RSV in Toddlers: Everything Parents Need to Know

RSV isn't only an illness for infants and babies—your toddler is susceptible, too. From symptoms to treatment, here's what you need to know about RSV if your child is between 12 and 36 months old.

You're lucky if you somehow made it out of the baby stage without encountering respiratory syncytial virus (RSV). According to the Centers for Disease Control and Prevention (CDC), almost all babies have had this virus that attacks the lower respiratory system at least once by the time they celebrate their second birthday. But even if you are one of the lucky ones, RSV is a highly contagious illness, which means toddlers (who touch everything and everyone) are very susceptible. Here's everything you need to know if your older baby happens to come down with RSV this season.

Sleeping toddler sick with RSV and has IV and Oxygen tubes on face
Jill Lehmann Photography/Getty Images

Is It RSV?

RSV is a respiratory virus that inflames the small airways in the lungs and is the most common cause of bronchitis and pneumonia. The CDC estimates that each year 58,000 to 80,000 kids under five are hospitalized, and 2.1 million kids under five will receive outpatient care for RSV. While this common virus that typically looks like a cold will affect virtually every child at some point, it is considered a serious illness that can quickly become severe—even life-threatening— in infants and toddlers since their lungs are so small.

But as the lungs mature, often the disease can be less severe, says Alyssa Silver, M.D., attending physician at Children's Hospital at Montefiore. "However, older infants can still be affected by RSV. It depends mostly on whether they've had the illness before and whether there are any complicating factors (like other illnesses at the same time)," she says.

RSV Symptoms in Toddlers

RSV affects the upper respiratory tract, and most toddlers will show signs of infection 4 to 6 days after exposure. Typically, the virus will run its course in about two weeks. But for some kids, RSV can spread to the lower respiratory tract, causing inflammation of the small airways, which means oxygen delivery can be compromised. However, RSV isn't usually as severe in toddlers as in infants since their lungs are bigger and they likely have built up immunity from past exposure and previous infections.

If your toddler has RSV, these are the symptoms to watch for:

  • Coughing
  • Decreased appetite
  • Fever
  • Runny nose
  • Sneezing
  • Wheezing

The CDC notes that these symptoms do not happen all at once and may appear in stages.

Treatment for RSV in Toddlers

So your toddler has come home from daycare with a fever and a nasty cough. A trip to the doctor has confirmed that it's RSV. What should you do?

For the most part, the treatment for RSV in toddlers is "supportive" in nature, says Amina Ahmed, M.D., professor of pediatric infectious disease and immunology at Atrium Health's Levine Children's Hospital. That means you'll be doing plenty of nose wiping and running a humidifier for the next few weeks. Hopefully, the virus will run its course, and you'll simply have to ensure your toddler is comfortable, hydrated, and clean (those runny noses, though!) until your child returns to their usual self again.

Here are some tips for treating RSV in toddlers.

Nasal aspirator

Use a nasal aspirator on younger toddlers. An electric one or the Fridababy Nose Frida will probably be better than that blue bulb you received in the hospital when your toddler was born. That's because these newer tools are more effective, especially for a stronger (and faster!) toddler.

Teach your child to blow their nose

Teaching your child to blow their own nose is an important lesson to help them stay healthy and prevent the spread of germs. It also frees you up since you won't constantly be wiping your child's runny nose! Be sure to use soft, sturdy tissues with moisturizer to help prevent the tender skin around their nose from drying out and becoming chapped, which can be painful.

Stay hydrated

Give your toddler a fun new cup to encourage hydration. Dehydration from poor feeding, high fever, or lack of drinking can only exacerbate the condition and lead to hospitalization, so try this trick to get your toddler drinking on the regular.

Ask your doctor about steroids

Consider steroid treatment if your doctor recommends it. "We occasionally try medicine like albuterol which opens airways, but it does not work for all babies, says Dr. Ahmed.

Did You Know?

Researchers think that staying hydrated may be a factor in preventing pneumonia. One theory is that dehydration can make inflammation in the lungs sticky and less able to pump oxygen efficiently, leading to pneumonia symptoms.

Risks of RSV in Toddlers

By now, you're aware that RSV in toddlers isn't as much of a concern as it is in young babies. But there are some risks you should be aware of. Since RSV can produce a ton of congestion, there's a slight risk of your little one experiencing a secondary infection like pneumonia or an ear infection, says Rudolph Valentini M.D., Chief Medical Officer at Children's Hospital of Michigan. "Children often get ear infections following a respiratory infection," he says.

And since your toddler is still so young, you may not yet know if they have any factors that can complicate the recovery process from RSV, such as asthma. "Any additional illnesses a child may have can make the effects of RSV more severe," says Dr. Silver. "Similarly, any infant who has had a recent illness that may affect the lungs (influenza, for example) and subsequently gets RSV can also then be more severely affected as well."

Prevent the Spread of RSV

Although RSV is very common and affects virtually every person at some point, you won't need a hazmat suit to keep RSV from spreading. The CDC recommends a few simple steps to help keep your family safe, especially if your child is at risk for severe infection.

  • Wash your hands frequently and with warm water and soap for at least 20 seconds.
  • Avoid touching your face, especially your nose, eyes, and mouth.
  • Stay away from folks who are sick.
  • Ask your child's daycare about their policy on kids attending while sick.
  • If your child is sick, keep them home to prevent the spread of germs.
  • Clean and disinfect high-touch surfaces like faucets, doorknobs, and phones.
  • Cover your mouth when coughing or sneezing to lower the risk of spreading germs.
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