Respiratory syncytial virus, or RSV, can lead to dangerous infections in young babies, yet it's not talked about near as much as the flu. From symptoms to treatment options, these are the need-to-know facts on RSV according to experts.

By Alyssa Silver, MD, attending physician at Children's Hospital at Montefiore and Christin Perry
January 22, 2020
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As if colds and flu weren't enough, there's another potentially serious virus you'll want to keep on your radar come late fall, winter, and early spring if you have an infant. It's called RSV, which stands for respiratory syncytial virus, and it can leave your baby feeling pretty miserable. Worse, it can be dangerous, especially for very young babies, elderly people, and anyone with a compromised immune system. But despite being quite common (some studies indicate that almost all kids have had RSV at least once by the time they turn 2), it doesn't get nearly as much attention as the flu.

Here, we asked experts to weigh in on everything you need to know about RSV, including how to spot the possible symptoms early on and how to get your little one healthy again if RSV does strike.

What Is RSV in Babies?

RSV is a virus that causes acute respiratory tract infections in infants, children, and adults. In most healthy people, RSV may present as nothing more than a bad cold. But in infants, an RSV diagnosis can quickly become dangerous if not treated correctly. That's because in babies under 6 months of age, the risk of significant lower respiratory disease is much higher, says Alyssa Silver, M.D., attending physician at the Children's Hospital at Montefiore in New York. In infants with still-developing immune systems and fragile lungs, RSV is more likely to lead to infections like bronchiolitis and pneumonia, which can make breathing extremely difficult for young babies.

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RSV Symptoms in Infants

So how do you know if your baby is just dealing with a simple case of the sniffles or something more serious, like RSV? Early symptoms of RSV mirror a cold, with coughing, sneezing, and nasal congestion. But as the virus progresses and moves into Baby's lungs, he may experience the following symptoms, according to the Cedars-Sinai Medical Center health library:

  • Wheezing
  • Apnea (short periods where breathing stops, which most often occurs during sleep)
  • Breathing faster than usual, or having trouble breathing
  • A bluish tint around the lips and fingertips

According to Dr. Silver, another hallmark symptom of RSV is called retractions, which occur when you can see a sucking motion of the skin between Baby's ribs when he's breathing. This indicates he's having difficulty breathing, which warrants a trip to the ER.

RSV Diagnosis

RSV is a difficult illness to diagnose, given that its symptoms are so similar to any of the spate of viruses that circulate during the fall and winter months. If you suspect your baby might be suffering from RSV, there are a few tests your doctor can run to obtain a positive RSV diagnosis. According to Dr. Silver, your pediatrician can use a cotton swab to collect nasal secretions to run 1 of 2 different types of tests for RSV: a rapid test (an immunoassay) that takes approximately 15 minutes for results, or a test that includes other respiratory viruses, which typically takes 2-3 hours.

RSV Treatment

And just as RSV can be difficult to diagnose, it can be equally difficult to treat. That's because there really is no specific treatment. Since RSV is a virus, it doesn't respond to antibiotics like an infection would. Chances are, if your little one comes down with a bout of RSV, you'll be hauling out the nasal aspirator and the humidifier for a week or two.

But for more severe cases, Baby may need a higher level of care. "Some infants will simply require suctioning mucus from their nose and smaller, more frequent feedings. For more severe illness, babies can need oxygen, intravenous (IV) fluids, or more support for their breathing through other types of breathing support (such as CPAP or ventilation)," says Dr. Silver.

How to Prevent RSV in Babies

Since there's no ace in the hole treatment for RSV in babies, the best course of action is to do everything you can to prevent it. We know, this is much more difficult said than done. With RSV being such a common childhood illness, you shouldn't feel guilty if your little one catches it. But there are some preventative measures you can take to avoid it. According to Dr. Silver, here's a list of things you can do to avoid the RSV virus:

  • Wash hands with soap and water or alcohol-based hand sanitizers with at least 60 percent alcohol
  • Avoid contact with anyone who is sick with cold symptoms
  • Keep those who are ill away from Baby as much as possible
  • Avoid having others touch baby's face and hands
  • If you're breastfeeding, continue to do so as long as you can avoid coughing/sneezing on baby

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