RSV and Bronchiolitis in Babies and Toddlers

Respiratory syncytial virus, or RSV for short, is a strange-sounding name for an illness you may not have heard of, but it’s more common than you may think. Usually RSV only causes cold-like symptoms, but sometimes it can lead to a lower respiratory tract infection known as bronchiolitis in babies or toddlers under the age of 2. Read on to learn more about RSV and bronchiolitis.

What Is RSV and How Do You Get it?

Respiratory syncytial virus is just one of many viruses that can cause a cough or cold in children and adults. In babies younger than 2 years old, RSV can sometimes lead to bronchiolitis or – in much rarer cases – pneumonia. Like many viruses, RSV can spread through saliva droplets when someone coughs or sneezes. It can live on surfaces like countertops or toys for several hours. This means your child could get infected by touching anything that has been contaminated and then touching his or her mouth, nose or eyes. The RSV infection can last from one week to several weeks depending on its severity.

What Are the Symptoms of RSV in Babies and Toddlers?

A mild case of RSV can cause cold-like symptoms such as:

If the RSV infection spreads to the lower respiratory tract, it can lead to bronchiolitis, an infection of the small airways of the lungs. It's not the same illness as bronchitis, which is where the larger airways of the lungs become infected and inflamed.

Bronchiolitis Symptoms

The symptoms of bronchiolitis include:

  • Rapid breathing

  • Wheezing

  • A rasping cough that doesn’t go away

  • Brief pauses in breathing

  • Vomiting after feeds.

How Common Is RSV and Bronchiolitis in Young Children?

Respiratory syncytial virus is an extremely common cause of lower respiratory tract infections in infants and young children. In fact, RSV is so common that nearly all kids have had it by the time they reach 2 years old. Luckily, in most cases, it only causes cold-like symptoms that improve on their own. For a smaller number of babies, the RSV infection can lead to bronchiolitis, which may need medical care.

How Contagious Is RSV?

Respiratory syncytial virus is highly contagious. Your child is most likely to catch it between November and March – the cold and flu season – although it’s possible to get it at any time of year. It’s also possible to catch it more than once. The RSV virus can spread quickly at playgroups and schools, so your baby can easily get it at playgroup or from an older sibling who brings the virus home from nursery or primary school. Keep in mind that your baby can spread an RSV infection through direct contact with anyone. No matter how difficult it is to resist, someone who kisses your baby’s cute little face, for example, could potentially pick up the virus.

Is It Possible to Prevent RSV?

Although you can’t completely protect your baby from infections like RSV, there are some simple steps you can take to reduce your little one’s risk of coming into contact with the RSV virus and getting infected:

  • Ask all family members, caregivers and visitors who come into contact with your baby to wash their hands with soap and warm water for at least 20 seconds before holding your child

  • Avoid having your baby come into contact with people who have cold or flu-like symptoms, such as a runny nose or temperature, especially if your infant is less than 3 months old

  • Regularly disinfect common objects and surfaces in your home like doorknobs, toys, kitchen counters etc. to cut down on germs like the RSV virus and others

  • Don’t smoke around your baby, as this can increase the risk of your child developing bronchiolitis

  • If you’re breastfeeding, you may like to know that antibodies produced by your immune system can be passed on to your baby in breast milk. These antibodies help prevent and fight infectious diseases such as RSV in your baby too.

Who Is Most Susceptible to RSV and Bronchiolitis?

Your infant may be at a higher risk of developing severe RSV or bronchiolitis if he or she

  • was born prematurely

  • has chronic lung disease

  • has congenital heart disease

  • has a weakened immune system.

When Should You See a Doctor?

Mild cold symptoms that seem to improve over time will usually clear up by themselves, but see your child’s doctor straight away or call 111 if your baby is less than 12 weeks old or if you notice any of the following symptoms:

  • Symptoms of bronchiolitis, such as a rasping cough and wheezing

  • Loss of appetite (taking less than half the usual amount at the last two or three feeds)

  • Signs of dehydration (such as no wet nappy for 12 hours or more)

  • A fever of 38 degrees Celsius or more

  • Your baby seeming very tired or crotchety.

Call 999 if your child

  • has trouble breathing (you might notice the skin being sucked in under the ribs, your baby grunting to breathe or looking pale and sweating)

  • is breathing very fast

  • can’t be woken or has trouble staying awake if woken

  • stops and starts breathing intermittently

  • has bluish skin, lips or tongue and inside of the mouth.

How Is an RSV Infection or Bronchiolitis Diagnosed?

If you suspect your little one has RSV or another respiratory infection, the doctor may ask you to describe the symptoms. Your child’s doctor may then give him or her a physical examination and listen to his or her breathing with a stethoscope. If your baby is having trouble breathing or shows signs of dehydration your child’s doctor may recommend treatment or further tests in hospital. These tests could include:

  • Nasal swab (to take a sample of mucus and test it to find out precisely what virus is causing the bronchiolitis)

  • Urine or blood test

  • Pulse oximeter test (using a small electronic device that clips to your baby’s finger or toe and measures the oxygen in his or her blood).

How Is RSV Treated?

There is no medicine available to treat the RSV that causes the infection. Keep in mind that since it’s a virus, antibiotics would not be prescribed because they’re only effective against bacterial infections. However, there are some things you can do at home to ease mild symptoms and help make your child more comfortable:

  • Keep your child upright. This can help with breathing, especially during feeds. You might find that changing to a more upright breastfeeding position is beneficial while your baby has RSV or bronchiolitis.

  • Give your child plenty of fluids. If your baby is still being nourished exclusively with breast milk or formula, it may help to give smaller but more frequent feeds. Additional sips of water can also help keep your child hydrated if you’re bottle feeding your infant or you’ve started to introduce solid food.

  • Take your baby’s temperature. Monitor your child’s fever and use the medicine recommended by your infant’s doctor to bring it down if necessary.

  • Try saline nasal drops. Ask your pharmacist or doctor whether over-the-counter saline (salt water) nasal drops might help ease your child’s blocked nose.

  • Don’t use cough or cold medicines. If your child has a cough, don’t give over-the-counter cough or cold remedies unless your child’s doctor has advised it. A soothing warm honey and lemon drink might help ease the symptoms of a cough or sore throat in a toddler, but keep in mind that you shouldn’t give honey to a baby under 1 year old.

  • Don’t smoke in the house. Cigarette and other kinds of tobacco smoke can make your child’s symptoms worse.

Hospital Treatment for RSV with Bronchiolitis

If your baby has a more severe case of bronchiolitis your doctor may recommend spending a few days in hospital for closer monitoring and additional treatment including:

  • Extra oxygen through a mask or thin tube placed in the nose

  • Help with feeding if your baby isn’t getting enough nourishment

  • Nasal suction to help clear your baby’s nose and airways.

The Bottom Line

RSV is one of those more common childhood illnesses that your baby or toddler may catch at some point – and may even catch more than once. Typically, it causes only cold-like symptoms and will resolve within a few days or weeks, but in some cases it can lead to complications like bronchiolitis. Good hygiene habits like regular handwashing, disinfecting surfaces and keeping your baby away from anyone who has cold-like symptoms can help prevent your baby or toddler from becoming infected with RSV. If your baby does get it, some simple at-home TLC is usually enough; but if the symptoms do become more severe, your doctor will be able to recommend the best treatment. Although it can be hard when your little one is feeling poorly, try not to worry too much about RSV–whether you’re caring for your little one at home or your little one requires a short hospital stay, your little one will be in good hands and will be feeling better soon.

How we wrote this article
The information in this article is based on the expert advice found in trusted medical and government sources, such as the National Health Service (NHS). You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.

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