13 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 (especially this year). But there’s another virus that’s making headlines right now that many people aren’t as well-versed in. It’s called respiratory syncytial virus, better known as RSV, and cases are currently soaring in the US, particularly in babies and young children.

According to surveillance data from the Centers for Disease Control and Prevention (CDC), RSV cases have been rising sharply since October. Public health experts are warning about the potential impact on kids, as the virus is overwhelming many hospitals and rapidly filling pediatric ICU beds. 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.

RSV is a common respiratory virus that usually causes coldlike symptoms, according to the CDC. 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, 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, per the CDC.

“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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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 too, John C. Brancato, MD, division head of emergency medicine at Connecticut Children’s, tells SELF.

The virus spreads in a few ways, according to the CDC:

• When an infected person coughs or sneezes, which can circulate virus-laden droplets that then make contact with a child’s eyes, nose, or mouth
• When a person touches a surface that has the virus on it (like a doorknob or toy) and then touches a child’s face before washing their hands
• When a child has direct contact with the virus, like getting a hug or kiss from someone who is infected with RSV

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Symptoms of RSV in infants depend on how serious the infection is. If a child has a mild coldlike illness, the AAP says they may experience the following:

• Dry or wet cough
• Congestion
• Runny nose
• Sneezing
• Fussiness
• Poor feeding
• Fever—a temperature of 100.4 F or higher (though the CDC notes that a fever may not always occur with RSV)

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

• Fast breathing
• Flaring of the nostrils
• Head bobbing with breathing
• Rhythmic grunting during breathing
• Belly breathing, tugging between the ribs and/or the lower neck
• Wheezing

“Babies with RSV can also have respiratory distress, where you can see the stomach muscles pumping in and out while they breathe,” Dr. Fisher says.

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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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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 6 months (don’t use aspirin or cough and cold medications—they’re not considered safe for babies). If you’re unsure about using a 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, the AAP says. 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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Unfortunately, there is no approved vaccine for RSV yet. But there are a few things you can do to lower the risk a baby will be exposed to the virus. (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 the child’s hands) often with soap and water for at least 20 seconds. Hand sanitizer works well in a pinch too.
• Try to prevent the child from touching their face with unwashed hands as best as you can. You should also make sure any adults interacting with the child avoid touching the little one’s face excessively.
• Avoid close contact with sick people. Make sure you cover your coughs and sneezes around the child 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 the child.

If a baby is considered to be at high risk for serious RSV complications, they could be a candidate for a preventative antibody medication, Dr. Olivero says. Check in with your pediatrician if you think the baby qualifies.

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Related:

• Pete Buttigieg Shared the ‘Terror’ and ‘Hope’ of Parenting After Both His Kids Were Hospitalized
• How an ‘Immunity Gap’ May Be Fueling the Recent Spike in Respiratory Illnesses
• Yes, RSV Can Spread to Adults From Kids—Here’s Why That Matters Right Now