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What should I do if my baby has RSV?
RSV is a common virus that causes cold-like symptoms, but it can be serious for babies. Here is what to watch for and do.
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What it is
Respiratory syncytial virus (RSV) is a common respiratory virus that usually causes mild, cold-like symptoms [5]. Almost all children get it at least once before they are 2 years old [9]. In most healthy children, RSV is not serious and gets better on its own [9].
However, RSV can be dangerous for infants and some young children [10]. It is the most common cause of bronchiolitis (inflammation of the small airways in the lungs) and pneumonia (infection of the lungs) in children younger than 1 year [1]. Two to three out of every 100 infants under 3 months are hospitalized with RSV every year [2]. Babies under 6 months old, young children born prematurely, and children with weakened immune systems or long-term lung or heart conditions are at higher risk of serious illness [9].
Symptoms usually start within a few days of infection [6]. Early symptoms may include a runny nose, eating or drinking less, and a cough that may progress to wheezing or difficulty breathing [4]. In very young infants (under 6 months), symptoms may also include irritability, decreased activity, and apnea (pauses in breathing for more than 10 seconds) [3]. Many infants will not have a fever with RSV [3]. RSV may not be severe when it first starts, but it can become more severe a few days into the illness [4].
What you can do at home
Most RSV infections are mild and get better by themselves [9]. There is no specific medicine to cure RSV. Care at home focuses on supporting your child.
- Offer fluids often to keep your child hydrated. If your baby is feeding less than usual, try smaller feeds more frequently.
- Use a bulb syringe or nasal aspirator to clear a stuffy nose, especially before feeding.
- Run a cool-mist humidifier in the room to help ease coughing.
- Watch your child closely. RSV can get worse a few days into the illness, even if it starts mild [4].
- Do not give any medication to a baby without checking with a doctor first. Never give aspirin to a child.
If your child is at very high risk of serious RSV illness, a doctor may recommend an injection of infection-fighting antibodies each winter to help prevent severe bronchiolitis [7]. Ask your doctor if this applies to your child.
When to see a doctor or go to the emergency department
Get medical help urgently if your child is unwell and getting worse, or if you are worried your child is seriously ill [6]. Seek urgent advice if your child has any of these signs:
- Feeding or eating much less than normal [6]
- A dry nappy for 12 hours or more, or other signs of dehydration [6]
- Very tired or irritable [6]
- Difficulty breathing, shortness of breath, faster breathing, or long gaps between breaths [6]
- A cough that gets worse [6]
- Noisy breathing (wheezing) [6]
- Your baby is under 3 months old and has a temperature of 38C or higher, or is older than 3 months and has a temperature of 39C or higher [6]
- Your baby feels hotter than usual on their back or chest, feels sweaty, or is shivering [6]
In the most severe cases, a child may need to be hospitalized and receive oxygen, IV fluids if they cannot drink enough, or a breathing tube with mechanical ventilation [1]. Most children improve with this supportive care and are discharged in a few days [2].
Common questions
Can my baby get RSV more than once? RSV infections are very common, and almost all children get them at least once before age 2 [9]. The sources do not state whether a child can get RSV more than once.
Is there a vaccine for RSV? Yes. CDC recommends immunizations to protect infants and some young children from severe RSV illness [5]. In the UK, a free RSV vaccination is offered to people who are 28 weeks pregnant or more, which helps protect the baby for the first few months after birth [8]. The vaccine helps reduce the risk of RSV causing serious problems like pneumonia and bronchiolitis [8].
My baby has a runny nose and cough. Is it RSV? RSV causes cold-like symptoms such as a runny or blocked nose, cough, sneezing, and tiredness [6]. Many viruses cause these symptoms, so you cannot tell for sure without a test. Watch your child closely, because RSV can become more severe a few days into the illness [4]. If you are worried, get medical help [6].
Sources
[1] CDC — “About RSV”, section “RSV can be dangerous for infants and older adults”, p. 1 — https://www.cdc.gov/rsv/about/index.html [2] CDC — “RSV in Infants and Young Children”, section “Severe RSV illness”, p. 1 — https://www.cdc.gov/rsv/infants-young-children/index.html [3] CDC — “RSV in Infants and Young Children”, section “RSV in very young Infants”, p. 1 — https://www.cdc.gov/rsv/infants-young-children/index.html [4] CDC — “RSV in Infants and Young Children”, section “Did you know? Symptoms in infants and young children”, p. 1 — https://www.cdc.gov/rsv/infants-young-children/index.html [5] CDC — “About RSV”, section “About RSV What to know”, p. 1 — https://www.cdc.gov/rsv/about/index.html [6] NHS — “Respiratory syncytial virus (RSV)” (2024), section “Symptoms of an RSV infection”, p. 1 — https://www.nhs.uk/conditions/respiratory-syncytial-virus-rsv/ [7] NHS — “Respiratory syncytial virus (RSV)” (2024), section “Injection for children at risk of serious infections”, p. 1 — https://www.nhs.uk/conditions/respiratory-syncytial-virus-rsv/ [8] NHS — “Respiratory syncytial virus (RSV)” (2024), section “RSV vaccination”, p. 1 — https://www.nhs.uk/conditions/respiratory-syncytial-virus-rsv/ [9] NHS — “Respiratory syncytial virus (RSV)” (2024), section “Respiratory syncytial virus (RSV)”, p. 1 — https://www.nhs.uk/conditions/respiratory-syncytial-virus-rsv/ [10] CDC — “RSV in Infants and Young Children”, section “RSV in Infants and Young Children What to know”, p. 1 — https://www.cdc.gov/rsv/infants-young-children/index.html
This guide summarises published paediatric guidelines. It is not medical advice and does not replace your paediatrician. In an emergency, call your local emergency number.
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