RSV (respiratory syncytial virus) is an extremely common winter virus. In older children and adults it causes an ordinary cold. In infants under one year, and particularly under six months, it can inflame the small airways — bronchiolitis — and make breathing hard work. Almost every child catches RSV by the age of two.
Signs of RSV and bronchiolitis
It usually starts like a cold — runny nose, mild cough, sometimes a fever — and in babies it can worsen around day three to five, which often catches parents out just as they think it is improving.
- Persistent cough and heavy congestion
- Wheezing or a rattly, crackly sound to the breathing
- Faster breathing than usual
- Feeding less, or taking much longer over feeds because of a blocked nose
- Fewer wet nappies
- Unusual tiredness or irritability
Go to the emergency room or call 911 if
These are the signs of a baby working too hard to breathe, and they matter more than any thermometer reading:
- The skin is pulling in between or under the ribs, or at the base of the neck, with each breath
- Nostrils flaring, or grunting at the end of each breath
- Pauses in breathing, or any blue or grey colour around the lips or face
- Too breathless to feed, or very hard to wake
- Signs of dehydration — no wet nappy for 8 hours, no tears
- Any fever in a baby under 3 months — see fever in children
How RSV is treated
There is no antibiotic for RSV, because it is a virus — antibiotics do nothing for it. Treatment is supportive, and done well it works: keeping your baby hydrated with small, frequent feeds, saline drops and gentle suction to clear the nose before feeds, and watching the breathing. Most babies manage at home. Some need a few days in hospital for oxygen or feeding support, which is not a failure of anything you did.
Do not use over-the-counter cough and cold medicines in young children — they are not recommended under the age of four and carry real risks without helping.
Preventing RSV
Handwashing, keeping babies away from anyone with a cold, and no smoking around your child all genuinely reduce risk. There are also immunisation options now available to protect infants against severe RSV, including an antibody given to babies and a vaccine given in pregnancy. Eligibility depends on your baby’s age and the season, so ask us what applies to your child rather than relying on anything written online, including this page.
Who is most at risk
- Babies under 6 months, especially those born prematurely
- Children with chronic lung or heart conditions
- Children with weakened immune systems
RSV care in MetroWest, Orlando
If your baby has a cold and the breathing is changing, call us the same day on (407) 445-9224. Primary Care Pediatrics, 1507 S Hiawassee Rd, Suite 105, Orlando, FL 32835, Monday to Friday, 9:00 AM – 5:00 PM. See also same-day sick visits.
