Is a deep, chesty cough keeping your little one up all night? Your child may have bronchitis. Also called a chest cold, acute bronchitis is an illness where the large airways to the lungs known as bronchi swell and then make excess mucus. The cough comes on suddenly and generally goes away within 3 weeks with no specific treatment necessary, according to the Centers for Disease Control and Prevention (CDC).

The American Lung Association (ALA) says acute bronchitis is generally caused by a viral infection. This is known as viral bronchitis. But it can also be caused by bacteria in the bronchi, which is known as bacterial bronchitis. Chronic bronchitis is another possibility, though 2020 research suggests chronic cough is rare in children. It produces similar symptoms, but they may last much longer, usually beyond 4 weeks.

Here’s more about what symptoms your child may experience with bronchitis, how this condition is diagnosed, and what antibiotic and over-the-counter (OTC) options are available for treatment.

Cough is the most obvious sign you’ll encounter if your child has bronchitis. The cough may start with or without mucus that ranges in color from clear to yellow, gray, or green. The color does not indicate the presence of a bacterial infection. Your child may also tell you their chest hurts while coughing.

Other symptoms include:

  • fever
  • chills
  • sore throat
  • stuffy nose
  • headache or body aches
  • fatigue

Wheezing and shortness of breath are other possible symptoms. The National Health Service (NHS) says they are more associated with chronic bronchitis. These symptoms can also be associated with other medical conditions as well.

If your child has either of these signs, be sure to discuss them with their pediatrician.

There are different types of bronchitis depending on the root cause. Before making a treatment plan, your child’s doctor will need to determine whether your child’s bronchitis is acute (short term) or chronic (long term) and viral or bacterial.

Viral bronchitis

According to the ALA, acute bronchitis may result from an upper respiratory virus like the common cold or flu. When this happens, it’s called viral bronchitis. This illness may last between 7 and 10 days, but according to the CDC, the cough may linger for up to 3 weeks. The cough with viral bronchitis tends to go away on its own. Viruses do not respond to antibiotics.

Around 95 percent of acute bronchitis cases in the general population are due to viruses.

Bacterial bronchitis

If acute bronchitis develops in response to bacteria growth in the bronchi, it’s called bacterial bronchitis. According to the NHS, this type of bronchitis is not as common as viral bronchitis. But the symptoms may be nearly identical and short in duration. In fact, 2008 research indicates that the color of the mucus cannot distinguish whether the bronchitis is viral or bacterial.

Just 5 percent of acute bronchitis cases in the general population are due to bacteria.

Chronic bronchitis

Chronic bronchitis lasts longer than 4 weeks, according to the American Thoracic Society (ATS), or comes back after treatment. Smoking and other habits are associated with chronic bronchitis. For this reason, it’s not often diagnosed in kids.

In a 2020 study on Swedish teens, only around 5.5 percent were diagnosed with this condition. About 37 percent of them were smokers.

Acute bronchitis is an illness that any child can develop. That said, some kids may be more prone to it than others.

Risk factors include:

  • asthma
  • allergies, such as pollen or perfume allergies
  • chronic sinus issues
  • exposure to outdoor pollution
  • exposure to secondhand smoke
  • living in a crowded environment

According to the NHS, acute bronchitis usually gets better on its own within 3 weeks. If it does not, it’s important to work with your child’s doctor for treatment or further investigation.

Pneumonia may develop in some children, which happens when the infection spreads to the lung tissue. About 1 in 20 cases of bronchitis may advance to pneumonia, but this statistic includes adults with other health issues.

If your child has frequent bouts of bronchitis and certain risk factors, their doctor may want to look into other lung conditions, like chronic bronchitis or possibly asthma.

Antibiotic treatment will not help if your child’s bronchitis is caused by a virus. Instead, a doctor may suggest getting rest and drinking lots of fluids.

Using a cool mist humidifier can help with breathing. Older children (4 years and older, according to the CDC, unless otherwise specified) may also find some relief with OTC cough suppressant medications or cough drops. You may use honey to soothe cough in younger kids over 1 year old.

A note on cough suppressants

Some doctors do not recommend using cough suppressants. The American Academy of Pediatrics recommends avoiding cough suppressants in children younger than 6 to avoid the risk of side effects.

Discuss possible side effects with your child’s doctor first before trying to use them.

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Other symptoms, like fever or headache, can be treated with OTC drugs like acetaminophen or ibuprofen. And if your child is having trouble breathing, their doctor may prescribe an inhaler.

According to the CDC and ALA, bacterial bronchitis may or may not require medication to go away. When antibiotics are indicated, treatment is usually a 5-day to 2-week course of an oral drug like amoxicillin. Your child’s doctor will prescribe what’s right for your child along with any other aids, like inhalers or nebulizers, to help with breathing as necessary.

Make an appointment to check out your child’s cough, especially if your little one has risk factors like asthma or other underlying health conditions.

Also visit your pediatrician if:

  • Your child’s cough lasts more than 3 weeks.
  • They have a fever of 100.4°F (38°C) or higher.
  • They have blood in the mucus.
  • They have trouble breathing.
  • They have frequent bouts of bronchitis.

Before a physical examination, your child’s doctor will ask you:

  • what symptoms they have been experiencing
  • how long the symptoms have persisted
  • what concerns you may have, including a history of breathing issues

The pediatrician will then examine your child’s ears, nose, and throat and listen to their lungs. For example, wheezing is a typical part of bronchitis. Rales and rhonchi may indicate the infection has progressed. Likewise, low fever is common with bronchitis. High fever is more typical of pneumonia and other infections.

The ALA says further testing usually isn’t necessary. But according to the ATS, some doctors may collect a mucus sample to test for different bacteria. Others may recommend an X-ray to rule out pneumonia if your child has a fever or other worrisome symptoms.

Bronchitis is contagious. Since most cases of acute bronchitis are caused by viruses, frequent handwashing can help prevent spread. The CDC also suggests isolating kids with the condition from others whenever possible.

Other prevention methods:

  • Teach your child to do a “vampire cough” or sneeze by coughing into their bent elbow. Or show them some other way to cover the mouth and nose when coughing or sneezing.
  • Avoid smoking around your child or otherwise exposing them to secondhand smoke or other pollutants.
  • Keep current with your child’s vaccinations, including the flu vaccine.

Eating a balanced diet, drinking plenty of water, and getting the recommended hours of sleep each night are other things you can do to help your child stay healthy.

While your child’s cough may sound junky and serious, the CDC reminds parents that both viral and bacterial acute bronchitis usually go away without medical intervention. Do your best to keep your little one comfortable and well hydrated. Report any unusual signs or red flags, like high fever or blood in the mucus, to their pediatrician. If your child gets bronchitis often, work with their doctor to rule out chronic conditions that may be at play.