Does My Infant Have RSV or a Cold?

Cold Symptoms vs. RSV Symptoms

It’s hard to tell the difference between a regular cold and RSV because they start out in much the same way. Cold symptoms include: 

• Coughing, which can be dry or rattling
• Stuffy nose
• Runny nose
• Sneezing
• Fever (100.4 F or higher)
• Not eating or drinking as much

Your baby may have only those “cold-like” RSV symptoms if their case is mild. And most cases are. But they could have more symptoms, including: 

• A very bad cough
• A hard time breathing
• Wheezing, which is a whistling noise when your baby breathes 

RSV Can Be Much More Serious Than Colds

Every year in the U.S., about 58,000 to 80,000 children under 5 years old must be admitted to the hospital for RSV complications. Those at the highest risk for these complications include children who:

• Are premature 
• Are 6 months old or younger
• Are younger than 2 years old and have heart disease they were born with or lung disease they’ve had a long time
• Have a weakened immune system
• Have a neuromuscular disorder, especially if the condition makes it hard for them to swallow or clear mucus from their throat

All kids are at risk for the common cold. But there are a few things that put your child at a higher risk:

Winter season. During fall and winter, your child tends to be inside more often. This causes them to be around more germs. The humidity also is usually lower around this time, which makes the passages in their noses dry and raises the risk for infection.

Weaker immune systems. Your child's immune system isn't as strong as most adults'. This makes it harder for them to fight off germs.

Spreading germs through touch. Kids are more likely to touch their nose, eyes, and mouth before washing their hands. This can easily spread germs that lead to a cold.

School and day care. When your child comes in contact with other kids, cold germs spread easily.

Bronchiolitis (inflammation in the lungs' tiny airways) and a lung infection called pneumonia are serious complications RSV can cause in vulnerable children. 

Wheezing and trouble breathing are signs your child may have bronchiolitis. Watch how your baby is breathing. Call your doctor if your baby’s ribcage seems to be “caving in” when they breathe.

Pneumonia in infants can be caused by RSV. It happens when the virus moves into the lower respiratory tract.  Signs of pneumonia include:

• Mucus from the mouth when the baby coughs
• Vomiting or diarrhea
• Loss of appetite
• Tiredness
• Fever
• Chills (baby seems cold even though it is warm around them)
• Fast breathing
• Hard breathing (like baby is having difficulty getting air in and out)
• Fussiness

If your baby is showing signs of pneumonia, contact your doctor as soon as possible. 

When It’s an Emergency

If the baby is having difficulty breathing, don’t wait. Get emergency medical help. Other serious symptoms mean you should take your child to the closest emergency department or call 911. They include:

• Bluish or gray color to the skin, lips, or fingernails
• Struggling to breathe (very fast breathing, chest sinking inward when inhaling, wheezing, grunting, nasal flaring)
• Cannot cry
• Signs of dehydration, including sunken eyes and fewer than one wet diaper every 8 hours
• Refuses to nurse or take the bottle
• Not as active, seems weak

Complications from RSV are not common, but you can be prepared if you know what to watch for. Speak with your doctor if your child is at higher risk of RSV complications to see if you should take more steps to protect your baby.