Within a week of Brian Hartnett and his wife, Rachel, bringing their newborn, Rosalind, home in 2023, their emotions turned from joy to fear. Their 2-year-old daughter, Josephine, came down with what appeared to be a cold. She then began experiencing coughing fits, so the couple took her to the hospital. 

A test revealed she had respiratory syncytial virus (RSV), a respiratory virus that impacts the nose, throat, and lungs. 

“Before that, she was a proud big sister who happened to hug up on her sister after she was born,” says Hartnett, who is based in Wilmington, North Carolina. “We were worried that Rosalind could, of course, have contacted RSV.”

They were right. The newborn started sniffling, coughing, and wheezing. She eventually tested positive for RSV, too. Her condition became severe: She stayed in the hospital for two weeks and needed a ventilator. 

“It was terrifying,” says Hartnett. “When you see a 2-week-old baby go from pretty much being fine to having a ventilator, it’s very alarming.”

RSV is very common, but it can be serious for some infants and young kids. Between 58,000 to 80,000 children under age 5 in the United States end up in the hospital because of RSV, according to the Centers for Disease Control and Prevention (CDC). Premature babies, kids under 2 (especially those under 6 months), and people who are immunocompromised are at an increased risk. 

“RSV is one of the main reasons previously healthy kids and also otherwise vulnerable kids are hospitalized every year,” says S. Christy Sadreameli, MD, MHS, a pediatric pulmonologist at Johns Hopkins Hospital in Baltimore and a national spokesperson for the American Lung Association. 

What should you do if you think your child has RSV? Experts break down what caregivers need to know. 

Just like any time your child comes down with an illness, the first step is to start monitoring symptoms. RSV symptoms can be similar to those of a common cold. 

“Any child with a runny nose could have RSV,” says Ada Fenick, MD, a physician and professor of pediatrics at Yale School of Medicine in New Haven, Connecticut. 

But the difference is RSV’s affinity for the chest. It can cause bronchiolitis or pneumonia, infections of the lower airways in the chest or lungs, according to the American Academy of Pediatrics (AAP).

“If you combine the lack of previous immunity to the virus and physically just how small and underdeveloped their lungs are, it’s a bad combination,” says Dr. Sadreameli. “That’s why very young kids, even if they’re otherwise healthy, can get very sick with RSV.”

The good news is most kids will get better within 10 days. Most infections resolve on their own, without medical intervention. However, since there is no treatment for RSV, you will want to keep your child as comfortable as possible. 

Make sure your child stays hydrated and gets lots of rest, says Dr. Sadreameli, who adds that over-the-counter cold- or flu-type remedies are not recommended for young children. Always speak with your child’s health care provider before giving acetaminophen or ibuprofen. Consider using a humidifier, as moist air can soothe congestion. 

Parents of babies can use suction devices to remove mucus from their nose when needed, suggests Dr. Fenick. 

Some kids may begin experiencing symptoms that warrant medical attention. For babies under 3 months, a fever should always be evaluated by a medical provider. Other things to look out for regardless of age: “Your child has a lot of coughing, looks like they’re breathing a little faster, or has trouble getting air,” explains Dr. Fenick.

How do you know a child is struggling with their breathing? Aside from that hard or fast breathing, Dr. Sadreameli says you may notice nose flaring or movement in their ribs.

“A thing you may see is what looks like the ribs flaring out a little bit, like the muscles are sucking in around it, or the tummy is sucking in very hard,” continues Dr. Sadreameli. “These are all things that could be a clue that the oxygen levels are also low, and even if the oxygen levels aren’t low, these signs are a clue to seek medical attention and to be evaluated.”

In Hartnett's case, he used the Owlet Dream Sock—which monitors heart rate, oxygen levels, sleep patterns, and movement—on both his daughters. He says the device notified him that their oxygen levels dropped. 

Dr. Sadreameli doesn’t necessarily recommend that parents go out and buy the device because she says it’s unclear if it’s sufficiently sensitive to detect what is needed. “However, if they have this device, or any other device that measures oxygen, if it’s reading low, I would err on the side of assuming it could be real,” she says.

If parents notice any concerning symptoms, they should call their child’s health care provider. “I would want to take a look at how bad it is,” says Dr. Fenick. “Some kids need to be supported with oxygen. Some kids need to have extra suctioning. It really depends on what the child’s specific situation is.” Some babies may also require a feeding tube if they are unable to eat properly because of their breathing. 

Experts point out that it’s important to stay as safe as possible during the cold and flu season in order to prevent contracting viruses like RSV.

Handwashing for at least 20 seconds is crucial, according to the CDC.

“Another good preventive measure is not visiting a newborn baby or someone who’s very high-risk when they’re sick,” says Dr. Sadreameli. “Even if an adult feels they have a mild cold, they should remember that it could be RSV and it may not be mild for the baby or the person they’re visiting.”

Dr. Fenick agrees, adding, “If a family member is sick, keep them away or wear a mask.”

Both Dr. Fenick and Dr. Sadreameli encourage families to give their child the RSV immunization, Beyfortus, during their baby’s first RSV season. It’s not a vaccine, but a preventive antibody that became available in 2024. Side effects can include rash, pain, swelling, or hardness at the site of injection.

“That will not necessarily prevent the illness, but it will give them the tools to fight the infection faster and harder, so that they have less of a chance of ending up in the hospital,” explains Dr. Fenick. 

Pregnant people can also receive an RSV vaccine between 32 and 36 weeks of pregnancy. This can protect the baby for about six months after birth. Most babies will not need Beyfortus in this case.

After his family’s RSV experience, Hartnett says they’ve become more proactive about preventive measures like handwashing. He encourages other caregivers to be careful too.

“It’s not to be taken lightly at all. It can come on very, very fast,” says Hartnett. “You have to be vigilant about respiratory infections, unfortunately.”