Spastic Bronchitis: When Do I Need To See A Pediatrician?

Spastic bronchitis often occurs in babies and young children. Although the disease can be treated well, you should observe the course of the disease well. In this article, you will learn what you should watch out for and when you should consult a doctor.

What Is Bronchitis?

Spastic bronchitis is the most common form of acute bronchitis. Bronchitis is especially common in babies and young children. As in normal bronchitis, which is acute, in a spastic variant, the mucous membrane in the bronchial tubes is severely inflamed.

As a result, it produces more mucus. In addition, the inflamed bronchial tubes are narrowed in a spastic condition. This is why physicians also refer to it as “obstructive bronchitis.” Obstruction means narrowing or closing.

On the one hand, this narrowing is caused by the swelling of the inflamed mucous membrane. On the other, the muscles of the airways spasm. From this derives the name spastic = spasmodic bronchitis.

Small babies are particularly susceptible to spastic bronchitis. This is because the bronchial tubes of such small people are also still extremely delicate and not fully developed. Therefore, they are particularly susceptible to spastic bronchitis. This is also true in young children.

In adults, on the other hand, spastic bronchitis is rather rare. The spastic variant is therefore often referred to as baby bronchitis or infant bronchitis. In both cases, spastic bronchitis is manifested by a whistling sound when breathing out.

Often the children can only breathe with great difficulty and in severe cases suffer from complete shortness of breath, similar to asthma. Because of these complaints, spastic bronchitis is also called “asthmatic” bronchitis. However, the name is not medically correct.

Spastic Bronchitis: These Are The Symptoms

If your baby or toddler is suffering from a normal cold or it could be spastic bronchitis, the first thing you notice is restricted and heavy breathing. Your child’s bronchial tubes will be inflamed and constricted. This makes it difficult for him to breathe, especially to exhale.

This breathing difficulty alone can be frightening for parents and young patients. If your child exhales, you will also hear distinct breathing sounds, such as whistling, humming, or rattling noise. This is accompanied by a spasmodic cough. This intense coughing is characteristic in the morning.

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This is because a large amount of mucus has formed in your child’s bronchial tubes during the night. This causes a violent coughing impulse because it has to be coughed up. The mucus that your child coughs up is usually whitish.

Only in very rare cases is the mucus bloody. If it turns yellowish-green, then bacteria have also settled in the inflamed mucous membrane. The pediatrician calls this a secondary bacterial infection.

Spastic bronchitis, like bronchitis, which is acute, is accompanied by typical symptoms of cold and flu-like symptoms. These include sore throat, headache, aching limbs, and fever.

Heavy breathing and coughing are very stressful for the patient. He is therefore quickly exhausted.

Do Not Underestimate Dangerous Shortness Of Breath

If spastic bronchitis puts your child in a state of dangerous shortness of breath, you must not underestimate it under any circumstances. Call the emergency services on 112. In addition to blue lips, bluish discolored nails and skin are clear warning signs.

Rapid breathing and movements of the nostrils also indicate respiratory distress.

Causes Of Spastic Bronchitis

Like almost all forms of acute bronchitis, spastic bronchitis is caused by viruses. These include so-called adenoviruses, parainfluenza viruses, and rhinoviruses. These pathogens are easily transmitted by coughing and sneezing as well as by touch.

However, they usually cause only a mild cold and not immediately acute or spastic bronchitis. However, full-blown bronchitis is contagious. A child with a less developed immune system gets sick more easily.

These Factors Increase The Risk

Pre-Existing Conditions

Acute bronchitis can always develop into spastic bronchitis if there are certain pre-existing conditions. In addition to lung diseases, these can include allergies, to which babies and young children are particularly susceptible.

Mucosal Weaknesses

Another risk factor is bronchial hyperreactivity. In affected people, the mucous membrane of the bronchial tubes reacts very sensitively to irritations and infections. This hypersensitivity causes the bronchial tubes to constrict more quickly and the mucous membrane to swell.

Early Childhood Damage

Premature birth and early contact with harmful substances and viruses are also risk factors. The contact may have already occurred during cold in pregnancy. Smoking during pregnancy or around their children is especially dangerous. This increases the risk for respiratory ailments, such as spastic bronchitis.

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If your child comes near another child who already has spastic bronchitis, this is also a risk factor. Because as a viral disease, bronchitis is contagious.

This Is How The Pediatrician Detects The Disease

If you think that your child is showing symptoms of bronchitis, you should consult an experienced physician. This can be your family doctor or a pediatrician. Especially the latter know bronchitis symptoms in children best because they are generally common in young patients.

Therefore, he can well assess whether the bronchitis symptoms really indicate spastic bronchitis and whether this disease is serious in your child.

First Step: The Medical History

First of all, the doctor obtains all the important information during a consultation. This is called anamnesis. In this process, the family doctor or pediatrician tries to determine how strongly the bronchitis symptoms point to an actual disease.

If he knows your child from previous treatments, it is easier for him to correctly classify previous illnesses or existing risks.

The pediatrician could ask these questions:

  • Does your child often suffer from infections?
  • Are they often respiratory infections?
  • Are there any previous diseases of the respiratory tract?
  • What are the bronchitis symptoms?
  • How long has it been present?
  • How does the cough manifest itself (morning, barking, seizure-like, with phlegm)?
  • Does shortness of breath occur?

Second Step: Physical Examination

Then the doctor examines your child. He listens to the small lungs and looks for breathing sounds. Spastic bronchitis causes a whistling sound when you exhale, called a wheeze.

This sound is a sign that your child’s airway is blocked. If humming sounds tend to occur as bronchitis symptoms, this indicates increased mucus in the airways.

The doctor will also tap the lungs. From the sound, the tapping sound, he concludes the condition of the lungs. If the lungs are normally filled with air, the sound is similar to the pounding of a drum. If, on the other hand, there are pronounced inflammatory foci, the knocking sound appears rather muffled.

The doctor also feels for the lymph nodes in the neck and checks the mouth and throat.

Third Step: X-Ray

If the disease is more severe, the doctor takes an X-ray of the chest, also known as a chest X-ray. On this, the doctor can see, for example, whether it is a limited inflammation of the bronchial tubes.

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Spastic bronchitis that has already persisted for a long time often threatens to develop into pneumonia. The X-ray also shows whether the airways are obstructed.

Fourth Step: Examination Of The Blood

If spastic bronchitis occurs for the first time, a blood test may not be necessary. However, a high white blood cell count indicates inflammation in the body. In the case of frequent illnesses, it is, therefore, best for the doctor to check the blood count thoroughly

Caution: False Leads

If your child shows bronchitis symptoms, this does not mean that it is actually spastic bronchitis.

Breathlessness, in particular, may indicate other causes. If your child shows bronchitis symptoms, the doctor will always check whether he or she has swallowed a foreign body that is now stuck in the bronchial tubes.

If, for example, when listening to the lungs, noticeable sounds can only be heard on one side, this could indicate that the child’s airways are blocked by a body that has no business being there.

Also, there are bronchitis symptoms that are actually from bronchial asthma. This is allergic bronchitis. The pediatrician will come on this track, for example, if your child often suffers from the symptoms of spastic bronchitis.

Correct Treatment Of Spastic Bronchitis

The doctor treats spastic bronchitis basically the same way as bronchitis that occurs acutely. Patients must take it easy, If they have a fever, they should be on bed rest. It is optimal if the upper body lies a little higher. This makes breathing easier.

The patient must also drink plenty of fluids. Water, tea, or broth are best. If your child is restless or anxious because of his or her restricted breathing, you should calm him or her down, because inner restlessness additionally increases the shortness of breath.

In addition, it means paying attention to fresh air. The air should be warm and humid, but not hot. It is advantageous to air the room regularly or to place a damp cloth on the radiator.

These Treatments Are Not Very Useful

Essential Oils

If you rub your child’s chest with ointment or essential oils during spastic bronchitis, this may further irritate the mucous membrane of the bronchial tubes. Then coughing and breathing problems intensify. Many essential oils, such as eucalyptus oil, should generally not be used on young children.

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Cough Suppressant

In bronchitis, coughing up mucus is very important. Medicines that dampen the urge to cough often have a counterproductive effect. You should only use cough stoppers or cough suppressants if your child’s cough is not productive, i.e. there is hardly any secretion in the bronchial tubes, and if the cough disturbs sleep at night.

Incidentally, the administration of cough suppressants for spastic bronchitis is also extremely controversial. This is because the agents cause the mucus to become fluid. It then threatens to disappear into the bronchial tubes.


So-called sympathomimetics, also known as ß2-receptor agonists, decongest and relax the constricted airways. One of the most common agents is salbutamol. These agents are usually given as an inhalation or in the form of a spray.

However, if the narrowing of your child’s bronchial tubes is due to the fact that the mucous membrane is very swollen, treatment with these agents is usually of little use. You should therefore follow your doctor’s instructions closely if your child has bronchitis. He knows best what to do.

Sometimes The Best: Treatment In The Hospital

Don’t panic if the doctor admits your child to a hospital for spastic bronchitis. Especially for babies or very young children, this measure can be a good help for recovery.

Here, the little patient can receive all the necessary medication and plenty of fluids via an IV. This puts much less strain on the little body. The supply of oxygen can also be continuously monitored in a hospital. If necessary, your child will receive additional oxygen.

Good Prognosis Is Not Rare

Spastic bronchitis in a baby or toddler scares many parents. They fear that the disease will develop into asthma and become chronic. But that doesn’t have to be the case. Only about one-third of children who suffered from spastic bronchitis as babies later developed bronchial asthma.

This primarily affects children in whose families allergic diseases such as neurodermatitis or asthma are known. In their case, parents and physicians must ensure that they are not exposed to harmful tobacco smoke during passive smoking and that the air in their living environment is not too dry and low in pollutants.

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