Pediatrics Group Issues New Guidelines for Bronchiolitis
By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

The American Academy of Pediatrics has stopped recommending use of a trial dose of a bronchodilator in treating bronchiolitis in children aged 1 to 23 months because such therapy does not alter the course of the illness, according to new guidelines published in Pediatrics.

The recommendations, which update the group’s 2006 guidelines, also include the following changes:

Palivizumab to prevent respiratory syncytial virus (RSV) infections should be administered during the first year in infants with hemodynamically significant heart disease or chronic lung disease of prematurity (infants born at 21% oxygen during the first 28 days of life).

Nebulized hypertonic saline shouldn’t be given to infants who are diagnosed with bronchiolitis in the emergency department but may be given to infants and children who are hospitalized.

Exclusive breast-feeding is encouraged for at least 6 months to reduce the severity of respiratory infection.