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

Cold and flu season is here, with a vengeance. An unseasonably early arrival of respiratory syncytial virus (RSV) has pediatrician offices, urgent care centers, emergency departments and inpatient units across the U.S. reeling from extremely high patient volumes.

We know there's a lot of scary news out there right now, but for most kids, RSV is just a miserable virus. Take these steps to ease your child’s 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 easily last a month. You can get the infection at any age and more than once in your lifetime. It tends to be particularly tough on babies and toddlers because the worst episode of RSV is usually the first time you catch the germ.

For the majority of children with RSV, symptoms can be successfully managed at home. Below, Children’s Hospital of Philadelphia (CHOP) Pediatricians, Julie Kardos, MD, and Naline Lai, MD, offer actionable ways parents can care for mild to moderate illness at home. They also note some of the red flags to watch out for that might require a trip to the doctor.

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. For the little ones who can’t (or won’t) blow their noses, put a drop or two of nasal saline in each nostril and use a suction device like a bulb syringe to pull out the discharge. Warning: Overzealous bulb suctioning can be irritating to the nose. Sometimes just the saline alone, without the suction, is enough to promote sneezing which will catapult 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 has been shown to work as well as popular over the counter cough medications without the possible 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 alleviate 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 the best forms of 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 hydrating foods like watermelon and cucumbers, are all great sources of hydration when ill. 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? Drs. Kardos and Lai recommend parents trust their instincts when trying to determine 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 underlying medical conditions, has a weakened immune system, or is seen by a specialist, be sure to check with their specialty care team if you have any concerns.)

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 the use of the shoulders or stomach to breath. Also 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
• Unable 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 are struggling to keep them hydrated and there is a change in their baseline urine output, they need medical attention. Other signs of dehydration include a dry mouth, lethargy and lack of tears when crying.

Pain

Like all cold viruses a child with RSV might develop bacterial infections such as ear infections, pneumonia, or sinus infections. Pay attention to complaints of ear pain, chest pain or sinus pain.

The bottom line

Don't panic! 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!