RSV, or respiratory syncytial virus, is the most common cause of lung inflammation and pneumonia in babies. RSV is very contagious and spreads by airborne droplets or by touching surfaces that have the virus on them.
For healthy children, RSV is usually no worse than a common cold. But for babies younger than 6 months or babies born prematurely, RSV may cause serious illness.
Other risk factors for serious RSV in infants and children include:
- Low birth weight
- Chronic lung conditions
- Neuromuscular conditions, especially those that make it hard to swallow or clear mucus
- Being born with certain heart conditions
- A weakened immune system
How Can I Tell If My Baby Has RSV?
RSV symptoms don’t happen all at once. They usually come in stages and include:
- Congestion or a runny nose
- Decreased appetite
In very young babies, the only signs of RSV might be crankiness, poor appetite, low energy, or long pauses in their breathing (apnea).
More serious cases of RSV can lead to bronchiolitis, swelling in the lung’s small airways, or pneumonia, an infection of the lungs.
What Should I Do If My Baby Gets RSV?
Right now, there is no cure for RSV or vaccine for children. Treatment works to ease symptoms until RSV has run its course. RSV symptoms usually last a week to two, then most children get better on their own.
If your baby gets RSV, you should:
- Use over-the-counter pain medicines (never aspirin) if your baby has a low-grade fever.
- Give your infant lots of fluids and feed often.
- Use a humidifier on the cool mist setting in the room where your baby sleeps.
- Use a bulb syringe to remove mucus from your infant’s nose, especially before breast or bottle feeding.
- Give your baby a lukewarm bath (not cold) if they have a fever.
You should not give cough medicines to children younger than age 4 since some may include ingredients harmful to them.
When Do I Call My Baby’s Doctor?
Call your doctor if your baby’s symptoms don’t improve or get worse after 7 days.
Doctors consider breathing problems in infants a medical emergency. You should always get medical help right away if your baby shows any signs of bronchiolitis such as:
- Fast breathing
- Wheezing, a high-pitched whistling sound when your baby is breathing
- Flared nostrils
- Grunting while breathing
- A sunken rib cage or upside-down “V” under the neck from chest contractions
Also call your doctor or get immediate care if your infant seems dehydrated; has bluish skin, lips, or tongue; has swollen, red eyes; and is much less alert and active than usual.
Signs of dehydration include:
- Dark urine or fewer than one wet diaper in an 8-hour period
- Vomiting often
- Baby appears very thirsty
- Few or no tears
- Dry mouth
Only about 2% to 3% of babies younger than 6 months old need to be hospitalized for RSV. Each year, 58,000-80,000 children under the age of 5 have RSV symptoms serious enough to go to the hospital. When they get there, your child may receive breathing treatments, IV (intravenous) fluids, or oxygen. Babies who get pneumonia will need antibiotics. Most children stay in the hospital a few days and only rarely do they need intensive care while there.
What to Tell Your Doctor About Your Baby’s Symptoms
Your doctor will want to know about any breathing problems and whether your baby:
- Has a fever higher than 100.4 F if they’re younger than 12 weeks
- Has fever that keeps going up to 104 F or higher if the baby is 3 months or older
- Is sleepless or cranky
- Tugs at their ears or has ear drainage
RSV can put children at greater risk of having ear or other secondary bacterial infections.
What If My Baby Is High Risk?
Palivizumab (Synagis) and nirsevimab (Beyfortus) are preventive medicines given to infants who are at high risk for serious RSV. If this includes your baby, your pediatrician will probably suggest one of these. With palivizumab, your baby would get monthly shots during RSV season. Nirsevimab is given once to protect against RSV or related complications for the whole RSV season. Both help prevent serious disease but do not work if your baby already has RSV.
How Do I Prevent RSV in My High-Risk Baby?
In the U.S., RSV season normally runs from fall to spring. If your baby is exposed to the virus, it can take up to 8 days for symptoms to show up. Most children are contagious for 3 to 8 days. But some infants can spread RSV for up to a month.
To help keep your baby from getting sick, make sure everyone in the family washes their hands often with soap and water, especially before touching the baby. And ask caregivers and visitors to do the same.
Also don’t forget to:
- Keep immunizations current. Get annual flu shots for everyone in the family, urge adult caregivers to get the whooping cough vaccine, and make sure your baby has received the COVID-19 vaccine.
- Disinfect high-touch surfaces in your home like countertops, doorknobs, and the baby’s toys and crib rails.
- Avoid sharing food or drinks.
- Stay away from people who are clearly ill.
- Keep your baby away from day care settings if they or other children are sick.
- Avoid taking your baby to crowded places during RSV season.
- Keep your baby away from cigarette smoke, which increases the risk for RSV and makes symptoms worse.
- Breastfeed, if possible.
Trust Your Instincts
If you’re a new parent, respiratory illnesses like RSV in infants can be worrying. Don’t hesitate to call your pediatrician or get immediate medical care if your baby’s symptoms concern you, even if they appear mild.
It’s not uncommon for babies and children to be infected with RSV multiple times – sometimes, even in a single season. Fortunately, additional RSV infections are usually much less serious.
Photo Credit: Catherine Delahaye / Getty Images
Allergy & Asthma Network: “What Is RSV (Respiratory Syncytial Virus)?”
CDC: “Fact Sheet: RSV in Infants and Young Children,” “RSV in Infants and Young Children,” “RSV Surveillance and Research,” “Symptoms and Care of RSV.”
Cedars Sinai: “Respiratory Syncytial Virus (RSV) in Children.”
Cleveland Clinic: “RSV in Children and Adults.”
Healthychildren.org: “RSV: When It’s More Than Just a Cold.”
MedlinePlus: “Respiratory Syncytial Virus Infections.”
FDA: “FDA Approves New Drug to Prevent RSV in Babies and Toddlers.”