents with a productive cough, accompanied by other symptoms, that persists beyond four weeks, antibiotics may be considered.
This is because most respiratory tract infections in children are caused by viruses. Recurrent or prolonged viral infections increase the risk of secondary bacterial infections and therefore antibiotics are necessary.
Nebulizers are medical devices used to administer medications in the form of an aerosol, which the patient inhales. These medications can be bronchodilators (such as those mentioned) and corticosteroids.
Corticosteroids decrease cell intensity, relax smooth muscle, and decrease obstruction. In infants between 6 and 35 months with chronic bronchitis, corticosteroids havebeen shown to reduce the intensity of the infection.
Maintaining a fluid intake is important, especially in febrile infants, who may lose fluid and electrolytes through sweat. An excessive loss of these can lead to dehydration and hydroelectrolyte imbalances (caused bypotassium or sodium imbalances, for example).
Nasal drops, such as Rhinovil, act as decongestants that reduce inflammation and secretion of mucus at the level of the nasal mucosa, the product of an infection at this level.
As we have mentioned, infections in the upper respiratory tract (such as in the nasal cavity) can predispose the baby to lower tract infections.
How to prevent bronchitis in babies?
Bronchitis, like other infections of the respiratory system, can be prevented or the risk of the child developing the disease can be significantly reduced, if the appropriate measures are taken.
We will show you some measures that you can adopt and implement in your baby’s daily life, to minimize the risk of infection.
Avoid contact with sick people or children
Minimize contact with adults or children who have any kind of cold, cough or flu, or have recently been ill. Remember that, during its first years, the infant has not yet fully developed its defenses.
In addition, in the first years of his life, the infant is unaware of the concept of hygiene measures. He uses his mouth to explore the environment that surrounds him, this involves touching others (either other children or adults), as a mechanism for exploration and learning.
This means that the baby is significantly exposed to a large number of microbes, including those that cause respiratory tract infections.
Wash hands before and after touching the baby
Hand washing is an effective and quick tool to prevent the transmission of microbes. This not only applies to babies, but also to adults. The baby tends to bring his hands to his face or mouth, carrying microorganisms with him.
Washing your baby’s hands, especially after playing with their toys, pets, or with other children, is a habit that should be taught to them, even from an early age.
Avoid sharing baby’s personal utensils
At home, each person should have their own set of personal utensils (soap, toothbrush or towel), as this prevents the transmission of germs.
Babies, although they don’t need a toothbrush yet, also need to have their own set of utensils. Remember that his immature defenses render him defenseless to
Avoid exposing the baby to cigarette smoke
Cigarette smoke contains hundreds of pro-inflammatory and pre-cancerous substances, lethal to humans, regardless of their age group.
In babies and infants, cigarette smoke is particularly toxic to their fully developing lungs and brains. In addition, it is one of the most important risk factors for the development of sudden infant death syndrome.
Even smoking during pregnancy increases the risk of birth defects for the baby, such as orofacial deformities (for example, cleft lip and palate).