You can't catch Bx or give Bx to anyone.
Bronchiectasis (Bx) is a chest disease - the airways in the lungs have become damaged and scarred.
The airways (or breathing tubes) become widened and mucus gets trapped in pockets within the airway. Having extra mucus in the airways means bacteria and viruses can grow quickly and cause infections.
These infections cause damage and more scarring to the airways and lungs. Once this has happened, the scarring is usually lifelong. But, with good treatment, there can be some improvement and further damage prevented. Good treatment is especially important in young children because their lungs are still growing.
Watch a video featuring former Warriors rugby league player Wairangi Koopu. It focuses on recognising the signs of infection that can lead to bronchiectasis, and acting on them. (Ministry of Health and Health TV video).
Bx is different from asthma but some children with Bx have asthma as well.
Most children get Bx after having a very bad chest infection or repeated chest infections. Bx usually develops after a child has had:
Problems with fighting off infection. Some children cannot fight infection very well because they are born with a problem in their infection-fighting (immune) system.
Medicines. Some medicines (such as oral steroids) cause difficulty in fighting off infection.
Objects stuck in the airway. If a child breathes in a nut or a piece of a toy and this gets stuck in the airway, it can cause a blockage that can lead to scarring.
Food or liquid going into the lungs (aspiration). Children who sometimes cough or choke when feeding have problems controlling their swallow. Food can end up in their lungs. This can also happen if food refluxes from the stomach and ends up going into the lungs. Over time this can cause Bx.
Primary ciliary dyskinesia. In this condition, the tiny mucus-clearing hairs (cilia) in the lungs are not working properly.
Once a person has Bx, they usually have it for life. Good treatment stops it getting worse and in very young children, can reverse some of the disease.
Children with Bx feel well most of the time.
A wet-sounding cough is the main symptom and usually lasts for weeks. Extra mucus (phlegm or sputum) in the airways causes the cough and your child may spit or cough up some of this mucus.
This cough can get worse during infections, first thing in the morning and during exercise. Remember though that exercise and playing sport is helpful for keeping well.
When children with Bx become unwell, they cough more and the mucus can change colour from clear to yellow or dark green. The mucus can sometimes be smelly. They may lose their appetite and feel tired.
If your child has Bx, take them to see your family doctor when they:
Your child is very sick and needs to see a doctor urgently if they:
Dial 111 within New Zealand (use the appropriate emergency number in other countries) for urgent medical help if your child:
A chest x-ray is usually the first investigation but does not always show Bx damage very well. Your child will probably also need a chest CT scan.
Chest CT scans show Bx damage well. This chest CT scan shows Bx damage in one lung.
Your health professional will collect some mucus from your child. Many children will be able to cough some mucus into a jar. Sometimes, a physiotherapist might need to help your child collect a mucus sample.
The mucus is tested for bacteria or viruses. If your child's mucus has bacteria, your doctor will give them the right antibiotic to treat the infection.
Your child will have some blood tests to show that they are able to fight off infection.
Your child will breathe into a machine to measure how their lungs are working. It usually takes about 15 minutes.
A doctor can use a special telescope (bronchoscope) to look into the lungs to see the condition of the airways and take a sample of mucus. This test happens under a general anaesthetic. See some information about anaesthetics [1].
Sometimes your child may need other tests such as a sweat test [2] (to look for cystic fibrosis).
Your child will need chest physiotherapy once or twice a day. There are different ways to do chest physiotherapy - either with breathing and percussion or by using a physiotherapy breathing device (PEP, acapella, bubble). This is to clear the extra mucus from your child's lungs to keep your child well. The physiotherapist will show you the best method to use with your child. The type of chest physiotherapy changes with age.
Exercise will help your child - it doesn't matter if they cough.
Exercise or playing sport 3 to 4 times a week is helpful to clear the mucus and to develop your child's lungs. Any type of exercise is good, especially if it makes your child take deep breaths. It doesn't matter if your child coughs during exercise.
Your child will need antibiotics if they start to get sick or if they are coughing more. Children with Bx need a longer course of antibiotics (10 to 14 days). Most often, you can give your child antibiotics at home. Sometimes, if your child is very unwell, they may need antibiotics in hospital.
Some children with Bx may benefit from inhalers because they also have asthma.
Children and young people with Bx can have an action plan. You and your doctor or another member of your child's healthcare team can discuss this so that it's right for your child. It lists your child's daily treatment and steps to take if your child becomes unwell.
Check this sample action plan (PDF, 234KB) [3].
If you want to give up smoking, call Quitline 0800 778 778. See the Quit/Me Mutu [5] website, or talk to your family doctor.
Your child will have regular reviews with the hospital team. The team can include lots of different health professionals. How often the reviews happen depends on how well your child is.
The review will include:
If your child has a chest infection that is severe or continues for a long time, they may need to go to hospital for 10 to 14 days to have specialist treatment.
Antibiotics. Your child will have these directly into a vein through a 'drip' [6]. Sometimes your child will have a special drip called a 'PICC line'. This is a long tube which lasts for longer than a 'drip' - it doesn't need replacing regularly.
Chest physiotherapy. A professional physiotherapist will do this twice a day.
Sometimes, your child will have extra testing just like they do at outpatients appointments such as:
You can check The New Zealand Bronchiectasis Foundation website [7] for:
Starship Foundation and the Paediatric Society of New Zealand acknowledge the cooperation of the Starship Respiratory Service at Starship Children's Health and the Paediatric Department, University of Auckland in making this content available to patients and families.
This page last reviewed 14 February 2021.
Email us [11] your feedback
Links
[1] https://kidshealth.org.nz/anaesthetic
[2] https://kidshealth.org.nz/sweat-test
[3] https://kidshealth.org.nz/sites/kidshealth/files/pdfs/2245_ndhb_-_bronchiectasis_pamphlets_-_action_plan_0.pdf
[4] https://kidshealth.org.nz/sites/kidshealth/files/pdfs/2245_ndhb_-_bronchiectasis_pamphlets_-_action_plan.pdf
[5] https://quit.org.nz
[6] https://kidshealth.org.nz/drips-intravenous-fluids-or-iv
[7] https://www.bronchiectasisfoundation.org.nz/
[8] https://www.bronchiectasisfoundation.org.nz/uploads/8/3/8/1/83813494/2245_ndhb_-_bronchiectasis_pamphlets_-_preschool.pdf
[9] https://www.bronchiectasisfoundation.org.nz/uploads/8/3/8/1/83813494/2245_ndhb_-_bronchiectasis_pamphlets_-_school.pdf
[10] https://www.bronchiectasisfoundation.org.nz/uploads/8/3/8/1/83813494/2245_ndhb_-_bronchiectasis_pamphlets_-_information_for_families.pdf
[11] https://kidshealth.org.nz/contact?from=http%3A%2F%2Fkidshealth.org.nz%2Fprint%2F122%3Flanguage%3Dmi