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What You Should Know About RSV in Babies

RSV is a respiratory infection that is common and sometimes serious in babies. Some symptoms include difficulty breathing, lethargy, cough, and more. Recognizing the symptoms and when to get help can keep your baby safe.

Respiratory syncytial virus (RSV) is a serious respiratory infection that can affect people of all ages.

But RSV is most serious when it occurs in babies. That’s because babies’ airways aren’t as well-developed, so they cannot cough up mucus like older children or adults. Also, their airways are smaller, so they can experience airway blockage easily, causing trouble breathing.

In many people, RSV causes cold symptoms, often with a cough. In babies, RSV can cause a more serious illness called bronchiolitis. Babies with bronchiolitis have wheezing along with their cough.

RSV can lead to other severe infections, including pneumonia. In some cases, babies may need to receive treatment at a hospital.

RSV is a virus, so there are currently no medications that can cure it to shorten the course of the illness. Instead, doctors will often recommend treatments or remedies to help manage symptoms until the infection passes.

People can often transmit RSV from November to April, when cooler temperatures bring people indoors and when they’re more likely to interact with others. People can also transmit RSV earlier in the year. For example, in 2022, the RSV season started earlier, with a high number of cases in October.

Keep reading to learn more about this virus, including symptoms to watch out for and when to get medical help.

Symptoms of RSV in babies

In older children, RSV can cause symptoms similar to that of a cold. But in babies, the virus causes more severe symptoms.

RSV tends to follow a timeline of symptoms. Symptoms often appear 4 to 6 daysTrusted Source after exposure to the virus. However, a baby may start experiencing symptoms earlier or later.

Symptoms a baby may have with RSV include:

  • faster than usual breathing
  • difficulty breathing and feeding
  • cough
  • fever
  • irritability
  • lethargy or behaving sluggishly
  • runny nose
  • sneezes
  • labored breathing using chest muscles
  • wheezing

Some babies are more likely to experience RSV symptoms, includingTrusted Source those born prematurely or babies with heart problems or a history of wheezing or breathing issues.

RSV vs. COVID-19

RSV and COVID-19 are both respiratory infections and share many similar symptoms. Both conditions can cause fever, cough, runny nose, and sneezing. Upset stomach, vomiting, or diarrhea may also occur in babies with COVID-19.

Symptom RSV COVID-19
cough common common
fever common common
irritability common common
lethargy or sluggish behavior common common
runny nose common may occur
sneezing common may occur
wheezing common less common
difficulty breathing may occur may occur
breathing that’s faster than usual may occur may occur
nausea or vomiting less common common
headache less common common
sore throat less common common


If your child has any of the above symptoms, their pediatrician may recommend testing them for both RSV and COVID-19, depending on cases in your area and their exposure risk to either of these viruses.

When to get medical help for RSV

RSV cases can range from mild cold symptoms to those of severe bronchiolitis. Even if symptoms are mild, it’s important to call your pediatrician if you suspect your baby has RSV. Always get emergency medical care if your baby appears to have trouble breathing.

Emergency symptoms to watch out for include:

  • dehydration, including a sunken fontanel (soft spot), dry diaper, or no tear production when they cry
  • difficulty breathing, which can include rib lines showing through the skin (retraction) as they breathe
  • blue fingernails or mouth, which is cyanosis, an indication that they are not getting
  • enough oxygen and are in severe distress
  • fever greater than 100°F (38°C), rectally obtained, in babies younger than 3 months
  • fever greater than 104°F (39°C) in children of any age
  • thick nasal discharge that makes it hard for the child to breathe

Treatment for RSV in babies

In the most severe cases, RSV may require the help of a breathing machine known as a mechanical ventilator. This machine can help to inflate your baby’s lungs until the virus goes away.

Doctors used to routinely treat many cases of RSV with bronchodilators. Some doctors still use bronchodilators for RSV treatment, but experts no longer recommend this for the most part.

Doctors prescribe bronchodilators for people with asthma or COPD to help open up the airways and treat wheezing, but they don’t help the wheezing that comes with RSV bronchiolitis.

If your baby has dehydration, their doctor may also provide intravenous fluid.

Antibiotics won’t help your baby’s RSV because antibiotics treat bacterial infections. RSV is a viral infection.

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