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Bronchiolitis, what is it?
Le bronchiolitis virus, which causes babies to blow, cough, snore for at least eight days, usually points its nose from mid-October. Not a nasty virus, but a cumbersome one. As a treatment, you simply need to clean the nose, moisturize and use the skilled hands of a physiotherapist, if necessary, to clear the baby’s congested bronchi.
Respiratory physiotherapy step by step
From the first signs of bronchiolitis (coughing fits, wheezing, etc.), it is essential to consult your pediatrician or general practitioner. Once the diagnosis has been made, your baby may be prescribed respiratory physiotherapy. On the other hand, if after a thorough examination, he only detects a slight bronchiolitis, treatment with respiratory physiotherapy is not necessarily useful.
Respiratory physiotherapist: the physiotherapist decides!
During the consultation with the physiotherapist, your baby will once again be examined. The practitioner listens to his breathing and hissing noise characteristic of bronchiolitis. He is also asked to ask you questions to find out in particular the number of your baby’s daily coughing fits. This information helps him to determine the progress of the disease and to decide, on a case-by-case basis, whether respiratory physiotherapy is well justified.
There are certain contraindications concerning the child’s age, weight and general conditionhealth. Caution is advised for babies born prematurely, or those who are too light weight for their height. Generally, physiotherapists redouble their vigilance for babies under 3 months, who are more fragile. In addition, they make sure with the parents that the child does not present other pathologies, for which the respiratory physiotherapy would be ineffective (allergies, asthma, etc.). If the physiotherapist declares himself unfit to treat your baby, he will then redirect you to one of the adapted services.
Finally, it is important to let the practitioner know when your child’s last meal was. The risks of aspiration and vomiting being frequent, it is recommended to feed him 2 to 3 hours before the physiotherapy session.
Respiratory physiotherapist: who to contact? Ile-de-France bronchiolitis network: – physiotherapists available at their practices on weekends and public holidays, from 9 a.m. to 18 p.m .: 0820 820 603 – liberal doctors available 7 days a week, consultations from 7 a.m. to 9 p.m.: 23 0820 800 Le SUK : emergency physiotherapy brigade in scooters, intervention 7/7 and 24/24 at home. Paris and Strasbourg 0811 142 200 The national bronchiolitis network : all bronchiolitis emergency numbers by department |
Respiratory physiotherapy: the course of the session
Once the progress of the bronchiolitis has been observed by the physiotherapist himself, the session can begin. The practice is often impressive, both for parents and children, but you can be sure of it, it is not painful! Respiratory physiotherapy is carried out within a regulated framework. The physiotherapist does a deep chest massage. With the pressure and movement of the hand, it causes bronchial drainage and thus makes the secretions go up to the baby’s mouth. Massage causes coughing, and the child, spitting, gradually clears his respiratory tract. If it does not reject anything during the session (which is quite common), that does not mean that it is ineffective. It is because the baby has swallowed the secretions which will then end up in the stool. Don’t worry either if your child is vomiting, it is also a way for him to evacuate secretions. Just remember to give him a drink to prevent him from becoming dehydrated.
The presence of parents often facilitates the session. So, do not hesitate to ask your physiotherapist to explain in detail the operations carried out. You can, on his advice, put your hand on the child’s chest yourself in order to feel the congestion of the bronchi. You will thus better understand the usefulness of the method.
In general, 5 to 6 sessions are enough to clear all the bronchi. If results are felt from the first sessions, the pace of one session per day must be respected. Indeed, the clearing of the bronchi must be done daily to hope to fully treat the affected child. The last consultations are often easier because the physiotherapist gently finishes clearing the bronchi with a less deep massage. It may happen that the number of sessions is slightly increased, once again the choice is made on a case by case basis. However, it must not never exceed 10 sessions. If this is the case, the physiotherapist must send the baby back to a specialist to diagnose another problem: allergies, asthma, etc.
With some exceptions, babies quickly regain their appetite, smile and energy. Unless there is a superinfection, conventional drugs are unnecessary.
Since November 2019, traditional respiratory physiotherapy techniques such as clapping or vibration, for example, are not recommended. The technique of increased expiratory flow (AFE) is not effective in the management of infants hospitalized with acute bronchiolitis. As it has not been proven to be effective for forms of bronchiolitis treated on an outpatient basis either, it is therefore not recommended. However, the HAS (Haute Autorité de santé) and the CNPP (National Professional Pediatric Council) stress the need to continue research and conduct studies to measure the impact of this technique, in particular on the use of hospitalizations.