Caught in the wave of bronchiolitis

TW: Hospitalisation of baby, mention of anxiety¦ Well, this is a first. I’m beginning to write this post from a hospital bed. Thankfully, I’m writing in the knowledge that everything seems to be fine now. Bronchiolitis is really common in babies in the autumn and winter. However, the nurses here have told me that thanks to lockdown last winter, the usual wave of cases coming in didn’t really happen. I actually read a news article last week saying that due to a combination of that and people now mingling, lots of babies are now catching respiratory syncytial virus (RSV), the virus responsible for it and hospitalisations are rising. According to Public Health England, over 60% of children have been infected with it by their first birthday. This rises to over 80% by 2 years of age. For most, it is a mild illness but some require hospitalisation. Unfortunately for us, Reuben was one of them.

The start

Last week, Autumn and I developed a mild cold. Our noses were a little bit runny on occasion, we had a slight sore throat and an intermittent cough. We had both been taking lateral flow tests beforehand and during, so we were fairly confident that it wasn’t Covid-19. Reuben had been getting his first two teeth through, so had been a bit congested and dribbly for a while. However, last Wednesday I came to the conclusion that he had probably caught our cold too. He barely slept during the day or night for a couple of days (I was exhausted!) Often, when he did fall asleep, he coughed and woke up again. He wasn’t himself. He was smiling less than usual, was less active than usual and cried whenever I put him down. Even when he has a cold usually, he’s still quite active and he usually sleeps more. I just put it down to being a combination of a cold and teething, thinking I’d feel sorry for myself if I had both those things going on too! He also kept having a slight temperature on and off.

On Saturday, it was Reuben’s christening. We’d had more sleep than we’d had in days the night before (fortunately!) However, the poor little thing wasn’t himself. He wasn’t smiley, was coughing more frequently and seemed full of cold. When he woke up once we were home, he felt quite hot. I took his temperature and it was high once again. He had some Calpol then seemed to perk up quite a bit and was more smiley again. The following day, even Calpol wouldn’t perk him up much. He’s usually so active and gets wound up if he’s held in the same position for long. He wants to be on the floor playing with his toys and trying to crawl! Yet now he would cry if he was put down, only wanted to be held. On Sunday he was even more lethargic. He was sleeping far more than usual, feeding far less and his breathing was noisy. He wasn’t really interested in toys at all.

Putting 2 and 2 together

On Monday morning, he was still the same. My husband insisted it was just a bad cold. My instincts were telling me differently, though. Yes, he is usually grumpy with a cold (and he’s had many thanks to Autumn bringing nursery germs home). However, he isn’t usually so lethargic. He still smiles when you sing to him or play with his toes. All I was getting was blank stares. I remembered I’d read an article the week before about an increase of cases of bronchiolitis, so I had a quick look at symptoms on the NHS website. Everything matched up. Then I scrolled to symptoms of bronchiolitis that require hospitalisation. He had several! He kept having a temperature, he wasn’t feeding normally and he was very tired and irritable. I also noticed that it looked like his stomach was sucking in under his ribs. It was time to ring 111.

111

I can barely even remember my conversation with the person the other end of the phone at 111 now. I just remember them saying they were going to send an emergency ambulance. I immediately set about brushing my teeth and getting dressed. Reuben was incredibly sleepy and I had to wake him up to bring him downstairs when the ambulance crew arrived. The paramedics listened to his chest and found some global crackling on one side. They also found that his oxygen levels were lower than they should be (85-90%). Some medication in a mask that Reuben hated did help to bring them right back up. However, despite responding well to it, his levels fell back down when it was taken away. As such, they decided to take him into hospital.

A&E

We were blue lighted all the way to Medway Maritime Hospital by the lovely ambulance crew. As Reuben was easily distressed, they didn’t use the baby harness. Instead, they strapped me to the bed and I cuddled him on my lap. I held an oxygen tube up to his little nose as we travelled. He didn’t wriggle on me at all. When he’s his usual self, he isn’t keen on sitting on my lap for long anymore. There are much more important things to try and do and see!

When we arrived at the hospital, we were wheeled through into children’s A&E where we were immediately greeted by the A&E doctor who did handover with the ambulance crew. He confirmed my suspicions that this very likely was bronchiolitis, but asked the usual Covid-19 questions just in case. He said it didn’t sound like a Covid cough and it seemed very unlikely, but of course we’d need to do a swab to rule it out. They also did a heel prick to check his blood sugars as he had been feeding a lot less. Fortunately, he wasn’t. I sat there with Reuben in my arms, holding an oxygen mask up to his face. Before long, he fell asleep. Usually it’s a palaver getting him to sleep, involving white noise and lots of rocking, but the bronchiolitis was making him feel so unwell that it seemed effortless for him.

He was rudely awoken by the mask being replaced by oxygen tubes going up his nostrils. Needless to say, he wasn’t at all impressed and it was a struggle to stop him from pulling them out! He was still very distressed and, noticing that he was chewing his hand a lot with his teething, a nurse brought him an orange ice lolly. He wasn’t impressed by that either, nor the ibuprofen he was given.

Paediatric assessment

Before long, the paperwork had been sorted out and we were wheeled through to the paediatric assessment ward. Reuben had perked up enough to try and eat the oxygen mask. Reuben fell asleep in my arms again, so easily. We weren’t waiting for long again before an x ray machine was brought into the room. Fortunately, the results of that showed that he didn’t have pneumonia. He barely fed before falling asleep again while we waited for the paediatric doctor. We tried him without oxygen, but his stats fell too low so I had to get the nurse to put it on again. The doctor wanted to try him without oxygen again, until we told them this. Instead, the amount of oxygen was reduced. His stats weren’t as high, but good enough. Having been asleep for most of the day, Reuben woke up around dinner time. When he’d been awake previously, he had just been laying there. Now, he rolled himself over. He still wasn’t cheerful, but it was amazing to see him doing something.  It had been agreed that we were going to stay in overnight by this point and we were moved through to the paediatric ward.

On the ward

I didn’t like going through to the ward. It was where I’d been with Autumn seriously ill as a baby, which had caused me to reach rock bottom with my mental health. Now I was here with another baby, without my husband or family for support. I reminded myself that things weren’t as serious this time and we were only expected to be here for a day or two. Things were different and this was bronchiolitis. It wasn’t some mystery illness. Reuben had a very slight temperature again, but some Calpol brought it back down quickly.

As the evening went on, he perked up more and more and his oxygen was reduced again and finally removed completely. He still wasn’t having much milk, but he was rolling over and moving himself around his cot! When my husband arrived to drop some things off to me shortly before 10pm, he smiled for the first time in 2 days! As I got myself organised and settled in for the night, he showed some interest in the toys his Dad had brought in for him. He even seemed to be quite annoyed to be in a confined space, which I dubbed “baby jail!”

As he went to sleep, he looked like he couldn’t believe all the drama of the day.

Overnight

I struggled to sleep, despite being incredibly tired. Our nurse came back each hour to check his stats and at 1am came in to do the first of two nebuliser treatments. He absolutely hated it, at least to begin with. By the end of it, he was quite chilled out and just trying to chew the mask. I gave him a nappy change and a tiny feed and he went straight off to sleep again.

At 4am, it was time for another one. Even though I laid him in a normal position in the cot, every time, he’d wiggle himself sideways to go to sleep for some reason. His legs were stuck in the bars of the cot for about the 20th time and the nurse was struggling to free him and I got up to help. She told me that his stats had been good so far and she gave him his second treatment while I strokes his little head. After another nappy change and a little feed, he was off to sleep again.

Good progress

In the morning, Reuben was still more tired than usual but doing really well. The nurse told me that his stats had remained really good all night. His oxygen saturation had even been at 100% at one point! When the doctor came round with 2 junior doctors, she told us that we may well be able to go home that day. It all depended on him continuing to feed and having wet nappies. She told me that with bronchiolitis, little and often is the key. She was also going to give us saline drops to clear his nose to help him feed.

Between naps, Reuben was almost completely back to his usual smiley self. He really enjoyed me singing to him and reading him books. He was happy moving himself around his cot and playing with his toys.

I kept offering him milk every hour or so and he would be on the boob for perhaps a minute or two at a time. Now that they were happy enough with him for the oxygen tubes to be removed, I could even take him out of the room. I took him for a walk outside, showing him children’s colourings of rainbow and some dinosaur toys.

Discharge

The small feeds and dirty nappies continued. After one last good observation, we were free to go! It is now the next day and while Reuben has been slightly sleepier than usual still, he is almost back to his normal self. His chest is clearly hurting and upsetting him when he coughs, but as long as he has Calpol in his system he seems quite alright. He is still only having small feeds, so I’m hoping that picks up again soon. The hospital had told me all I need to do was ring if I had any concerns about his bronchiolitis and we could go back to the assessment ward if necessary. I found that really reassuring. However, it seems like a corner has been turned and hopefully tomorrow he’ll be better still!

I’m so glad that once again, I trusted my instincts. It was a good job I had bronchiolitis on my radar as I think that helped! I am concerned that if I hadn’t have trusted my instincts, things may have got worse. Even though Reuben needed hospitalisation, I’m aware that it all could have been so much worse. Please make sure that you are aware of the symptoms of bronchiolitis.

Has your little one had bronchiolitis? I’d love to hear from you in the comments.

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