RSV in Babies and Toddlers

Respiratory syncytial virus, or RSV for short, is a strange-sounding name for an illness you may not have heard of, but it’s more common than you think. In fact, it’s one of the viruses that can cause a cold. Find out more about RSV and learn how to recognize the signs in infants and babies as well as how the infection can be treated.

What Is RSV and What Are the Symptoms?

RSV is just one of many viruses that can cause a common cold in children and adults. In some cases, RSV can lead to bronchiolitis or pneumonia in children younger than 1 year old. The cold-like symptoms of an RSV infection can include:

  • Runny or stuffy nose

  • Sneezing

  • Sore throat

  • Mild cough

  • Mild headache

  • Fever

  • Fussiness

  • Poor feeding.

If the RSV infection spreads to the lower respiratory tract, it can lead to bronchiolitis, an infection of the small airways of the lungs. It's not the same illness as bronchitis, which is an infection of the larger airways of the lungs. The symptoms of bronchiolitis include:

  • Rapid breathing

  • Wheezing

  • Flaring of the nostrils

  • Head bobbing or rhythmic grunting while breathing

  • Breathing from the belly or retracted breathing between the ribs or lower neck.

How Common Is RSV in Infants?

In infants and in young children, RSV is the most common cause of lower respiratory tract infections. RSV is most common in infants between 2 and 8 months of age. In fact, RSV is so common that nearly all children get the infection by the time they reach 3 years old. Luckily, in most cases, it will only cause cold-like symptoms. For a smaller number of children, the RSV infection may lead to bronchiolitis, which may need medical care.

How Contagious Is an RSV Infection?

RSV is highly contagious, especially from October through March—the cold and flu season. It can spread through saliva droplets when someone coughs or sneezes. It can live on surfaces like countertops for up to 6 hours, and your hands for up to 30 minutes or even more. Your child can get infected after touching anything that has been contaminated, and then touching his mouth, nose, or eyes. The RSV virus can spread quickly at daycare centers and schools. Your baby can easily get it at daycare or from an older sibling who carries the virus home from school. Keep in mind, if your baby has an RSV infection, she can spread it through direct contact with anyone. Someone who kisses her face, for example, could potentially pick up the virus.

Can an RSV Infection Be Prevented?

Although you can’t completely protect your baby from infections like RSV, there are some simple steps you can take to reduce your little one’s risk of coming into contact with the RSV virus and getting infected:

  • Have all family members, caregivers, and visitors who come into contact with your baby wash their hands with soap and warm water for at least 20 seconds before holding her. If soap and water are not available, an alcohol-based hand sanitizer works well too.

  • Avoid having your baby come into contact with people who have cold-like symptoms, such as a runny nose

  • Limit contact with siblings or other children who have cold symptoms, and ensure that they wash their hands often

  • Regularly disinfect common objects and surfaces in your home like doorknobs, toys, kitchen counters, etc. to cut down on germs

  • Whenever possible, avoid visiting crowded areas like shopping malls or entering enclosed spaces like elevators where your baby could come in contact with ill people

  • Don’t smoke around your baby, as this can increase her risk of getting an RSV infection

  • Keep your baby up-to-date on her immunizations and ensure your entire family gets the flu shot every year. The Tdap vaccine against whooping cough is especially important for family members who come into contact with your child.

  • If you are breastfeeding, you may like to know that breastfeeding can pass on protective antibodies to your baby that can help prevent and fight infectious diseases such as RSV. In fact, breastfeeding while you have a cold may even help your baby by passing on more antibodies.

Who Is Most Susceptible to RSV?

If any of the following apply to your infant, she may be at a higher risk of severe RSV:

  • She is a newborn younger than 12 weeks old during RSV season (from fall to spring)

  • She was born prematurely or at a low birth weight

  • She has chronic lung disease

  • She has congenital heart disease

  • She has cystic fibrosis

  • She has a weakened immune system due to an illness

  • She has a history of allergies or eczema.

When Should You Contact Your Baby’s Healthcare Provider?

If your baby has any of the following symptoms, contact his healthcare provider as soon as you can:

  • He wheezes when he inhales or exhales

  • His chest retracts around his ribs and breastbone while breathing

  • He can’t drink fluids because he is unable to suck and swallow

  • His lips or fingertips are turning a bluish color

  • He has a fever that lasts more than three days (or if he’s under 3 months old and has a fever at all)

  • He is showing signs of dehydration, such as a dry mouth, drinking less fluid than normal, being unable to cry tears, or urinating less than normal (you might notice he has fewer wet diapers, for example).

How Is an RSV Infection Diagnosed and Treated?

If you suspect your little one has the symptoms of RSV or another respiratory infection, call your child’s healthcare provider. You may be asked to describe his symptoms and take him in for a physical exam. In some cases, to help make a diagnosis, the provider may swab your baby’s nose for a sample to test for the RSV virus or order an X-ray to check for chest congestion. There is no medication to treat an RSV infection. Keep in mind, since it’s a virus, antibiotics would not prescribed because antibiotics are effective only for bacterial infections. The RSV infection can last from one week to several weeks depending on its severity. However, there are some things you can do at home to ease your child’s symptoms and help him feel more comfortable:

  • Use a cool mist humidifier, saline nasal drops, or a nasal aspirator if your child has a stuffy nose

  • If your child has a cough, don’t give cough suppressant medicine, since the coughing can actually help clear his lungs of the infection

  • If your child has a fever, check with his healthcare provider about giving him a fever-reducing medicine like acetaminophen or ibuprofen (if he's older than 6 months)

  • Make sure your child is getting enough fluids to prevent dehydration.

If your baby has a more severe case of RSV, the healthcare provider may give your little one a medication via a nebulizer to help open up the breathing tubes. This approach can help some babies, and may prevent the need for hospitalization. If the RSV infection has resulted in bronchiolitis, your baby’s provider may recommend hospitalization, especially if he is having trouble breathing, eating, or drinking.

The Bottom Line

The RSV virus is one of the viruses that your little one may catch. Typically it causes only cold-like symptoms and will resolve within a few days or weeks, but in some cases it can lead to complications and even require hospitalization. Good hygiene habits like regular hand-washing, disinfecting surfaces, and keeping your baby away from anyone who has cold-like symptoms can help prevent your baby or toddler from becoming infected with RSV. But if your little one does get it, some simple at-home TLC will likely work to get him back to his old self in no time. If your child has more severe symptoms, the healthcare provider will be able to make a diagnosis and recommend the next steps in treatment.

How We Wrote This Article

The information in this article is based on the expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.