RSV in babies: How to prevent and treat RSV during RSV season

What is RSV infection and what are the symptoms of RSV infection?

Respiratory syncytial virus is an infection of the respiratory tract. The virus causes inflammation in the respiratory tract, leading to the symptoms of RSV. If your child is exposed to RSV, it may take up to a week for them to show symptoms.

With mild RSV, inflammation mostly affects the upper respiratory tract, which includes the nose and throat. A mild RSV infection causes symptoms that mimic the common cold like:

• Runny nose
• Stuffy nose (congestion)
• Sore throat
• Sneezing
• Low-grade fever
• Headache

Older children and adults are more likely to have mild, cold-like RSV infections. 

What are potential complications of RSV infection?

Because newborns' and infants' respiratory tracts are small and still developing, they are more likely to develop severe RSV. Severe cases of RSV aren't limited to the upper respiratory tract. Inflammation also affects the lower respiratory tract (the lungs) and can cause pneumonia or bronchiolitis.

Viral pneumonia is a lung infection that can range from mild to severe. Bronchiolitis is when the small airways of the lungs become swollen, making it hard for your child to breathe. Newborns and young infants are most likely to develop bronchiolitis since their airways are so small. Babies who were born prematurely and children with lung conditions like asthma are also at higher risk for developing severe RSV or bronchiolitis.

Severe RSV or bronchiolitis may cause symptoms including:

• Fever
• Severe cough
• Low appetite
• Lethargy or extreme low energy and tiredness
• Irritability or an inability to be soothed
• Breathing issues

RSV breathing

A newborn or infant with severe RSV may have difficulty breathing that can show up as:

• Struggling to breathe
• Fast breathing
• Short or shallow breathing

Signs of trouble breathing include:

• Wheezing sounds, or a whistling sound when your child breathes out
• Your child’s chest muscles or the skin around the chest pulling in when they breathe (also called retractions)
• Your baby’s nostrils flaring while breathing 
• Cyanosis, a bluish tint to the skin, especially around the lips or nails

If you notice any signs of trouble breathing, get medical help immediately.  

RSV cough

Cough is a common symptom of RSV, particularly severe RSV or bronchiolitis. An RSV cough can be dry or wet (with mucus), but is often persistent.

How long does RSV last in newborns?

RSV symptoms can last 7 to 14 days, but some symptoms like coughing and wheezing may last longer. It can take up to one month for some babies and children to feel completely back to normal.

RSV in babies vs. older children and adults

RSV tends to be more severe in newborns and young infants. Older children and adults may only experience cold symptoms, while infants are more likely to have RSV that causes bronchiolitis or viral pneumonia.

RSV vs. the common cold

In some people — newborns and infants included — RSV is typically more serious than the common cold. However, most people get RSV multiple times throughout their lives. The first infection is usually the most severe. After the first, RSV may simply show up as a cold with standard, cold-like symptoms.

How do I help prevent RSV?

As a parent, there are two ways to help protect your child against RSV. For most babies, one of these options is good enough.

RSV antibody immunization

An antibody immunization can protect newborns and infants against serious illness or hospitalization from respiratory syncytial virus. Traditional vaccines prompt the body’s immune system to make antibodies to fight off certain germs. The RSV antibody immunization works differently, providing the RSV-fighting antibody directly as a shot.

The CDC recommends that newborns and babies less than eight months old get protection against RSV to help prevent severe RSV infection and potential hospitalization. If their mother did not receive the adult RSV vaccine during pregnancy, a newborn should get the RSV antibody immunization during the first week after birth, especially if they are born during RSV season. If your baby is due for routine vaccines, they can also get the RSV antibody at the same time. 

RSV vaccine for pregnant people

The RSV vaccine for adults is another protective option that allows the pregnant person to receive the vaccine and pass along the RSV-fighting antibodies to their baby. This way, the baby has some protection against severe RSV infection — such as bronchiolitis or pneumonia — after birth. One dose of the maternal RSV vaccine should be given between 32 weeks and 0 days and 36 weeks and 6 days of pregnancy to offer protection to your baby. It’s recommended that this vaccine be given between September and January to offer the most protection during RSV season.

What is the treatment for RSV infection?

It's better to prevent RSV infection because there's no treatment for RSV. RSV infections are viral and won’t get better with antibiotics since antibiotics only work against bacteria. Just like with the common cold, you treat RSV by managing your baby’s RSV symptoms as much as possible:

• A cool mist humidifier can help loosen mucus and relieve congestion.
  
  
• Medications like acetaminophen — or ibuprofen for infants and children older than 6 months — can help with fever, headache, or sore throat.
  
  
• Drinking lots of fluids can help your baby or child stay hydrated and loosen mucus.

Respiratory syncytial virus can be concerning for parents. RSV season also overlaps with flu season, so it can be hard to know exactly what's going on if your child is ill. If you have questions about RSV, contact your local pediatrician or text a Summer Health pediatrician anytime.