For a 6-month-old with suspected bronchiolitis, which management approach is most appropriate?

• A. Supportive care (fluids, nasal suctioning); avoid routine bronchodilators or steroids.
• B. Administer routine bronchodilators.
• C. Start systemic steroids.
• D. Begin antibiotics.

Answer: (A)

Bronchiolitis in infancy is typically a viral illness that mainly affects the small airways, so the goal is to support the child rather than treat the virus directly. The best approach is supportive care focused on keeping the child hydrated and helping clear airway secretions. This means offering fluids as tolerated and using gentle nasal suctioning to relieve nasal congestion, especially before feeds, which improves breathing and feeding. Routine bronchodilators or steroids haven’t shown consistent, meaningful benefit in uncomplicated bronchiolitis, so they’re not routinely used. Antibiotics aren’t indicated because the illness is usually viral, unless there is a clear sign of a bacterial coinfection such as pneumonia. Oxygen therapy is added only if the baby is hypoxic, and hospital care is considered if there are red flags like poor feeding, dehydration, or significant respiratory distress.