What should you know about infant RSV cough?

RSV can start with a runny nose and cough before causing inflammation deeper in the breathing tubes. In infants, coughing may interrupt sucking or come with wheezing and faster breathing. The sound alone cannot diagnose bronchiolitis.

Other causes include a common cold, reflux, allergic rhinitis, asthma, or acute bronchitis. A cough that persists, repeatedly returns, or affects feeding deserves review.

Offer frequent feeds and watch wet nappies. Clear visible nasal mucus gently before feeds, hold the baby upright while awake, keep the room free from smoke, and wash hands carefully.

Do not give honey, cough mixtures, or another person’s inhaler to an infant. Note when coughing occurs and whether breathing changes; a short video may help the clinician.

Get emergency help for pauses in breathing, blue or grey lips, severe chest indrawing, grunting, marked limpness, or an infant who cannot feed. Prompt assessment is needed for much fewer wet nappies or worsening breathing.

Contact a clinician for fever in a very young infant, persistent wheezing, worsening cough, or unusual sleepiness. Urgency depends on breathing and overall condition, not on assuming a cough identifies one diagnosis.

Does this fit bronchiolitis, or could reflux, allergy, asthma, or another problem contribute? Is my baby hydrated, and which breathing or feeding changes should prompt another review?