By Hilary Stempel, MD, MPH
When my twins were born last fall, RSV was the virus I was most concerned about. Respiratory Syncytial Virus (RSV) is a long name for a very common virus that causes coughs and colds in children and adults alike. It spreads quickly through daycares and schools. This illness can be like an annoying cold in older children and caregivers, but it can be very serious in infants.
RSV infections often happen in the fall when it becomes colder and kids are in school. During COVID, when social distancing and masking was so common, we saw much less RSV than usual. This means fewer kids developed immunity to RSV. Now, there are lots of kids who are getting their first infection with RSV all at the same time.
As a pediatrician I’ve cared for hundreds of kids with RSV. When I think of RSV, I immediately think of babies with thick snotty noses, draining constantly, and often having difficulty breathing and eating. Many of these babies have fevers and generally feel yucky. RSV infects the small airways of the lungs and this is part of the reason they can have more breathing difficulties than other cold viruses.
Certain kids are at higher risk for having more serious RSV and these children can get a vaccine, Synagis (Palivizumab) given monthly during RSV season. Children who may qualify for the vaccine are those who are born very prematurely, have serious heart conditions, or have serious lung illnesses. Most children are healthy enough that we do not give them this vaccine. Antibiotics do not work for RSV.
It’s common for kids in childcare to get RSV. The best treatment at home is to help with their symptoms.
Runny nose: suction with a home aspirator and nasal saline can be very helpful to clear up for the congestion. Be prepared to do this often!
Fever and discomfort: treating the discomfort with an anti-fever medicine like tylenol (acetaminophen) or motrin (ibuprofen) can make them more comfortable.
Hydration: give your child small sips of their favorite liquid often. They may also enjoy eating fruit popsicles. It is ok if they don’t want to eat much real food when ill with RSV.
Medication Tip: Ibuprofen is only for infants and children older than 6 months.
Remember: Fevers in babies less than 3 months old can be serious and you should always call your healthcare provider to decide if they should be seen.
There are two main concerns with RSV infection.
1. Breathing troubles. RSV can make it hard for babies and young children to breathe well on their own. If this is the case, they may need extra breathing support (ex: more oxygen, humidified air) at the hospital. Hospital stays are usually short and very helpful.
Signs of breathing problems include:
Nasal Flaring (nostrils moving in and out with breathing)
Grunting with breathing
Tugging at the neck
Ribs sticking out during breathing
2. Dehydration. With the symptoms of snotty noses, fever, and feeling unwell, this can make it very difficult to drink enough liquids for children to stay hydrated. Sometimes kids need to be in the hospital to help them stay hydrated.
Sometimes kids get sick enough with RSV that it's helpful to be seen by a healthcare provider.
Go to the emergency room if:
Your child has any of the serious breathing problems mentioned above
Go to urgent care or clinic if:
You’re having difficulty with suctioning your baby’s nose
You need help having your child drink enough fluids
Symptoms are lasting longer than 5 days and are not improving
You’re concerned that they should be getting better but are not
You have questions about their fever or cough
If your child gets RSV, try not to feel guilty! This is a very common infection.
Kids often get RSV more than once. Their next infection is usually milder.
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