RSV and Babies: Symptoms, Prevention, and Vaccine Updates

Keep your baby safe from RSV this season with this helpful guide that includes what to look out for, how to reduce your baby’s risk, and the latest recommendations for who should get the vaccine and when. 

As we enter the season of holiday travel, family get-togethers, and crowded indoor events, new parents want to know how to protect their children from common respiratory viruses like RSV, COVID, the seasonal flu, and the common cold. In recent years, RSV rates have significantly increased, with newborns and young babies being among the most severely affected. While the RSV vaccine is currently only available for pregnant people, infants, and people over age 60, thankfully there are several additional ways to lower the risk of contracting or spreading RSV.

What is RSV?

Respiratory syncytial virus (RSV) is a common respiratory virus that usually peaks during the winter months. Almost all children get infected with RSV at least once before they are 2 years old. For most healthy children, RSV acts like the common cold. However, it can be more severe for very young infants and older adults, and can lead to serious illness, hospitalization, and even death, particularly in high-risk groups.

Symptoms of RSV

The symptoms of RSV can vary depending on the age of the individual and their overall health status. For healthy children and adults, RSV symptoms are typically mild and may include:

• Sneezing
• Congested or runny nose
• Sore throat
• Cough
• Low-grade fever
• Headache

RSV symptoms are often worse for infants and younger children. They have underdeveloped immune systems, smaller airways, and have a harder time clearing mucus. Their symptoms may include:

• Wheezing
• Short periods without breathing (apnea)
• Irritability
• Trouble eating, drinking, or swallowing
• Decreased appetite
• Decreased activity

In severe cases, RSV infection can spread to the lower respiratory tract, causing pneumonia or bronchiolitis – inflammation of the small airway passages. In addition to the cold-like symptoms listed above, symptoms of severe RSV infection may include:

• Rapid breathing
• Difficulty breathing – look for the belly and chest “caving in” with each breath, and/or pausing between breaths
• Flaring of the nostrils & head bobbing with breathing
• Rhythmic grunting during breathing
• Skin turning blue or purple due to lack of oxygen (cyanosis) – look for changes to the lips, tongue, gums, fingernails, and around the eyes

RSV: When to Call the Doctor

Because RSV often starts as a regular cold, it’s time to call the pediatrician when those symptoms progress and don’t get better. Call your pediatrician if your baby has:

• Wheezing or persistent coughing
• Decreased activity or appetite
• Ear tugging or ear drainage
• Symptoms of moderate dehydration (not enough wet diapers, dry lips and mouth)
• For babies younger than 12 weeks, a fever 100.4°F or higher
• For a child of any age, a fever over 104°F
• Symptoms that worsen or do not start to improve after 4 days

The scary part of RSV is that it can turn into a serious medical emergency, especially for very young infants. Go to the emergency room if your baby has:

• Difficulty breathing
• Symptoms of severe dehydration (dark yellow or brown urine, no tears when crying)
• Significantly less activity and alertness, or if they are hard to wake up
• Blue, gray, or purple-tinged skin

It’s important that all caregivers know what to do if a baby is seriously ill. Before this cold and flu season starts, make sure the addresses and phone numbers for the pediatrician’s office, the closest Urgent Care facility, and Emergency Room are handy for anyone caring for the baby.

7 Ways to Reduce the Risk of Contracting RSV and other Airborne Viruses

To reduce the risk of contracting RSV and other respiratory viruses like COVID, the flu, and the common cold, the following preventive measures are recommended:

1. Hand Hygiene: Practice regular hand hygiene by washing your hands with warm water and soap for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer as an alternative.
2. Respiratory Etiquette: Cover coughs and sneezes with a tissue or the inside of your elbow. Wash your hands after coughing or sneezing, and promptly dispose of used tissues in the trash.
3. Avoid Close Contact & Limit Time in Crowded Spaces: If possible, limit how long you spend in crowded or shared spaces, such as day care, indoor shopping centers, or large gatherings, to reduce the risk of RSV exposure. Limit close contact with individuals who have RSV or other respiratory illnesses. 
4. Clean Surfaces: Clean and disinfect high-touch surfaces and objects, such as doorknobs, toys, and mobile devices, to reduce the spread of RSV and other germs.
5. Stay Home When Sick: If you are sick with RSV or another respiratory illness, stay home to prevent the spread of the virus to others.
6. Wear a Mask: Wearing a mask can provide protection against respiratory infectious diseases, especially when in crowded or shared spaces.
7. Get vaccinated (if you are eligible)

Is there an RSV vaccine? Who can get it?

The FDA approved the first-ever vaccine for RSV in May of 2023. A 2025 summary of 50 different studies found that when pregnant people, babies, and older adults receive the RSV vaccine, hospitalizations and ER visits go down by 80%!

The following is a summary of the vaccine recommendations for from the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), the Centers for Disease Control and Prevention (CDC), and the American College of and the American College of Obstetricians and Gynecologists (ACOG):

• Pregnant people should receive the RSV vaccine between 32 and 36 weeks of pregnancy if their baby will be born during RSV season (October through March). Their baby will not need an additional infant RSV vaccine.
• Infants birth through 8 months should get the RSV vaccine if their birth parent DID NOT receive an RSV vaccine AND they are going into their first RSV season. This shot can be given at the hospital after birth or at a well-baby checkup. 
• Babies 8 through 19 months who are at increased risk of severe RSV AND are going into their second RSV season should also receive the vaccine. 
• Adults 50-74 years old who are at increased risk of severe RSV should get the vaccine before RSV season begins. 
• All adults 75 years and older should receive the vaccine, which is available year-round.

It is important to talk with your healthcare providers about the best options for RSV vaccination based on you or your child’s age and risk factors.

FAQ for Preventing RSV in Babies

What is the first symptom of RSV?

The first symptoms of RSV for the same as for the common cold: sneezing, stuffy or runny nose, and coughing.

How long does baby RSV last?

For most babies, RSV symptoms last for one to two weeks, with symptoms peaking around days three to five. However, a cough can linger for up to four weeks in some cases.

How is RSV transmitted?

RSV spreads through respiratory droplets from an infected person’s cough or sneeze, which can be inhaled or land on your eyes, nose, or mouth. It can also spread by touching a contaminated surface, like a doorknob, and then touching your face.

What are the treatment options for RSV?

For babies and young children with mild symptoms:

• Nasal saline with gentle suctioning to allow easier breathing and feeding
• Cool-mist humidifier to help break up mucus and allow easier breathing
• Fluids & frequent feedings
• Acetaminophen or ibuprofen (if older than 6 months) to help with low-grade fevers. Always avoid aspirin and cough and cold medications.

More serious cases, especially in infants, the elderly, or those with weakened immune systems, may require hospitalization for:

• IV fluids
• Supplemental oxygen
• Prescription antiviral medication
• How can baby RSV be prevented?

The best way to avoid contracting RSV is to wash your hands frequently, keep surfaces clean, limit the time spent in crowded spaces or with sick people, and stay up to date with seasonal vaccines. For people who are already sick, they can prevent spreading the virus by covering their cough, wearing a mask, and staying home until their symptoms improve. 

When should I take my baby to the hospital for RSV?

Call your pediatrician if your baby has:

• Wheezing or persistent coughing
• Decreased activity or appetite
• Ear tugging or ear drainage
• Symptoms of moderate dehydration (not enough wet diapers, dry lips and mouth)
• For babies younger than 12 weeks, a fever 100.4°F or higher
• For a child of any age, a fever over 104°F
• Symptoms that worsen or do not start to improve after 4 days

Go to the emergency room if your baby has:

• Difficulty breathing
• Symptoms of severe dehydration (dark yellow or brown urine, no tears when crying)
• Significantly less activity and alertness, if they are hard to wake up
• Blue, gray, or purple-tinged skin
• I’m pregnant. Should I get the RSV vaccine?

If you are pregnant, it is recommended that you get the RSV vaccine between 32 and 36 weeks of pregnancy if your baby will be born during RSV season (October through March).

If I got the RSV vaccine when I was pregnant, does my baby still need to get it?

No, if you get the vaccine while pregnant, your baby will not need an additional infant RSV vaccine.

Is the RSV vaccine safe for pregnant people?

According to the American College of Obstetricians and Gynecologists, the RSV vaccine is safe to receive during pregnancy. Studies found that vaccine recipients experienced typical side effects, including pain at the injection site, headache, muscle pain, and nausea. Because there is a slight concern for preterm labor, the vaccine is given between 32 and 36 weeks of pregnancy. 

If you’re feeling overwhelmed by this cold and flu season or simply want expert support as you care for your newborn, we’re here to help. Our experienced overnight newborn care specialists can give you the peace of mind, rest, and guidance you need. Call us today to learn more and reserve the support your family deserves.