Coughing, rapid breathing and difficulty breathing … These symptoms characterize bronchiolitis. This minor bronchial infection affects 480,000 newborns each winter, nearly one in three (30%) children under two years of age.
In the presence of this disease, for decades, doctors prescribe respiratory physiotherapy. It consists in helping the baby evacuate the mucus to the throat and mouth with manual pressure on the ribs, stomach.
The parents who used it always remember it. And it's rarely a good memory. This technique has now been discouraged by the High Health Authority (FAS) in its new recommendations.
"We have no evidence of this method. In hospitalized children with the most severe forms, respiratory physiotherapy is not only useless but safe and counter-productive. This will aggravate the condition of the child, who is already tired and has trouble breathing, "said Professor Pierre-Louis Drewis, general practitioner and deputy chairman of the FAS Recommendation Committee.
In detail, respiratory physiosis is therefore "contraindicated" in the hospital, and "not recommended" in city medicine.
"We are the only country in Belgium to copy the respiratory kin. In other countries, we can see that evolution is no longer pervasive: children are treated the same way, "adds Pierre-Louis Druise.
Three stages of gravity
For the first time, the Haute Autorité de Santé and the National Professional Pediatric Council (CNPP) defined three stages of severity for this pathology.
Light forms, in which the baby continues to take more than half of the usual diet, do not require hospitalization: a primary care physician (GP, pediatrician, PMI …) explains to parents the technique of nose washing. and advises them to monitor the progress of their child's health.
As for moderate forms, with food intake less than half the usual amount, the institution considers that they should be assessed for city-based or case-by-case orientation. in the hospital. "
Finally, severe forms, such as infants under 6 months, are systematically directed to the hospital and, if necessary, to the intensive care unit.
Nose washing "will help your child breathe better"
It is estimated that only 2-3% of infants under one year would be hospitalized each winter. For the vast majority of cases, management is based on a nose wash.
This action consists of introducing serum into the nostrils to evacuate the secretions of the nose. But he often deters parents who are afraid to get their baby to cry:
"Nasal washing is perceived as something unpleasant for parents, but it will help the child breathe better by blocking the airways. You have to learn this gesture, do it with them, and then get them to do it, "we explained.
Medications against said
This is where the role of the physiotherapist is essential:
"The bronchiolitic networks of physiotherapists have their relevance because they allow the child to be monitored at home, to reassess his condition and to recall clear advice to parents, especially on nasal wash," the FAS specialist continues.
As for drugs, such as bronchodilators, adrenaline, hypertonic saline, they have "no indication of this disease", according to the health authority. Antibiotics should be reserved for rare cases of bacterial superinfection. Antitussive syrups and bronchial prevention fluids are contraindicated.