How to Treat RSV at Home and When to Go to the Doctor

In 2022, respiratory syncytial virus (RSV) hit hard. While for most kids, RSV is just a miserable cold virus, for others, it can lead to hospitalization or an admission to the intensive care unit.

As we head into another RSV season, there is hope. There is a new preventive medication approved for babies before or during their first RSV season. That, plus common-sense prevention tips, can make a big difference for little ones at risk for getting the sickest. Learn more about how to prevent RSV and, if your child does get it, how to ease their discomfort and get through the worst of it at home, if possible. 

What is RSV?

RSV is a virus that causes a miserable cold with thick mucus and a cough that can last a month. You can get the infection at any age and more than once in your lifetime. RSV tends to be particularly tough on babies and toddlers because the worst episode of RSV is usually the first time you catch the virus.

For the majority of children with RSV, symptoms are mild to moderate, and parents can manage them at home. But there are some red flags to watch out for that might mean a trip to the doctor.

How to prevent RSV

• Practice trusted infection prevention steps! This means good handwashing and staying home when sick to prevent the spread of germs.
• Get a dose of antibody before the RSV season starts. A new preventive medication is now available. The Centers for Disease Control and Prevention (CDC) recommends it for babies before or during their first RSV season. The medication's name is Beyfortus (Nirsevimab). It is a single dose “monoclonal antibody” given in one shot into the muscle. It puts antibodies into the bloodstream that will help babies fight the virus. It decreases the chances of getting very sick and landing in the hospital from RSV. Babies can get it at the hospital when they are born, or your pediatrician's office. Some high-risk babies are also eligible for a dose before or during their second RSV season. Ask your baby’s pediatrician for more information.

To learn more about the new preventive medication for RSV:

• Listen to this podcast episode to hear more about the science behind the monoclonal antibody, it's safety and proven benefits.
• Watch this video from the Vaccine Education Center to learn about the product's effectiveness in clinical trials, who should receive it and when.

How to tell if my child has RSV

Signs of RSV typically peak on days three, four and five of illness. They may include:

• Runny nose
• Coughing
• Sneezing
• Loss of appetite
• Fever
• Wheezing

How to treat RSV at home

Like all colds, there is no medication to kill RSV. However, there are many ways to ease your child’s discomfort at home, including:

• Clear up congestion. If your little one can’t (or won’t) blow their nose, put a drop or two of nasal saline in each nostril. Use a suction device like a bulb syringe to pull out the discharge. Warning: Overzealous bulb suctioning can be irritating to the nose. Sometimes the saline alone is enough to promote sneezing, which will shoot out the mucus.
• Pick up steam. Run a cool mist humidifier in your child’s bedroom and give steamy baths. The water vapor loosens congestion. Note: Use a cool mist humidifier rather than a vaporizer, which is a burn hazard.
• Let honey help. If your child is at least a year old, try giving them honey to help relieve their cough. Honey works as well as popular over the counter cough medications without the side effects.
• Relieve pain. Give acetaminophen (if over 2 months of age) or ibuprofen (over 6 months of age) as needed for fever or discomfort. These medications can help ease muscle aches, headaches and sore throats. For ear pain, you can also put a warm washcloth over the ear.
• Stay hydrated. For infants, breast milk or formula are best for hydration because of their nutrition. For older children, mix it up. Make sure there is salt and sugar in their fluids if they are not eating. Apple juice, water, popsicles, milk, soup, and foods like watermelon and cucumbers are also great sources of hydration. Milk will not make mucous worse. 

How to know if a medical visit is needed

So how do you know when to take your child for medical care? Trust your instincts when trying to decide if a child’s cold requires medical attention.

Navigating Sick Season

Frequent illness is a normal part of childhood. Focus on what you can control and use these tips to help navigate the inevitable illnesses that circulate every year.

If you are not certain, call your child’s pediatrician’s office. You can also use the CHOP symptom checker to help you determine how serious their symptoms are. If your child has other medical conditions, has a weakened immune system, or sees a specialist, be sure to check with their specialty care team. 

In general, keep an eye out for these signs of a more serious case:

• Breathing trouble. This looks like:
  • Rapid breathing
  • Using extra muscles to breathe (watch for them using their shoulders or stomach to breathe, and look for the skin between the ribs getting sucked in with each breath)
  • Grunting at the end of each breath
  • Nostrils flaring with each breath
  • Pale or blue lips/mouth
  • Inability to breathe and drink at the same time
  • Lethargy
• Dehydration. Most kids urinate every three to six hours or so. You know your child’s baseline. If you struggle to keep them hydrated and they don't pee as much as usual, they need medical attention. Other signs of dehydration include a dry mouth, lethargy and lack of tears when crying.
• Pain: Like all colds, a child with RSV might develop ear infections, pneumonia or a sinus infections. Pay attention to complaints of ear pain, chest pain or sinus pain.

The bottom line

Don't panic! If your child is eligible, you can be proactive and take advantage of the antibody treatment to help prevent serious illness. If they do get sick, take steps to ease your child’s discomfort and get through the worst of it at home, use your judgement, and watch for the above warning signs.

We’ll get through this together!