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BRONCHIOLITE IN LONDON


What is bronchiolitis?

Bronchiolitis is an acute viral infection of children under the age of two. It is caused by a highly contagious virus that causes inflammation of the walls of the bronchioles (the smallest airways) and an increase in secretions responsible for an obstruction phenomenon.


What are its symptoms?

Bronchiolitis usually starts with a cold. Gradually, a dry cough appears, followed by respiratory discomfort that results in rapid, wheezing breathing. There is usually a fever. At this stage of the disease, the child may have difficulty eating. Symptoms improve within a few days and the child recovers within 8-10 days, but a residual cough may persist for a fortnight before disappearing. Most often, bronchiolitis is benign, but in certain fragile children, it may require hospitalisation.

!!!! RED FLAGS !!!!!

- child is less than six weeks old.

- born prematurely and/or with breathing problems at birth and is less than three months old.

- has a heart disease or chronic pathology.

- Refuses to eat and/or drink.

- He has digestive problems (vomiting, diarrhoea, etc.) which can lead to dehydration.

- His behaviour changes (fatigue, malaise, agitation...).

- He is pale and/or his lips and fingers turn blue.

- He/she has increasing difficulty in breathing: his/her breathing is rapid and shorter or irregular, he/she makes pauses in breathing, he/she shows signs of respiratory struggle.




If your child does not show any signs of seriousness and while waiting for the consultation, here are the gestures that relieve:

- Clear the nose before meals and regularly (as many times as necessary) with physiological serum and disposable tissues;

- Remove a few layers of clothing if he has a slight fever, so that he can evacuate his heat;

- offer him/her water regularly and frequently, to avoid dehydration;

- continue to feed him normally, splitting his meals if he is tired;

- air the room frequently and keep the temperature at a maximum of 19°C

- Continue to put your child to sleep on his/her back as usual;

- Avoid exposing your child to passive smoking: this aggravates the disease and encourages relapses;

- Do not give your child cough suppressants or bronchial fluidizers: they are contraindicated in small children. Moreover, coughing is essential to evacuate bronchial secretions;

- if he has a fever (over 38°), give him paracetamol to make him feel better;

- Keep your baby at home during the acute phase of bronchiolitis.


WHY RESPIRATORY KINESITHERAPY ?

The treatment by the physiotherapist allows :


-de-cluttering of the upper airways to improve breathing and eating.

-bronchial drainage to avoid superinfection.

- reassure, accompany and advise the parents on hygiene and treatment.

The use of HFCWC 5 (high frequency chest wall compression)

induced similar clinical effects to airway clearance techniques and was safe for out-of-hospital infants with VAD. Both techniques reduced respiratory symptoms and improved clinical status.

" González-Bellido V, Velaz-Baza V, Blanco-Moncada E, Del Carmen Jimeno Esteo M, Cuenca-Zaldívar JN, Colombo-Marro A, Donadio MVF, Torres-Castro R. Immediate Effects and Safety of High-Frequency Chest Wall Compression Compared to Airway Clearance Techniques in Non-Hospitalized Infants With Acute Viral Bronchiolitis. Respir Care. 2021 Mar;66(3):425-433. doi: 10.4187/respcare.08177. Epub 2020 Nov 3. PMID: 33144386.


MICRONUTRITION IN PREVENTION AND TREATMENT

All viral infections begin with an inflammatory phase and the composition of the reserves of certain micronutrients is essential for a rapid resolution of the infection.

THE OMEGA 3 natural anti-inflammatories: the omega 3 are essential fatty acids: the body is unable to produce them. They must be provided by the diet.

All the membranes of our body are composed of fatty acids. Depending on the composition of this membrane your cells will react differently to infection. To put it simply, if your cell membranes (e.g. bronchioles) are made up of saturated fatty acids your cells will experience severe


and uncontrolled inflammation. If the membranes of your cells are composed of a satisfactory quantity of essential polyunsaturated fatty acids, the inflammatory reaction will be light and rapid.

However, for a growing child, omegas are mainly used for cerebral development.

Supplementation with omega 3 at a rate of 500mg/day (250mg EPA+250mg DHA) is therefore a good solution for reducing the inflammation time.

VITAMIN D and VITAMIN A are immune system modulators and anti-bacterial.

A complication of a


respiratory viral infection can be a bacterial superinfection. Vitamin D (together with vitamin A) is able to stimulate the production of a natural antibiotic. These two vitamins help coach your baby's immune system to respond effectively to the attack of this virus.

And in winter, the lack of sunlight does not allow a satisfactory synthesis of vitamin D.

For children aged 0 to 18 years, the daily supplementation in vitamin D and vitamin A is 400 IU to 800 IU per day for each vitamin in the form of drops directly or added to milk or food.