15 RSV Symptoms in Babies All Caregivers Should Be Aware of Right Now

Thanks to the pandemic, you’re probably a lot more aware of infectious diseases than you ever thought you would be. We wouldn’t be surprised if you can recite the symptoms of COVID-19 in your sleep and know all about the importance of getting your annual flu shot.

But there’s another virus you should definitely be aware of, especially if you have kids or you’re expecting one. It’s called respiratory syncytial virus (RSV), and while it’s usually not super serious in older kids and healthy young adults, it can be really risky for babies and older people. According to the CDC, RSV is the most common cause of hospitalization in infants, affecting up to 8src,srcsrcsrc kids younger than five every year.

If you have kids—and an infant, in particular—here’s what you need to know about RSV symptoms in babies, plus when to seek medical care for a sick child.

What is RSV?

RSV is a common respiratory virus that usually causes coldlike symptoms. In fact, doctors usually can’t tell just from your symptoms if you have RSV or another virus that causes the common cold, Danelle Fisher, MD, the chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, California, tells SELF.

Most people recover just fine (in about a week or two) when they’re sick with RSV. However, the symptoms can potentially become serious for infants and other young children, as well as older adults and those with severely weakened immune systems. In fact, RSV is the most common cause of bronchiolitis, an inflammation of the small airways in the lungs, and pneumonia, an infection of the lungs, in kids under the age of one in the US.

“Because children less than two years of age have smaller lower airways, the inflammation, which results in mucus production, can occlude those small lower airways, leading to labored breathing and sometimes lower oxygen levels,” Rosemary Olivero, MD, a pediatric infectious disease physician at Helen DeVos Children’s Hospital in Grand Rapids, Michigan, tells SELF. Kids two and older have larger lower airways, though, and “tend to have less respiratory difficulty with RSV infections,” even if their lower airways do get inflamed, Dr. Olivero says.

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How does RSV spread to infants?

It’s important to get this out of the way: Almost all children get RSV at least once before they’re two years old, per the American Academy of Pediatrics (AAP). Infants usually get RSV from parents, other caregivers, or close family members, although they can also pick it up when they’re out in public, John C. Brancato, MD, division head of emergency medicine at Connecticut Children’s, tells SELF.

The virus can be transmitted in a few ways:

• Typically, RSV spreads through large droplets. That means a kid could get it if an infected person coughs or sneezes around them, Michael Chang, MD, an infectious disease physician at UTHealth Houston, tells SELF.
• You can also pass the virus from person to person, like when you are hugging or kissing a child.
• Droplets can also land on surfaces (like a doorknob or toy). So if you come into contact with an infected surface and then touch your baby, or your child directly touches something, they could get RSV.

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RSV symptoms in babies

Symptoms of RSV in infants depend on how serious the infection is. They may experience the following:

• Dry or wet cough
• Congestion
• Runny nose
• Sneezing
• Irritability or fussiness
• Eating or drinking less
• Fever—a temperature of 1srcsrc.4 degrees Fahrenheit or higher (although many kids don’t get a fever with RSV)

If the RSV infection progresses and moves into the lungs, a baby could have the coldlike symptoms above, along with the following:

• Shallow, fast breathing
• Flaring of the nostrils
• Head bobbing with breathing
• Bluish lips or fingertips
• Rhythmic grunting during breathing
• Chest retractions, which is when the skin between and under the ribs “caves in” when inhaling
• Wheezing
• Apnea, or pauses in breathing for more than 1src seconds

If your baby is having these symptoms, the inflammation in the lungs might be interfering with their ability to get enough oxygen. “If the restriction in airflow is bad enough, then you start recruiting other body muscles to help you breathe and overcome that blockage,” Dr. Chang says. “You may see head bobbing, tugging, and grunting because the baby is trying to use their chest, neck, and rib muscles to breathe.”

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When to call a pediatrician or go to the hospital

If your baby has a high fever; difficulty breathing; has gray or blue skin, lips, or nail beds; severely decreased activity and alertness; or if your child stops breathing for more than 1src seconds, take them to the emergency department ASAP, even if they start breathing normally again. “If your infant has apnea and you think it’s RSV, there’s a risk they will have more events,” Dr. Chang says.

Rest assured, most babies who get sick with RSV will be okay. “The vast majority of infants diagnosed with RSV recover without any complications,” Gary Reschak, MD, a pediatrician at Northwestern Medicine Huntley Hospital, tells SELF. However, babies who are born premature or who have underlying lung disease usually face a higher risk of complications, Dr. Fisher says. Having a weakened immune system or certain neuromuscular disorders can also put an infant at greater risk of severe RSV.

If you suspect that a baby you take care of may have RSV and you’re just feeling concerned, Dr. Reschak recommends calling the pediatrician’s office to talk about next steps. Again, most infants experience common coldlike symptoms, he says, but if a child is showing signs of bronchiolitis—including a lingering cough, wheezing, or difficulty breathing—or just doesn’t seem able to get comfortable, you’ll want to have them examined by a health care provider as soon as you can.

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RSV treatment

The AAP recommends that you do the following as a child tries to fight off the virus:

• Use a nasal saline with gentle suctioning to help the baby breathe easier.
• Run a cool-mist humidifier in their room to combat dry air and help break up excess mucus.
• Make sure the child is having frequent feedings (and try to suction their nose before attempting to feed them) to avoid dehydration.
• Use acetaminophen or ibuprofen to help with fevers if the baby is older than six months (don’t use aspirin or cough and cold medications—they’re not considered safe for babies). If you’re unsure about using medication, it’s always best to check in with a pediatrician first.

In severe cases, a baby may need supplemental oxygen, IV fluids, or further inpatient treatment in a hospital. This happens in only about 3% of children with RSV, and most of these babies can go home after two or three days.

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RSV prevention

Vaccination is the best way to protect your child from severe illness or hospitalization due to RSV. The CDC recommends that people who are pregnant get a maternal RSV vaccine if they are between 32 and 36 weeks of gestation during RSV season. (So basically, September through January.) This will help you create and pass protective antibodies to the baby through the placenta. If you didn’t get the vaccine during pregnancy, no worries: Babies under eight months (or up to 19 months if they have certain conditions) can get a shot that contains monoclonal antibodies, which also protect them. (The monoclonal antibody shot is usually given from October through March.)

While there are no shots for children of other ages (or adults under 6src), everyone 75 or older can now get an RSV vaccine. (In addition, you can also get it if you are 6src to 74 and have certain conditions like chronic heart or lung disease.) Adults who are eligible and get vaccinated will not only help protect themselves, they can also lower their chances of spreading the virus to a baby—or anyone else for that matter.

There are a few other things you can do that can help. (Spoiler: Most of them are the same things you should do to avoid getting seriously sick from any other virus during cold and flu season.)

• Wash your hands (and your child’s hands) often with soap and water for at least 2src seconds. Hand sanitizer works well in a pinch too.
• Try to prevent a youngster from touching their face with unwashed hands as best as you can. You should also make sure any adults interacting with a child avoid touching the little one’s face excessively.
• Avoid close contact with sick people. Make sure you cover your coughs and sneezes around kids too.
• If possible, limit time in childcare centers and other group settings.
• Clean frequently touched surfaces in the home often.
• Consider asking loved ones to wear a face mask if you know they will be in close contact with your child.

There’s a lot about parenthood we can’t control, and it’s not always possible to keep your baby from getting sick. But taking steps to protect your family from illness—and knowing what symptoms to look for—can often help. When in doubt, always check in with your child’s doctor.