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Respiratory Syncytial Virus - The Symptoms of RSV in Children

Medically reviewed by Ika Villanueva Caperonce, MD · Infectious Disease · Makati Medical Center

Written by Lorraine Bunag, R.N. · Updated Jun 01, 2021

Respiratory Syncytial Virus - The Symptoms of RSV in Children

The symptoms of RSV in children sometimes make parents think that their child only has the common cold virus. Here’s what you need to know about the Respiratory Syncytial Virus.

What is Respiratory Syncytial Virus?

The Respiratory Syncytial Virus, shortened as RSV, is one of the most common causes of bronchiolitis in children. Bronchiolitis is the inflammation of the small airways in the lungs (bronchioles). Additionally, it’s also a common cause of pneumonia in small babies. A lot of children will be affected by this virus at least once before their 2nd birthday.

Please note that even adults can contract RSV. It’s just that for them (and for healthy children over the age of two), it’ll present like a common cold. The symptoms of RSV in younger children, especially those with a compromised immune system, are more alarming.

RSV is very contagious. Babies often get them from adults or children who got the virus from school. The virus enters the child’s eyes, mouth, or nose via:

  • Person-to-person contact. This happens through contact and droplet transmission (saliva, mucous, and nasal discharge).
  • Unclean objects. The virus may remain on objects and surfaces for as long as 6 hours.
  • Unclean hands. RSV can stay alive on unclean hands for about half an hour.

Who Are More At Risk of Developing the Symptoms of RSV?

While anyone can get the virus, some conditions predispose a child to be more at risk. Children and small babies have a higher risk of contracting RSV if they:

  • Are born prematurely or have low birth weight.
  • Are just 6 months old or younger.
  • Have a weak immune system or have a pre-existing health condition.
  • Are under 2 years old, with heart disease or lung disease.
  • Have a neurological disorder, especially one that makes it hard for them to swallow or clear out mucous or phlegm.
  • Have Down syndrome
  • Are exposed to secondhand smoke

The Symptoms of RSV in Children – More than just a Cold

If your child has the risk factors mentioned above, you should look closely at the following signs and symptoms.

symptoms of RSV in children

First, look for cold-like signs. Children who only show cold-like signs may improve with home remedies. However, if the cold symptoms are accompanied or followed by the more severe signs, then medical care might be necessary.

The Cold-like Symptoms of RSV in Children

  • Runny nose
  • Mild headache
  • Sore throat
  • Dry cough
  • Low-grade fever
  • General ill-feeling
  • Sneezing
  • Decrease in appetite
  • Earache
  • In young babies, you may notice fussiness, decrease in activity, and pauses in breathing.

Most children will only have the symptoms above. However, few will also experience severe symptoms of RSV in children.

The Severe Symptoms of RSV in Children

With RSV, the cold-like signs may progress to or be accompanied by the following, more severe symptoms. This is especially the case if your child has the risk factors mentioned above. Additionally, note that these symptoms are also related to bronchiolitis, one of the diseases caused by RSV.

  • Short, shallow, and rapid breathing
  • Flaring of nostrils
  • Wheezing; this is when you hear a high-pitched “whistling” sound while breathing
  • Belly breathing; you can note this by looking for the “caving in” of the chest and the formation of inverted “V” under the neck. This means that the child is working too hard to breathe.
  • Cyanosis; the development of bluish tinge in the fingernails and lips.
  • High-grade fever
  • Head bobbing with breathing

When to Seek Immediate Medical Help

Because RSV can lead to complications like pneumonia, middle-ear infection, and asthma, it’s important to bring your child to the doctor if:

  • You notice ANY of the severe symptoms of RSV in children. Pay particular attention to high-grade fever, cyanosis, and signs of difficulty breathing.
  • There are signs of dehydration, especially in babies. You can check by counting their wet diapers. If they have fewer than 1 wet diaper every 8 hours, they might be dehydrated.

Home Management

In most cases, the symptoms of RSV in children are just mild and can be managed at home. If they developed the milder signs, you can:

  • Make them feel as comfortable as possible.
  • Give them plenty of fluids if they are older than 6 months. Be sure to give it to them in small amounts. Small frequent feedings will also help.
  • Give them breast milk or milk formula in small amounts more often.
  • Encourage them to rest for faster recovery.
  • Ask them to expel mucous by encouraging them to blow their nose. If they are too young to do so, you can use a nasal aspirator.
  • Use a cool-mist humidifier, if possible. This will help “breakdown” the mucous.


Now that you have a general idea about the symptoms of RSV in children, it’s time to learn about prevention. To protect your child from contracting RSV, you may do the following:

  • Breastfeed your baby. Breast milk provides antibodies that protect them from infections.
  • Protect your children from people with cold-like symptoms. This includes even siblings and other close family members. Cough and sneeze away from kids and use disposable tissues.
  • Perform frequent hand washing. Wash your hands before approaching or carrying a child. Do it, too, before preparing food and after coughing or touching possibly-contaminated objects. Ask others to wash their hands often, especially if they’ll take care of young children.
  • Wash your child’s toys. This will help prevent the spread of RSV.
  • Clean and disinfect often-touched surfaces. Clean surfaces like doorknobs and counters as children often touch them.
  • Isolate your child’s items. Never share items like washcloths, clothes, utensils, and drinking cups between siblings. Remind older children not to use their sibling’s pacifiers or toothbrushes.
  • Protect your kids from cigarette smoke. This may cause them some respiratory issues and might make them vulnerable to experience the symptoms of RSV in children.

The symptoms of RSV in children will ultimately determine if they need hospitalization. Very few children need hospital confinement, but when they do, they might receive oxygen treatment to help them breathe easier. The doctor might also give them intravenous fluids to help in hydration.


Hello Health Group does not provide medical advice, diagnosis or treatment.

Medically reviewed by

Ika Villanueva Caperonce, MD

Infectious Disease · Makati Medical Center

Written by Lorraine Bunag, R.N. · Updated Jun 01, 2021

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