Every parent wants their child to be healthy.  One of the biggest barriers to this today is the fact they are born on planet Earth.  We humans have polluted this planet to such an extent that every baby born today almost certainly has more than one thousand (more likely many thousands) man-made chemicals in its body.  We have no idea what most of these chemicals can do to the developing fetus, much less what sort of combined effects they may exert in combination.

These chemicals include pesticides, solvents, herbicides, formaldehyde, fragrances, styrofoam (styrene), phthalates, flame retardants, plasticizers, PCB’s, PBDE’s, PFC’s and the list goes on.  Most parents and expectant parents are unaware of the problem and its potential for adverse health effects in themselves, much less in their baby or developing fetus.

Some awareness of this problem is reaching the public in recent years, but only as a series of isolated problems that can be easily dismissed as uncommon or of little importance by themselves.  One example of progress is recent research showing increased risk of ADHD with higher levels of organophosphate pesticides in their blood or urine.  The American Academy of Pediatrics recently stated publicly that because of this and other noted adverse effects of pesticides, we should try to make sure our children are not exposed to pesticides.  Agreed; but how do we do that?

The problem is much larger than pesticides, or any other single type or category of chemicals.  It is the mass of exposures taken together as a whole.  It is what we refer to as the “total load” phenomenon in environmental medicine.  We use the concept of a rain barrel to depict the diverse toxins going into us from our environment.  This includes man-made chemicals, naturally occurring toxins, heavy metals, electromagnetic radiation, excess sugar, psychological stress and everything else that is bad for us.  Eventually that rain barrel can overflow and manifest as some sort of chronic illness condition, or multiple apparent conditions.

This is one general cause behind the massive increases we are seeing in neurological and neuropsychiatric problems in our young children today.  Conditions like autism and related disorders have skyrocketed in incidence over the last generation, and will likely continue to rise.  ADHD and other conditions requiring special education are rising dramatically in our schools as well, and it’s not just because we are looking for them.  It seems that more children are having seizures, mood disorders and cancers; and the environment is a major cause of this collective epidemic.

The purpose or theme of my guest blog series is to alert parents and expectant parents to the presence of some of the more common and avoidable environmental toxins, to point out their sources, discuss their health effects, offer strategies for avoidance, discuss means of toxin elimination, and encourage readers to help move public policy more toward the interests of human health in this regard.

I’ll admit it. I’m addicted to Grey’s Anatomy. My dad was a surgeon, and as a kid I really wanted to go to medical school when I grew up. But I couldn’t even get through premed. Advanced calculus undid me.  Now I get my medical thrills from TV.

So when Jessica Capshaw reached out to help us at Moms Clean Air Force, it was all I could do to keep from suiting up and slapping a scalpel into her waiting hand. Capshaw plays Dr. Arizona Robbins on the ABC show, Grey’s Anatomy; she’s the new head of pediatric surgery. Jessica and her husband, Christopher Gavigan, who is a co-founder of The Honest Company, have two children, Luke and Eve, and are expecting a third child in early summer.

Years ago, I had a volunteer job at a New York City hospital, in the pediatric oncology ward. While it was heartbreaking to see the suffering of tiny patients, it was also astonishing to bear witness to their bravery and strength. I felt honored to read and play games with them. Some of those faces, swathed in white bandages, are forever engraved in my memory. I think of them whenever I read research linking childhood cancers to certain pollutants.

We can prevent toxic air pollution. The more I learn about what is spewing out of coal-fired power plants, the more outraged I become that this is legal. We have to end it. Capshaw has it right: polluters have money and influence, but moms have love. Lots of love. And mother love is the strongest force of all.

Right now, we are awaiting finalization of the strong new Mercury and Air Toxics Standards–twenty-one years in the making–signed by Administrator and Mom Lisa Jackson (whose son suffers from asthma). But we can’t wait silently. The opposition is in full gear to kill or delay these rules.

Moms have to tell Washington: Listen to your mothers! Stop toxic air pollution. Who is going to protect our children if we don’t?

Click here to sign a petition to stop toxic air pollution.

Of course reducing toxic exposures is an important way to reduce risks from unhealthy chemicals, but a growing body of research suggests paying attention to positive habits – such as good food, healthy sleep and active play can often reduce or even eliminate harm when exposed.

An update on this emerging field of research appeared in October 2011 in the NIH journal Environmental Health Perspectives, focusing on the physical effects of stress and relaxation.

Psychological stress can change how chemicals affect the body. Stress has been demonstrated to change the effects of lead exposure and of exposure to air pollution in children. But much remains to be learned about other chemicals and other types of exposures. And about how this all works.

We know that some stress is good for children; a little adrenaline or cortisol can fuel kids to reach new heights of achievement. And we know that when stress becomes too prolonged, too severe or too frequent the immune system can be altered in a way that increases the impact of chemical pollution.

Sadly, sometimes the most stressful environments are also the most polluted.

In January 2011, Science to Achieve Results (STAR) research grants totaling $7 million were awarded by the EPA to work on new approaches to understanding how stress changes what happens when kids are exposed – and what we can do about it.

I’m excited about this, and expect it to uncover valuable new knowledge. But in the meantime, common sense makes sense. Follow Healthy Child Healthy World’s Five Easy Steps: Minimize pesticide exposure; use nontoxic products; clean up indoor air; eat healthy; and be wise about plastics. And do what it takes to minimize un-useful stress. Have fun together!

Cooney CM. Stress-Pollution Interactions: An Emerging Issue in Children’s Health Research. Environmental Health Perspectives. 2011; 119:a430-a435.

As a father and pediatrician, I’ve changed many diapers — enough to teach me that diapers are a daily reminder that as humans we deplete resources as we consume, and we make messes with our waste.

Those landfill diapers that are so easily tossed into the trash are clearly a major ecological issue. But what about the energy, water, and often chlorine involved in laundering cloth diapers? Comparing the environmental impact of different types of diapers has been the subject of a number of studies-with differing results often linked to the vested interests of those behind the study.

The largest and most objective study to date was carried out by the Environment Agency, the public body responsible for protecting the environment in England and Wales. The panel compared disposable diapers to home-laundered cloth diapers and commercially laundered cotton diapers in terms of global warming, ozone depletion, smog formation, depletion of nonrenewable resources, water pollution, acidification, human toxicity, and land pollution. The study did not include what I call hybrid diapers-the reusable diapers equipped with flushable, biodegradable liners.

This study found that overall environmental impact is about the same for all three options they did consider; the biggest impact is on global warming, resource depletion, and acidification. For disposable diapers, the most significant impact comes during manufacture; for home-laundered diapers, the primary impact comes from the electricity used in washing and drying; for commercially laundered diapers, the biggest impact comes from use of fuels and electricity.

Thus, according to the Environment Agency, if you choose cloth diapers, the first focus should be on reducing the energy used during washing and drying and reducing fuels and emissions during transportation (see Chapter Seven for more information about laundry). If you choose disposable diapers, focus first on greener manufacturing, such as used by the Eco-Diapers mentioned previously.

Although the Environment Agency report is more thorough than other analyses to date, it is still quite incomplete. For instance, it looked only at the major brands used-not the greener alternatives. It didn’t look at making choices back at the very beginning of the manufacturing process: at the oil rigs where the plastic liners of landfill diapers begin, at the forests where the wood pulp starts as trees, and in the cotton fields long before cotton is a cloth. There is a big difference between cotton grown drenched in toxic chemicals and cotton organically grown, between sustainable forestry and irresponsible logging, between dioxin-producing chlorine gas in pulp mills and bleach-free diapers.

Whatever we choose for diapers, we have an unavoidable impact on the environment. But whatever we choose, we can make those diapers a little greener.

Dr. Greene’s Answer:

Theresa, I’m so glad you asked! When we get lead in our mouths, it makes its way into our bloodstreams where it can cause damage to our brains and other organs. Our bodies take the lead from our blood and store almost all of it in our bones and teeth where it does much less harm. The history of lead exposures throughout our life is often detectable there, telling a story like the rings on a tree.

The lead stays pretty much locked away in our bones, except in three times in our lives when the bones are in transition, and when calcium and lead in our bones re-enter the blood stream: pregnancy, nursing, and aging (osteoporosis).

Convincing placebo-controlled studies have shown that pregnant or nursing women who take extra calcium end up with less lead in their blood – and in their babies. Another  study even showed newborns whose mothers had at least 7 glasses of milk a week ended up with lower lead levels at birth.

This made me wonder: might we be able to lower blood lead levels by eating chia seeds, or going for a walk outside, or enjoying a spinach salad, or playing a vigorous game of tennis, or opting for iced tea instead of cola, or choosing the pasta sauce with lower sodium, or asking those who smoke to smoke outside?

We want to do what we can to keep our calcium (and lead) locked in our bones. I suspect that other measures proven to keep our bones strong will also protect us from lead. These are my strong hunches, not tested yet for lead as far as I know (someone please do this!).

My eight suggestions for protecting you from past lead exposures:

1. Be sure to get at least 1000 mg of calcium each day – especially sure if you are pregnant or nursing. The number is higher if you’re a teen mom (1300 mg) and again after age 50 for men and women (1200 mg). If you’re not getting it in your diet, take a supplement. The women in the studies took a 1200 mg as a supplement, in addition to whatever they got in their diets.

2. Be sure to get plenty of magnesium in your diet. Most of the magnesium in our bodies lives in our bones, and it plays a major role in keeping minerals in our bones. Adult women need at least 310-320 mg per day; adult men need at least 400-420 mg. Magnesium-rich foods include spinach and other dark leafy greens, soy, seeds (pumpkin seeds, sunflower seeds, sesame seeds, and especially chia seeds), beans, broccoli, almonds, salmon, and halibut. If you take a calcium supplement, you might want to choose one with calcium and magnesium.

3. Be sure you’re getting plenty of vitamin D to keep your bones strong. Again, if you’re not getting plenty from the sun or your diet, I suggest a supplement – 1000 IU a day.

4. Be sure you’re getting plenty of vitamin K in your diet. Adult women need at least 90 mcg per day; adult men need at least 120 mcg. Vitamin K is vital for bone health and for getting the most out of vitamin D. Vitamin K-rich foods include spinach, broccoli, romaine lettuce, asparagus, green beans, peas, carrots, cauliflower, and tomatoes. If you’re taking a vitamin D supplement, you might want to choose one with vitamins D and K.

5. Be sure to get weight-bearing exercise. This helps to keep your calcium in your bones. Walk at least 30 minutes a day.

6. Avoid too much soda. Several studies link consumption of some soft drinks with losing minerals from the bones. Some argue that the link is not from the sodas themselves, but form other nutrients they replace. Even if they don’t weaken bones, they do seem to promote movement of minerals in and out of bones.

7. Avoid too much sodium. Most Americans, adults and children, get far too much sodium in their processed foods.  Too much sodium is not just bad for your heart, it’s bad for your bones and can cause bone loss.

8. Avoid cigarette smoke. Tobacco smoke can directly damage bone cells, and can decrease absorption of calcium in your diet, making it more likely you try to pull some out of your bones.

For Our Children

When I initially wrote this list, I was thinking of parents wanting to protect themselves from past exposures. But having completed it, I think all eight suggestions are even more important for children themselves. They tend to have more to lose from lead (they’re more susceptible to its toxic effects), they tend to have higher lead levels, and they have bones that are more actively modeling and remodeling.

Let’s make it a priority to reduce toxic exposures where we can, but also to enjoy the benefits of great food and great exercise in preventing or reversing the damage of the toxins.

Note: Re-read all eight on the list for your children – but kids need:

1. Calcium – 800 mg from 4 to 8 – 1300 mg from 9 to 18
2. Magnesium – 130 mg from 4 to 8 – 240 mg from 9 to 13
3. Vitamin D 400 IU
4. Vitamin K – 55 mcg from 4 to 8 – 60 mcg from 9 to 13
5. At least an hour a day of active play
6. Even less soda!
7. Even less sodium – and certainly never more than 1900 mg a day
8. No exposure to second or third hand smoke.

How are we doing? Most kids don’t get enough calcium. Many don’t get enough vitamin D. Many don’t get enough active play. And far too many get too much soda, sodium, and exposure to tobacco. We can’t change the past, but we can change the effects of the past!

^{Ettinger, A.S., Hu, H., and Hernandez-Avila, M. “Dietary Calcium Supplementation to Lower Blood Lead Levels in Pregnancy and Lactation.” Journal of Nutrition Biochemistry , Mar 2007, 18(3):172-178.
Ettinger, A.S., Lamadrid-Figueroa, H., Tellez-Rojo, M.M., Mercado-Garcia, A. Peterson, K.E., Schwartz, J., Hu, H., and Hernandez-Avila, M. “Effects of Calcium Supplementation on Blood Lead Levels in Pregnancy: A Randomized Placebo-Controlled Trial.” Environmental Health Perspectives, Jan 2009, 117(1):26-31.
Ettinger, A.S., Tellez-Rojo, M.M., Amarasiriwardena, C., Pterson, K.E., Schwartz, J., Aro, A., Hu, H., and Hernandez-Avila, M. “Influence of Maternal Bone Lead Burden and Calcium Intake on Levels of Lead in Breast Milk over the Course of Lactation.” American Journal of Epidemiology, 1 Jan 2006, 163(1):48-56.
Hernandez-Avila, M., Sanin, L.H., Romieu, I., Palazuelos, E., Tapia-Conyer, R., Olaiz, G., Rojas, R., and Nvarrete, J. “Higher Milk Intake during Pregnancy is Associated with Lower Maternal and Umbilical Cord Lead Levels in Postpartum Women.” Environmental Research, 1997, 74(2):116-21.
Jacobsson, H. “Short-time Ingestion of Colas Influences the Activity Distribution at Bone Scintigraphy: Experimental Studies in the Mouse.” Journal of the American College of Nutrition, 2008, 27(2):332-336.
Libuda, L., Alexy, U., Remer, T., Stehle, P., Schoenau, E., and Kersting, M. “Association Between Long-Term Consumption of Soft Drinks and Variables of Bone Modeling and Remodeling in a Sample of Healthy German Children and Adolescents.” American Journal of Clinical Nutrition, Dec 2008, 88(6):1670-1677.
Tucker, K.L., Morita, K., Qiao, N., Hannan, M.T., Cupples, L.A., and Kiel, D.K. “Colas, But Not Other Carbonated Beverages, Are Associated with Low Bone Mineral Density in Older Women: The Framingham Osteoporosis Study.” American Journal of Clinical Nutrition. Oct 2006, 84(4):936-942.}

Dr. Greene’s Answer:

Illnesses arise from interplay between our genes and the environment. When you look at all the conditions on the rise in kids – problems such as asthma, ADD, high blood pressure, childhood cancers, diabetes – you can’t blame our genes. These conditions have increased so rapidly in the last 30 years that we know the environment is the problem, which means that the environment also holds the answers.

As I say in “Raising Baby Green,” we are the environment. There is no separation. If a chemical exists “out there,” we should assume it’s “in here” – in our homes and in our bodies. We know there are harmful chemicals in our environment, but, as parents, we can create new healthy habits to reduce our families’ exposure to risky elements.

Having a baby is a time of pivotal change. The world will never be the same. You are embarking on the journey of a lifetime together. Much will be spontaneous and unexpected, yet there is also something of a roadmap for this journey already written deep into your being.

It’s no accident that it occurs to so many parents who smoke that this is the time to stop. Whether it’s when parents first learn they are expecting a baby, or when they glimpse their baby on ultrasound, or first gaze into their baby’s eyes, or when their little one first laughs out loud – somehow instinct, inspiration, will, and power often combine to change stubborn, pleasurable, physically and psychologically ingrained habits.

The desire to protect your baby and set a good example becomes even stronger than the addiction to smoking. You want your body and your home to be welcoming and healthy environments. The future matters in a new and living way.

If you also happen to notice a larger smokestack: that our culture has been addicted to, a different kind of smoking (burning oil, in its many forms – from fossil fuels in our cars, to those in our wall sockets, to foods grown with oil-based fertilizers and pesticides), this realization might activate even deeper instinct, grander inspiration, tougher will, and greater power.

And it doesn’t stop there…

Read the entire chapter in Raising Baby Green.

Introduction to wheezing:

Our airways are designed to be responsive to harmful substances in the air. If we walk through clouds of smoke, our airways will shrink, protecting our delicate lung tissues from the noxious ingredients in the smoke. They should return to normal when we begin to breathe fresh air.
Some people – those with asthma – have an exaggerated tightening response.

What is wheezing?

Wheezing is the noise made by air moving through tight airways in the chest. Classically, wheezing is heard when children are breathing out, and these tiny airways collapse.
Wheezing does not necessarily mean asthma – and vice versa.
Wheezing can progress to respiratory distress.

Who gets wheezing?

Wheezing is the classic symptom of asthma, but it is also an important feature of other problems such as inhaled foreign bodies, RSV infections, other types of bronchiolitis, or cystic fibrosis. Wheezing might be a symptom of gastroesophageal reflux or of a food allergy. It can also be present during many common viral infections, especially during the first two years of life.
Not all children with asthma wheeze. Some cough instead, as a way to move air through the narrowed airways.

What are the symptoms of wheezing?

Tight, noisy breathing during expiration.

Is wheezing contagious?

No – although the causes of wheezing may be contagious.

How long does wheezing last?

Wheezing lasts as long as the airways are too tight. The duration depends on the underlying cause.

How is wheezing diagnosed?

The cause of wheezing should be carefully considered. Inhaled foreign objects should always be suspected – especially with the first episode of wheezing. They are most common at the age when the child is unlikely to be able to describe what happened.
Reflux should also be considered as a possible cause, as should other sources of airway obstruction.
Wheezing and asthma are so linked in many people’s minds that other causes are often missed.

How is wheezing treated?

Wheezing is treated by reversing the tightness of the small airways of the chest. This might be done with bronchodilator medicines to relax the smooth muscles around the airways. It might be done with anti-inflammatory medicines to reduce swelling within the airways. Or it might be done by removing an inhaled object.

How can wheezing be prevented?

Wheezing can often be prevented by taking steps to prevent the individual underlying causes. See separate articles

Related A-to-Z Information:

Adenovirus, Asthma, Bronchiolitis,Common Cold, Cough, Cystic Fibrosis, Food Allergies, Gastroesophageal Reflux, Peanut Allergy, Pneumonia, RSV (Respiratory syncytial virus)

Related concepts:

Plumbism

Introduction to lead poisoning:

Most people aren’t aware that lead remains a top environmental health hazard for US children. More than one in 25 American children have blood lead levels high enough to lower IQ or cause learning disabilities, violent behavior, attention-deficit disorder or hyperactivity.

What is lead poisoning?

Lead is a metal that does not belong in the human body. During the 1970s, lead in gasoline caused severe brain damage in thousands of children. Today, lead-based paint is the most common source of lead poisoning in children in the United States  (CDC, http://www.cdc.gov/nceh/Lead/tips.htm). Over many years, painted surfaces crumble and become common household dust. This dust coats the objects that curious children put in their mouths. Adults can also ingest lead in this way. It is the most common way for the lead in paint to get into a person. Children will also chew on windowsills or other painted surfaces. Sometimes they eat old paint chips.  Sometimes they are exposed to lead in objects and foods imported from other countries.
Deaths from lead poisoning are now rare, but it is common for a child’s blood to contain enough lead to cause intellectual and developmental delay, neurologic problems, kidney disease, and anemia.

Who gets lead poisoning?

Young children are at the highest risk for lead poisoning. Children absorb 40-50 percent of the lead that gets into their mouths. Adults only absorb 10 percent. Even small amounts of lead can produce high concentrations in the blood of young children because their bodies are small. Since children’s brains are still developing, the effect of lead poisoning can be especially damaging.
Children exposed to dust from lead-containing paint are the most often affected. Lead is used to make paint last longer. Before World War II, heavily lead-based paints contained as much as 40 percent lead by dry weight. The amount of lead in household paint was reduced in 1950, and reduced even further in 1978. Most apartments and houses built before 1950 still contain paint with high levels of lead, particularly on doors and around windows. Newer household paints may test positive for lead, but generally contain much smaller amounts.
Lead levels in paints are measured in parts per million (ppm). You will need to find the concentration of lead in your paint to determine the level of risk. Currently, 600 ppm of lead is allowed in paint, since this much should not produce toxic levels in a child who eats it. If a chip contains 5,000 ppm or more, something must be done to make the area safe.
Other sources of lead include some types of glazed ceramics, fumes from burning batteries, some Asian cosmetics, and dust carried home by those whose work or hobby involves lead. Some traditional folk remedies may contain lead. For example, Azarcon and Greta are powdered folk remedies often used in Latin American countries for “empacho” (intestinal illness) but have been found to be almost 100% lead! Lead has also been found in some imported candies and in some antique furniture and metallic toys (Journal of Environmental Health, 70(10):80, 86, 2008).
Dangerous lead levels are most common among the inner city poor.

What are the symptoms of lead poisoning?

Blood lead levels over 10 micrograms/dL can damage the brain. Children with levels up to 7 times that high might have no obvious symptoms while the damage is being done.
Severe lead poisoning can cause persistent vomiting, seizures, coma, and death.
At lower levels, the child might have anemia, abdominal pain, severe colic, attention problems, hyperactivity, learning disabilities, or mental retardation.

Is lead poisoning contagious?

No

How long does lead poisoning last?

Lead will continue to accumulate as long as the child is being exposed. The damage from the lead can be permanent.

How is lead poisoning diagnosed?

Lead poisoning is best diagnosed with a blood test – before symptoms are obvious. This is especially true for children with anemia. The risk of lead poisoning should be assessed during well-child visits, especially for children under age 2.

How is lead poisoning treated?

The treatment varies depending on the degree of poisoning. Sometimes emergency medical treatment is necessary. In some cases medicines are given to reduce lead levels.
In all cases, the source of lead should be identified and the child protected from exposure.

How can lead poisoning be prevented?

Learn whether or not any paint near your child is likely to be contaminated with lead. If there is any question, it is wise not to place a crib, playpen, or high chair where paint is peeling or can be chewed. Keep the home as dust- free as possible by regularly wet-mopping the floors. In particular, wipe windowsills with water and a household detergent.
Paint samples can be tested for lead. A common response to a positive lead test is to strip the old paint. DON’T. The process of removing old paint (especially sanding, scraping or burning) can produce large amounts of lead dust. Lead poisoning is very common during remodeling. Use a contractor skilled in lead abatement to enclose or remove the lead from your home.
For information on finding such a contractor, and finding local laboratories that can test lead concentration in your home or apartment, contact your local Health Department and ask for the Department of Environmental Health. Another great resource is the National Lead Information Center at 1-800-424-LEAD. Lead specialists are available through this hotline to answer your questions and will send you detailed information on preventing lead poisoning.
In addition, good nutrition (fresh fruits and vegetables, plenty of calcium and iron) causes less lead to be absorbed into the body. And the lead that is absorbed will do less damage.

Related A-to-Z Information:

Anemia (Low hemoglobin), Attention Deficit Hyperactivity Disorder (ADHD), Breath Holding, Depression, Epilepsy, Fragile X Syndrome, Head Banging, Iron Deficiency, Thumb-sucking, Tourette’s Syndrome, Vomiting

Introduction to bronchiolitis:

Worried parents stand over the crib, listening to their baby cough and struggle to breathe. He may have bronchiolitis. Most parents have heard of pneumonia or bronchitis, but what does bronchiolitis mean?

What is bronchiolitis?

Bronchitis is inflammation of the large airways in the chest and pneumonia is inflammation of the lung tissue. Bronchiolitis is inflammation of the smaller airways connecting the two.
Bronchiolitis is usually a viral infection. RSV is responsible for the illness in many children. Adenovirus, parainfluenza (croup), and other viruses can also cause bronchiolitis.
In adults and older children, RSV usually appears as a bad cold. However, in babies and toddlers whose bronchioles are smaller and easier to plug, these viruses often cause bronchiolitis when inhaled.

Who gets bronchiolitis?

Bronchiolitis is primarily a disease of young children before their second birthdays. The most common age for bronchiolitis is about 6 months.
Winter and early spring are bronchiolitis season. Children in day care are usually much more likely to get bronchiolitis. Kids who are exposed to cigarette smoke are at even higher risk. Babies who attend day care are less likely to get bronchiolitis than those who stay home with a parent who smokes.
Boys are more often affected, as are formula-fed infants. Those at high risk for asthma also appear to be prone to bronchiolitis.
Most kids who get bronchiolitis have been exposed to an adult or another child with a cold in the previous week.

What are the symptoms of bronchiolitis?

Bronchiolitis usually begins with cold symptoms such as a runny nose, sneezing, and perhaps a mild cough. The appetite is often decreased. The child may have a fever or might be a bit cooler than normal.
After a day or two, breathing becomes faster and the cough becomes more severe. It may be a deep or wheezy cough. The child may develop wheezing and respiratory distress.
Breathing difficulties can make it hard for babies to feed.

Is bronchiolitis contagious?

Bronchiolitis is very contagious. It spreads most commonly by contact transmission, droplet transmission, and fomites.

How long does bronchiolitis last?

Mild bronchiolitis may last only for a day or so. Often the disease lasts 5 to 12 days. The first 3 days are the most critical.

How is bronchiolitis diagnosed?

Diagnosis is often based on the history and physical exam. A chest x-ray can give additional information, as can a pulse oximeter to measure oxygen levels. A nasal swab for RSV and other viruses might be done to identify the specific cause of bronchiolitis.

How is bronchiolitis treated?

There are no specific medicines for treating bronchiolitis at home. It is important to give plenty of fluids to prevent dehydration. Also, a humidifier or saline nose drops might be recommended to thin the mucus.
Some children need supplemental oxygen or even mechanical help to breathe.  A powerful aerosol treatment specifically against RSV is sometimes used for hospitalized children.
Steroids and antibiotics are not usually helpful. It is unclear whether inhaled medications such as albuterol are helpful.

How can bronchiolitis be prevented?

If possible, protect your baby from exposure to sick individuals during the peak bronchiolitis season. In addition, good hand washing, particularly just before anyone handles susceptible infants, can decrease spread. Don’t forget to use a tissue when you cough or sneeze.
Two products are now available to prevent RSV infection in children at high risk for serious disease. RSV-IGIV (RespiGam) and palivizumab (Synagis) have been approved for high-risk children (such as premature babies and infants with severe heart or lung diseases).

Related A-to-Z Information:

Adenovirus, Asthma,Common Cold, Contact Transmission, Cough, Croup, Cystic Fibrosis, Dehydration, Droplet Transmission, Fomites, Pneumonia, Respiratory Distress, RSV (Respiratory syncytial virus, Sudden Infant Death Syndrome (SIDS), Wheezing