What does respiratory syncytial virus infection mean in infants?

RSV often begins with a runny nose, blocked nose, cough, reduced appetite, or fever. In some infants the infection moves into the smaller airways, causing bronchiolitis. You may notice faster breathing, wheezing, noisy breathing, or the skin between the ribs pulling inward. A young baby may mainly show poor feeding, fewer wet nappies, unusual sleepiness, or irritability rather than a strong cough. Symptoms can change over several days, so observing breathing and feeding matters as much as checking temperature.

Infants born prematurely, very young babies, and children with heart, lung, or immune problems can become more unwell with a respiratory infection. RSV is contagious and spreads through respiratory droplets and contaminated hands or surfaces.

Keep the infant comfortable and offer smaller, more frequent feeds if congestion makes feeding tiring. Clear the nose gently with saline and a suitable nasal aspirator before feeds, if advised by a clinician. Hold the baby upright while awake and provide a smoke-free environment. Do not give cough medicines or other medicines unless a healthcare professional has recommended them for this infant. Monitor breathing, alertness, feeding, and wet nappies, and arrange medical advice if these are worsening.

Seek urgent medical help if the infant is struggling to breathe, breathing pauses occur, the lips or face look blue or grey, the baby is difficult to wake, or feeding is much reduced with signs of dehydration. Chest retractions, grunting, or marked exhaustion also need prompt assessment. A fever in a very young infant should be discussed urgently. If you are worried about the baby’s breathing or responsiveness, do not wait for symptoms to become severe.

Ask whether the infant’s breathing and hydration need assessment, how to count breaths, which feeding changes are concerning, and whether any underlying condition increases the risk of severe illness. You can also ask when to return for review and which medicines, if any, are appropriate.