Learn how to tell if your baby has the respiratory virus RSV, risk factors for severe RSV symptoms, and how to know when your baby needs medical attention, in our parent's guide.
How do I know if my baby has RSV?
RSV, or respiratory syncytial virus, is a viral respiratory illness that can cause severe symptoms in babies and young children. Here's how to tell if your baby has RSV, and how to know when your baby needs medical attention.
What is RSV?
RSV stands for respiratory syncytial (pronounced sin-SISH-uhl) virus. This virus causes a respiratory illness. When older children and most adults catch this virus, it usually just causes an illness like the common cold. And many young children will only experience a mild cold from the virus as well.
But the virus can cause more serious symptoms in some babies and young children, and require them to receive hospital care.
And RSV can be fatal in rare cases. Each year, about 500 children under 5 lose their lives to RSV complications.
Learn more about RSV from the UC Davis Children's Hospital:
How is RSV spread?
RSV is a contagious virus. Like other colds, the flu, and Covid-19, RSV spreads via droplets in the air.
When someone with the RSV virus coughs or sneezes, the droplets enter the air, and someone can catch the virus by breathing the droplets in.
The droplets can also land on the skin, toys, and other surfaces. If a child touches a surface with the droplets, and then touches their nose, mouth, or eyes, they can catch the virus. (The virus usually lingers on surfaces and skin much longer than Covid-19.)
Given these factors, RSV easily spreads among babies and young children in day care and other child care settings.
Children can even catch RSV multiple times in one season (although any repeated infections are usually milder than the first.)
As the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics report, someone who catches RSV is usually contagious for 3-8 days.
But some infants and young children, especially those with compromised immune systems, can be contagious with RSV for as long as 4 weeks (even after the symptoms are gone).
RSV's rise in the summer of 2021
RSV cases usually peak in the winter. But the summer of 2021 marked an unusual spike in RSV cases and hospitalizations in the United States.
There wasn't the usual rise in infant and young child RSV cases in the winter of 2020, due to pandemic restrictions and parents working from home. Most young children weren't around other young children at the time, as there wasn't much need for day care.
But when parents started working outside the home again, many of their young children re-entered day care. At day care, the close proximity to other children and the high-touch surfaces of these settings made conditions ripe for RSV to spread more rapidly. In other words, the virus started making up for lost time.
What babies are at highest risk for severe RSV?
According to the Centers for Disease Control and Prevention (CDC), around 58,000 children under 5 years of age are hospitalized with RSV annually.
Certain categories of babies are at highest risk for being hospitalized with severe RSV:
- The youngest infants (6 months of age and younger).
- As the CDC reports, "One to two out of every 100 children younger than 6 months of age with RSV infection may need to be hospitalized."
- Babies born prematurely
- Babies and toddlers with congenital heart disease
- Babies and toddlers with chronic lung conditions
- Babies with weaker immune systems
- Babies who have a neuromuscular disorder
The American Academy of Pediatrics (AAP) lists additional factors that may increase the risk of severe RSV:
- Having eczema
- Having food allergies or environmental allergies
- Low birth weight
- High exposure to secondhand smoke
And these factors increase a baby's risk of RSV in general. (They do not increase the risk of severe RSV, but are of particular concern if your baby is at increased risk for severe symptoms).
- Being in a childcare setting with several other children (e.g. day care)
- Living in crowded living conditions
- Having siblings who receive day care or who attend in-person school
How do I know if my baby has RSV?
According to the CDC, "virtually all children get an RSV infection by the time they are 2 years old," and while "RSV will [usually] cause a mild, cold-like illness... it can also cause severe illness."
Most RSV infections will start out with mild, cold-like symptoms. These symptoms usually appear 2-8 days after someone is infected with the virus.
Initial symptoms of RSV may include:
- Runny nose and/or congestion
- Decreased appetite
Other symptoms of RSV may include:
- Difficulty breathing
- Reluctance or refusal to feed
- Sore throat
Usually, these symptoms develop in stages --- a child won't have all of them at once.
And some children may not experience some symptoms (like fever) at all.
In the youngest infants (6 months of age and younger), the only symptoms of RSV may be:
- Tiredness or less activity
- Pauses in breathing (apnea)
- Decreased appetite or refusal to feed
But while most RSV infections stay mild and can be treated at home, RSV can sometimes become more severe after a few days.
When does my baby need medical attention for RSV?
RSV can lead to bronchiolitis (lung inflammation) pneumonia (lung infection), and other visible difficulties with breathing. All of these require prompt medical attention.
The following symptoms indicate that your baby has severe RSV and needs to see a doctor as soon as possible. Babies at high risk who develop these symptoms may require care in the hospital.
Call your doctor right away if your baby shows these severe symptoms:
- Rapid, shallow, or short breathing
- Visibly or audibly struggling to breathe
- Rib cage caving in when baby inhales
- Significant grunting or wheezing
- Tugging between the ribs or lower neck
- Pauses in breathing
- Signs of dehydration (including producing less than one wet diaper every 8 hours)
- Significant tiredness or inactivity
A baby who is hospitalized may be given oxygen, intubation, or other treatments to assist them with breathing. (Most hospitalized babies improve thanks to this treatment, and can safely leave the hospital after a few days.)
Even if baby doesn't have these severe symptoms, you should also call your doctor if:
- Baby's symptoms worsen after several days
- It seems like baby isn't getting enough fluids
- Baby is younger than 6 months and has any cold symptoms
- Baby is at known high risk for severe RSV and has any cold symptoms
Soothing RSV symptoms
Although RSV usually goes away on its own, symptoms may persist for up to two weeks.
If baby has mild RSV, there are actions you can take to soothe their symptoms at home:
- Turn on a cool mist humidifier to help break up congestion and help your little one breathe easier.
- Try using nasal saline drops and gentle suctioning of the nose to ease congestion, help breathing, and make feeding easier.
- Make sure your little one gets plenty of fluids (breastmilk or formula, plus water if desired and if baby is old enough)
- If your little one has a fever or is in pain from RSV, and is old enough, you may want to give acetaminophen (Tylenol) or ibuprofen (Motrin).
- Only give acetaminophen if baby is over 12 weeks old and it’s approved by your pediatrician
- Only give ibuprofen if baby is over 6 weeks old and it’s approved by your pediatrician
Reducing the risk of RSV
How to reduce your baby's risk of contracting RSV? These steps will help protect your baby from RSV and other viral illnesses:
- Wash your and your baby's hands regularly, with soap and warm water, for at least 20 seconds.
- Avoid close contact with people who are sick.
- Regularly disinfect high-touch surfaces, including toys and seats.
These steps are important to protect all babies, but especially those at highest risk for severe RSV.
And if baby is sick (with any viral illness), keep them home and away from other children, to reduce the spread!
All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health.
These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease.
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