How To Recognize RSV in Your Baby – and What To Do

Respiratory syncytial virus (RSV) is a viral illness that causes symptoms such as trouble breathing. It’s the most common cause of inflammation of the small airways in the lungs (bronchiolitis) and pneumonia in babies.

RSV can affect a person of any age but causes the most problems for the very young. Most babies have been infected at least once by the time they are 2 years old. Babies can also be reinfected with the virus. Babies born prematurely or with heart, lung or immune system diseases are at increased risk for more severe illness.

It's important to recognize the signs and symptoms of RSV so that you can get your child assessed and treated if necessary, says UH Rainbow Babies & Children's pulmonology specialist Kristie Ross, MD.

“If a family member or caregiver your infant spends time with has cold or respiratory symptoms, the symptoms could be a result of RSV infection. Your healthcare provider can help with a diagnosis and treatment,” she says.

“In addition, if your infant falls into a high-risk group, they may be able to receive preventative doses of a medicine called palivizumab now to protect them against possible infection.”

We asked Dr. Ross, who is Chief of Pediatric Pulmonology at UH Rainbow, to answer more questions about RSV and what steps you should take to prevent it for your baby.

How Is RSV Spread?

RSV is spread when your baby comes into contact with fluid from an infected person’s nose or mouth. This can happen if your baby touches a contaminated surface and then touches their eyes, mouth, or nose. Your baby also can catch RSV by inhaling droplets from an infected person’s sneeze or cough. Symptoms start about two to five days after contact with the virus.

What Are Symptoms of RSV in a Baby?

A runny nose and congestion are often the first signs of infection.  After a few days, symptoms can worsen to fever, cough, wheezing or rattling in the chest, and breathing hard and fast.  In high-risk babies, RSV can lead to severe breathing illness and pneumonia. This may become life-threatening. Your child may need to be treated in the hospital to help with breathing.

The most common symptoms of RSV include:

• Runny nose
• Fever  
• Cough
• Short periods without breathing (apnea)
• Trouble eating, drinking or swallowing
• Wheezing
• Flaring of the nostrils or straining of the chest or stomach while breathing
• Breathing faster than normal, or trouble breathing
• Turning blue around the lips and fingertips 

How Can I Help Prevent RSV in My Child?

To reduce the risk for RSV, the American Academy of Pediatrics (AAP) recommends all babies, especially preterm infants:

• Be breastfed
• Be protected from contact with smoke
• Not go to childcare with lots of children during their first winter season
• Not have contact with sick people

Also make sure that household members wash their hands or use an alcohol-based hand cleaner before and after touching your baby. Don’t allow people to smoke in your home or in your car. Remove your baby from any area where people are smoking.

How Can I Help Prevent RSV in My High-Risk Baby?

In addition to general steps for prevention, the AAP recommends that babies at high risk for RSV get a medicine called palivizumab. This is given as a monthly injection during RSV season to help prevent infection. As mentioned before, although RSV season typically starts in the winter, in some areas of the country the RSV season has already arrived. Because of this, the AAP is recommending that in affected areas, palivizumab administration be started now instead of waiting. Ask your baby’s provider if this applies for your child.

When Should I Call My Child’s Health Care Provider?

If you are concerned your baby may be at high risk for RSV, or if your child has symptoms of RSV, call their pediatrician or pediatric specialist. Symptoms of RSV can seem like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

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The highly specialized pediatric pulmonologists at University Hospitals Rainbow Babies & Children's work closely together and across multiple disciplines to diagnose, treat, manage and prevent various lung diseases in children, ranging from common breathing problems to rare pulmonary disorders.