There are a number of different treatments for bronchiectasis in children, which we explain here. The best treatment for your child will depend on their symptoms. In this section we cover:
Airway clearance
Airway clearance exercises (a type of physiotherapy) are important for managing bronchiectasis in children. A range of techniques can be used to move and clear mucus from the airways. A physiotherapist will show you and your child how to do this.
They might recommend:
- using a device for your child to blow into
- breathing exercises
- moving your child into different positions while gently drumming your hands on their chest (this is called percussion).
Your child’s physiotherapist will recommend the best approach for your child. They’ll consider your child’s age, symptoms and how bad their bronchiectasis is. The physiotherapist will tell you when and how often to do airway clearance. You might need to do the exercises every day, even if your child has no symptoms.
The physiotherapist might use saltwater solution in a nebuliser at the start of the session. This helps to clear mucus before the session starts.
It can help to read aloud to your child or to have the TV, an audio book or some music on while doing their airway clearance. Make it a fun part of their normal routine, so they don’t see it as a chore.
Medicines for bronchiectasis
The medicines your doctor may prescribe for your child depends on the cause of their bronchiectasis. For example, new medicines are hugely helpful in children with bronchiectasis caused by cystic fibrosis.
Antibiotics
Antibiotics are used to treat bacterial infections. Children with bronchiectasis may be prescribed a longer course of antibiotics than other children, usually for a minimum of two weeks. Many infections can be treated with antibiotics your child can take in tablets or liquid form. If your child is more unwell, they may need to stay in hospital to have antibiotics directly into a vein (through a drip). The doctor will explain the best options.
If your child keeps getting infections, a specialist might recommend that they take antibiotics long term. This is to prevent infections that can cause symptoms to worsen (sometimes called flare-ups or exacerbations). One option is a six-month course of the antibiotic azithromycin, which has been shown to reduce flare-ups of bronchiectasis.
Sometimes antibiotics are given through a device called a nebuliser. A nebuliser makes the medicine into a mist that is breathed in through a face mask. It helps get the medicine into your child’s airways. Nebulised antibiotics are used for particular types of infection or when long-term treatment is needed.
Inhaled salt water
Your doctor may prescribe your child with a nebuliser to deliver saltwater solution into their lungs. This may help move mucus and clear the airways.
Inhalers
Your child may be given a type of inhaler with medicine to help relax and open their airways. This is called a bronchodilator.
Living with bronchiectasis
“Both my boys live with bronchiectasis and I do physio with them twice a day. If they’re not well, they need physio three times a day.
If they get really bad, then they need to go to hospital and they get intense physio.
My elder boy took to physio quite well. There’s lots of blowing exercises – such as blowing bubbles – and we make it fun. After a set of 10 blows, I hold him tight to feel his chest and he has a good cough to get rid of his mucus.
My younger boy needs a bit more coaxing. He got a bit upset at first, especially if he’s having physio in hospital. But it doesn’t hurt them and it’s absolutely worth it to get the mucus out.
I found it tricky to do at first, but you get used to it. I’d say to anyone: persevere – it makes such a difference!” Joanne, whose boys are 10 and 4
Ways to help your child with bronchiectasis?
Keep them active
Regular exercise has shown to help clear the lungs of mucus. In adults with bronchiectasis, exercise helps to improve walking distance and breathlessness. It also reduces the number of flare-ups for some people. We don’t yet know if children get the same benefits, but keeping active is important for everyone to lead a healthy life. Talk to your child’s doctor about the exercise level that’s right for them.
Give them a healthy diet
Fighting infection and coughing can use up your child’s energy. They may need more food than other children. Their immune system will need plenty of protein and vitamins to fight infection. The NHS website has useful information about a healthy diet and vitamins.
Make sure they drink enough
This keeps mucus thin and makes it easier to cough up.
Let them cough whenever they need to
This is vital to your child clearing their lungs of mucus.
Don’t smoke or vape
Don’t smoke or vape or let anyone else smoke or vape around your child. Explain the importance of them not smoking themselves. Being exposed to second-hand smoke increases your child’s risk of infection.
Make sure your child’s vaccinations are up to date
Including the flu and coronavirus vaccines. Some health centres will not give vaccinations to children on antibiotics. You might need to explain that your child is on antibiotics regularly because of their bronchiectasis.
Look out for signs of colds and infections
If your child has signs of a cold or infection, contact their doctor straight away to get treatment. See a doctor if your child is coughing more than usual or producing more or differently coloured mucus.
Will my child need to go to hospital with bronchiectasis?
Most children with bronchiectasis can be looked after at home. They should have a review for their bronchiectasis at least twice a year. This review is to check their symptoms and how they affect their daily life, to check how many flare-ups they’ve had, and to take a mucus sample. Your child should also have reviews with a chest physiotherapist.
If your child gets a bad infection, they may have to stay in hospital for two to three weeks. This is to get antibiotics into a vein and have extra physiotherapy to clear their lungs.
You should get medical help straight away if:
- your child’s skin turns pale or blue or their lips and tongue are blue
- they’re struggling to breathe or breathing fast
- their temperature is over 38°C (101°F)
- they’re coughing up blood
- the medicine they’re taking is not making them better as quickly as expected.
Find out when to call 999 about your child’s breathing.
Further support
Looking after a child with a long-term condition, like bronchiectasis, can be difficult. It’s important you take time to take care of yourself, as well as your child. Talk to your doctor or nurse if you feel like you’re struggling to cope. You can also always call our helpline – they can help answer your questions or worries. Call 0300 222 5800, Monday to Friday between 9am – 5pm.
You may also want to join our Parent and Carer Support Network which provides support and a space for parents and carers of children with lung conditions to come together.
Child-BEAR Net (Children’s Bronchiectasis Education Advocacy and Research Network)
The Child BEAR Net is an international collaboration aiming to improve the care and clinical outcomes of children with bronchiectasis.