As if we haven’t spent enough time talking about viruses over the last couple of years, this winter flu/cough/cold season has gotten off to an early and rocky start. Parents of young children (especially those under two) have likely seen much about the high levels of viral activity in the area. 

We’re going to focus on RSV in babies and young children – this virus is currently keeping lots of littles (and their parents!) awake at night and sometimes sending them to the pediatrician’s office or urgent care.

What is RSV anyway?

Respiratory Syncytial (sin-SISH-uhl) Virus (RSV) is a common, respiratory viral infection. For most, it typically causes relatively mild, cold-like symptoms, usually lasting a week or two. However for young children and the elderly, it can be much more severe. It is the leading cause of pneumonia and bronchiolitis (inflammation of the small airways in the lungs) in children under one-years-old.  

How to protect babies from RSV:

• Wash your hands frequently and require anyone who comes into contact with baby to also wash their hands
• Encourage family members (especially siblings!) to avoid kissing or touching baby’s face and hands
• Remind everyone to keep their hands off their face/mouth 
• Cover coughs and sneeze (and promptly wash hands again)
• Encourage visitors to your home to wear a mask and wear your mask in public settings
• Clean and disinfect high touch surfaces- door knobs, light switches, railings and toys that end up in baby’s mouth
• Avoid close contact with sick people: this includes staying out of pediatrician’s office/urgent care unless absolutely necessary

Common symptoms (older infants and toddlers):

• Excess mucus or runny nose
• Decreased appetite
• Coughing/wheezing
• Fever

In very young infants (under 6 months) you may only see:

• Irritability or general fussiness
• Decrease in activity 
• Poor feeding
• Wheezing

How to treat RSV in babies at home:

• Prevent dehydration – fluids and frequent smaller feedings, suction nose just before feeding.
• Saline nose drops with gentle suctioning.
• Keep a cool mist humidifier running as much as possible.
• Manage fever and discomfort with skin to skin, cool compresses and OTC meds – acetaminophen before 6 months of age, ibuprofen is ok after 6 months. 

Avoid the following for infants:

• Over-the-counter cough/cold medicine (unless recommended by your doctor)
• Aspirin or other pain relief medications
• Vapor rubs/oils like Vicks, eucalyptus, etc either applied to skin or defused

When to seek medical care:

• Trouble breathing – fast breathing, blue tinged skin or lips, pulling hard to breathe (see the AAP’s video on Signs of RSV in Babies)
• Fever over 100.4 for a newborn (under 4 months of age)
• Dehydration – fewer than 1 wet diaper every 8 hours
• Lethargy – significant decrease in activity or alertness. Trust your instincts here – you know your baby best. 

Your pediatric care provider is able to treat the vast majority of infants and young children with RSV. In the event that your usual pediatrician is not available (after hours, booked, etc) or has recommended more immediate care, a pediatric specific urgent care is your next best option. Unless recommended by a pediatric provider, avoid the ER if possible. Our local pediatric emergency departments are flooded with patients, so if you absolutely have to go to the hospital, pack plenty of patience. 

If this was helpful, be sure to check out our tips for keeping baby healthy or traveling while pregnant or with a baby during the holiday season!