Acute respiratory syncytial virus (RSV) bronchiolitis is a major cause of hospitalization in the first year of life. The disease manifest itself with wheezing and rales. Wheezing does not depend on bronchospasm but on clogging of the small airways by cellular debris and inflammatory cells; this is why bronchodilators are useless. In the epidemic period, RSV infects almost all children, most of them will develop an upper respiratory tract infection and some will develop classic bronchiolitis. In fact, the disease manifests itself, in its most serious form, in infants who were born with relatively narrower airways and in those who do not defend themselves well from oxidative stress. For those reasons, bronchiolitis can be considered as “a canary in the mine” which unmasks these two fragilities which, if not corrected, predispose to the development of asthma and chronic obstructive bronchitis. Infants who require hospitalization for bronchiolitis have low levels of selenium, vitamin D and natural antioxidant substances which, if not supplemented, predispose to frequent relapses and chronic respiratory disease. The prevention of bronchiolitis must therefore begin during pregnancy with a diet rich in antioxidant substances such as fruit and vegetables typical of the Mediterranean diet, must continue with exclusive breastfeeding for the first five months of life, then with a diet rich of fruits and vegetables and, if necessary, with any supplementation of trace elements, vitamins and polyphenols which, by protecting against oxidative stress and inflammation, also reduce the risk of developing chronic non-communicable adult diseases.
