Home Help for families Information & Advice Health & medical information Common concerns Flu and RSV Respiratory syncytial virus (RSV)
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A coughing and wheezing baby or child is always a worry, but even more so if your child already has a health condition or complex medical needs.
RSV (respiratory syncytial virus) is one of the most common viral causes of coughs and colds in winter. It’s highly infectious, and the main cause of breathing difficulties (bronchiolitis) in young children. Most babies and children infected with RSV get mild symptoms of bronchiolitis, but some can become unwell with breathing difficulties and need to be admitted to hospital.
In 2021, doctors predict more children than ever in the UK will contract RSV. Over the past year there have been few respiratory viral infections, other than Covid-19. But right now, rates are unusually high for this time of year. This is because since the easing of Covid restrictions, more people are mixing, and there are many young children who have never been exposed to RSV.
Our health lead Amanda Elliot has compiled the following questions and answers to help you protect your child from the virus, better understand the symptoms of bronchiolitis and know what to do if you baby or child becomes very unwell with breathing difficulties.
And if you are a parent caring for a child aged 5 and under please join our new baby and toddler email group and get our latest advice to help you and your child stay well this winter.
RSV (respiratory syncytial virus) is one of the most common viruses that cause coughs and colds. It circulates widely in the UK in the autumn and winter months, peaking in December. Almost all children are infected with the virus by the time they’re two years old.
RSV may cause a cough or cold in children and adults, but in young children it is the main cause of bronchiolitis. In fact, it’s the most common cause of bronchiolitis in children aged under two.
Most cases of bronchiolitis are mild, and children recover without treatment within two to three weeks. Some children are more vulnerable to the virus and breathing problems, so it is important to look out for more serious problems.
The virus enters the windpipe and makes its way down to the smallest airways in the lungs (bronchioles). The infection causes inflammation or swelling in the small airways and excess mucous.
Swelling can narrow and block the child’s airways so it is harder for them to breathe. Babies and young children have small, underdeveloped airways, so they are more likely to get bronchiolitis.
Early symptoms usually appear a few days after becoming infected and are like a common cold, such as a blocked or runny nose, cough or slightly high temperature. Symptoms can appear worrying and usually get worse between the third and fifth day before gradually improving. Symptoms may include:
Parents need to be especially vigilant if their child or baby:
The virus spreads through coughing and sneezing. Children can breathe in tiny droplets of liquid in directly from the air or pick it up from an infected surface, like toys or a table.
Your child can become infected after touching a toy that has the virus on it and then touching their eyes, mouth, or nose. The virus can survive on a surface for up to 24 hours. A child can remain infected with RSV for up to three weeks even after the symptoms have vanished.
RSV is easily spread, so it’s impossible to completely prevent it. But there are ways to reduce the risk:
Some children with bronchiolitis need to be admitted to hospital. Babies and children born prematurely (before 37 weeks) are more likely to need to go to hospital. If you are worried, do not hesitate to contact your GP or call NHS 111. Keep these contact numbers handy.
Doctors will refer your baby or child hospital if they are not getting enough oxygen into their blood because they’re having difficulty breathing, or if they are not eating or drinking enough.
Once in hospital, your child will be closely monitored and given various treatments, depending on their condition.
See your GP or call NHS 111 if:
Call an ambulance (999) if:
For more information on breathing difficulties in children and when to call an ambulance, visit the British Lung Foundation website.
Babies or children with bronchiolitis will be admitted to hospital if they are not getting enough oxygen into their blood. Most children need to stay there for a few days.
Your child will be able to leave hospital and return home when their condition has stabilised. This will be when they have enough oxygen in their blood without the need medical assistance, and they’re able to take and keep down most of their normal feeds. Nurses will measure your child’s oxygen levels with your child’s using blood pulse oximeter, a small clip or peg that’s attached to your baby’s finger or toe.
The hospital may also:
There’s no medicine that can kill the virus that causes bronchiolitis, but there are a few things you can do at home to ease mild symptoms and make your child more comfortable (see the section below on how to care for your child at home).
Most children get better within two-three weeks, while some will still have symptoms after four weeks. A small number of children will have severe infection and need hospital treatment.
Antibiotics and corticosteroids are not recommended for treating bronchiolitis.
Children at high risk of developing severe bronchiolitis may be able to have monthly antibody injections (Palivizumab) during the winter (November to March). Children considered to be at high risk include:
The injections may help limit the severity of bronchiolitis if your child becomes infected. But they can be expensive and are not always available on the NHS. Speak to your GP if you think your child has an increased risk of developing severe bronchiolitis.
These care tips can help ease your baby or child’s symptoms. Do not hesitate to contact your GP or out-of-hours service if their condition worsens.
Babies and children can be given paracetamol to treat pain or fever if they’re over two months old. You can give ibuprofen to babies aged three months or over who weigh at least 5kg (11lbs).
Always follow the manufacturer’s instructions. Do not give aspirin to children under the age of 16. Do not try to reduce your child’s high temperature by sponging them with cold water or underdressing them.