What You Need to Know about RSV

Matthew Campbell, MD, FAAP, pediatrician with CHI Memorial Pediatric Diagnostic Associates

Matthew Campbell, MD, FAAP, pediatrician with CHI Memorial Pediatric Diagnostic Associates

Respiratory Syncytial Virus, commonly referred to as RSV, is a potentially dangerous breathing condition that primarily affects infants and young children. Anyone can develop RSV, but it’s not dangerous for older children or adults who typically experience general cold symptoms. RSV occurs most often in children under age three, and children less than one year are the most susceptible to the virus.

RSV is more dangerous for premature babies and newborns in the first few months of life because they are most likely to develop significant complications related to an immature immune system and lungs. This means the body hasn’t had enough opportunity to build antibodies to various bacteria, antigens, viruses or other infectious particles that lead to sickness and decreased ability to fight off infections.

Immature lungs do not allow enough oxygen exchange, and oxygen levels can drop. The airways in a baby’s lungs are small and not completely developed, so they may not have as much room for oxygen to move across the lungs and into the blood vessels.

Identifying the Symptoms

The initial symptoms of RSV are congestion, runny nose and cough, and they are often worse in the first seven to 10 days. Some children may experience a decrease in appetite due to significant mucus production. Telltale signs of RSV include breathing faster or retraction, where the muscles under, above or between the rib cage tighten with every breath. Babies with RSV can also become irritable or lethargic.

As a parent with a sick child, it can be hard to know when the right time is to see the doctor. See your pediatrician if your child:

  • Starts to develop difficulty breathing
  • Seems lethargic, listless or inconsolable
  • Develops a new fever
  • Stops drinking and makes less than three wet diapers in 24 hours
  • Has symptoms that worsen after one week instead of improving

For a younger baby – think two or three months old and younger – I would err on the side of caution and consider seeing your pediatrician sooner if you have any concerns. The chance of serious complications like a bacterial infection such as sepsis, urinary tract infections or meningitis are greater in very young children.

Diagnosis and Treatment

Diagnosing RSV requires a simple office test and takes about 15 to 20 minutes. I like to know these results particularly for very young babies because their risk of hospitalization is higher.

Unfortunately, there aren’t many good treatment options for RSV. Parents often ask for antibiotics, steroids or albuterol nebulizer treatments, none of which are effective in addressing this virus. As a pediatrician, I focus on treating the symptoms unless a secondary infection develops. When a baby is really sick or dehydrated, has difficulty breathing or low oxygen levels, hospitalization may be necessary to deliver IV fluids and supplemental oxygen.

At home, focus on saline and suction of the nose to decrease the amount of mucus, and use a humidifier. Some bottle-fed children need Pedialyte rather than formula because milk is thicker and can lead to further mucus production and vomiting. Breast feeding can help because the mom has antibodies to RSV that can decrease the severity of symptoms. The most important thing you can do is to keep your baby hydrated and comfortable until symptoms resolve.  

CHI Memorial Pediatric Diagnostic Associates offers three convenient locations in Chattanooga and Ringgold, GA. To schedule an appointment with Dr. Campbell, call 423.698.BABY (2229).

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