RSV is a respiratory infection that is common and sometimes serious in babies. Some symptoms include difficulty breathing, lethargy, cough, and more.

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Respiratory syncytial virus (RSV) is a serious respiratory infection that can affect people of all ages.

But RSV is most serious when it occurs in babies. That’s because babies’ airways aren’t as well-developed, so they cannot cough up mucus like older children or adults. Also, their airways are smaller, so they can experience airway blockage easily, causing trouble breathing.

In many people, RSV causes cold symptoms, often with a cough. In babies, RSV can cause a more serious illness called bronchiolitis. Babies with bronchiolitis have wheezing along with their cough.

RSV can lead to other severe infections, including pneumonia. In some cases, babies may need to receive treatment at a hospital.

RSV is a virus, so there are currently no medications that can cure it to shorten the course of the illness. Instead, doctors will often recommend treatments or remedies to help manage symptoms until the infection passes.

People often transmit RSV from November to April, when cooler temperatures bring people indoors and when they’re more likely to interact with others. People can also transmit RSV earlier in the year. For example, in 2022, the RSV season started earlier, with a high number of cases in October. Transmission can also occasionally happen during summer months.

In older children, RSV can cause symptoms similar to that of a cold. But in babies, the virus causes more severe symptoms.

RSV tends to follow a timeline of symptoms. Symptoms often appear 4 to 6 days after exposure to the virus. However, a baby may start experiencing symptoms earlier or later.

Symptoms a baby may have with RSV include:

  • faster than usual breathing
  • difficulty breathing and feeding
  • cough
  • fever
  • irritability
  • lethargy or behaving sluggishly
  • runny nose
  • sneezes
  • labored breathing using chest muscles
  • wheezing

Some babies are more likely to experience RSV symptoms. Research from 2022 indicates this to especially be true for those born prematurely or babies with heart problems or a history of wheezing or breathing issues.

RSV vs. COVID-19

RSV and COVID-19 are both respiratory infections and share many similar symptoms. Both conditions can cause fever, cough, runny nose, and sneezing. Upset stomach, vomiting, or diarrhea may also occur in babies with COVID-19.

lethargy or sluggish behaviorcommoncommon
runny nosecommonmay occur
sneezingcommonmay occur
wheezingcommonless common
difficulty breathingmay occurmay occur
breathing that’s faster than usualmay occurmay occur
nausea or vomiting less commoncommon
headacheless commoncommon
sore throatless commoncommon

If your child has any of the above symptoms, their pediatrician may recommend testing them for both RSV and COVID-19, depending on cases in your area and their exposure risk to either of these viruses.

RSV cases can range from mild cold symptoms to those of severe bronchiolitis. Even if symptoms are mild, it’s important to call your pediatrician if you suspect your baby has RSV. Always get emergency medical care if your baby appears to have trouble breathing.

Emergency symptoms to watch out for include:

  • dehydration, including a sunken fontanel (soft spot), dry diaper, or no tear production when they cry
  • difficulty breathing, which can include rib lines showing through the skin (retraction) as they breathe
  • blue fingernails or mouth, which is cyanosis, an indication that they are not getting enough oxygen and are in severe distress
  • fever greater than 100°F (38°C), rectally obtained, in babies younger than 3 months
  • fever greater than 104°F (39°C) in children of any age
  • thick nasal discharge that makes it hard for the child to breathe

In the most severe cases, RSV may require the help of a breathing machine known as a mechanical ventilator. This machine can help to inflate your baby’s lungs until the virus goes away.

Doctors used to routinely treat many cases of RSV with bronchodilators. Some doctors still use bronchodilators for RSV treatment, but experts no longer recommend this for the most part.

Doctors prescribe bronchodilators for people with asthma or COPD to help open up the airways and treat wheezing, but they don’t help the wheezing that comes with RSV bronchiolitis.

If your baby has dehydration, their doctor may also provide intravenous fluid.

Antibiotics won’t help your baby’s RSV because antibiotics treat bacterial infections. RSV is a viral infection.

If your doctor gives you the OK to treat RSV at home, you’ll likely need a few tools. These will keep your baby’s secretions (mucus) as thin as possible so they don’t affect their breathing.

A bulb syringe

You can use a bulb syringe to clear thick secretions from your baby’s nose.

To use the bulb syringe:

  1. Compress the bulb until the air is out.
  2. Place the tip of the bulb in your baby’s nose and release the bulb. This will pull mucus into the bulb.
  3. When you remove the bulb, squeeze it onto a cloth or paper towel to clear the bulb.
  4. After clearing your baby’s nose, wash the bulb with warm soapy water, rinse it, and allow it to dry well between uses to prevent mold.

It’s especially important to use the bulb syringe before your baby’s feeding. A clear nose makes it easier for your baby to eat. Combine the tool use with over-the-counter saline drops, which you can place into each nostril and suction out afterward.

Cool mist humidifier

A humidifier can introduce moisture into the air, helping thin your baby’s secretions. Make sure to clean and care for the humidifier properly.

Hot water or steam humidifiers could be harmful to your baby because they can cause scalding.

You can talk with your child’s doctor about treating any fevers with acetaminophen. Your doctor will suggest a dose based on your baby’s weight. Do not give your baby aspirin, as this can harm their health.

Providing fluids, such as breast milk or formula, can prevent dehydration in your baby. You can also ask your doctor about potentially giving your baby an electrolyte-replacing solution, like Pedialyte.

Keep your baby in an upright position, which makes it easier for them to breathe. You can keep your baby more upright in a stable and secure car seat or baby seat while they are awake during the day.

Except while in a car, never put a baby to sleep in a car seat due to the risk of suffocation. If using a car seat to prop your baby up while they are awake, place the car seat on a stable, secure, low surface with direct supervision at all times.

Limiting your baby’s exposure to cigarette smoke is also vital to keeping them healthy. Cigarette smoke can make your baby’s symptoms worse.

When an otherwise healthy baby has RSV, they can pass on the infection to someone for 3 to 8 days. Try to keep the child with the infection separate from other siblings or children to prevent transmission.

RSV is transmissible through direct and indirect contact with a person who has an active infection. Transmission can involve touching a person’s hand after they sneeze or cough, then rubbing your eyes or nose.

Frequent handwashing with warm, soapy water for at least 20 seconds per time is the best way to reduce the risk of RSV. It’s also important to help your baby cover sneezes and coughs.

The virus can also live on hard surfaces, such as a crib or toys, for several hours. If your baby has RSV, regularly clean toys and surfaces where they play and eat to help reduce the spread of germs.

Babies can make a full recovery from RSV in 1 to 2 weeks. Most babies can recover from RSV without receiving treatment in a hospital setting.

If you think your baby has dehydration or is in moderate to severe distress, get emergency medical care.