When your baby has a slight cough or runny nose, it’s easy to assume it’s just a cold. However, these mild symptoms can sometimes be the first signs of something more serious, such as RSV. In India, infants under six months or those born prematurely are especially at risk.







Understanding the early signs and risks and when to seek medical help gives you confidence as a carer. This guide is here to help you spot warning signs early and make informed decisions.







What is RSV?RSV stands for Respiratory Syncytial Virus. It often begins with upper respiratory symptoms (nose, throat). In many infants, it stays mild. But in some, it affects the lower airways—leading to bronchiolitis or pneumonia. Studies in India show that RSV detection in children varies widely—from 2.1% to 62.4%—depending on region and season. RSV cases often rise after the monsoon and into the early winter months in India.







Early Signs to Watch ForEarly signs may seem mild. But prompt attention matters. Here’s what to look for:

Runny nose / nasal congestion	Clear or slightly thick mucus, sniffles
Cough	Starts mild, may become wet or persistent
Reduced feeding or appetite	Less interest in breast or bottle
Irritability or sleep disturbance	Fussiness, difficulty settling
Mild fever	Up to 38 °C or slightly more
Less wet nappies / fewer wet diapers	Possible dehydration warning

In very young infants (< 6 months), you might also see:

• Periods of apnoea (pauses in breathing)


• Low activity or lethargy


• Sometimes, no fever—just tiredness or poor feeding

Why RSV Can Be RiskyNot every baby with RSV will face complications. But some factors increase risk:

• Age: Babies under 6 months are more vulnerable.


• Premature birth: Under developed lungs and weaker immunity.


• Underlying conditions: Heart problems, lung issues, and immune disorders.


• High-exposure environments: Crowded living conditions, poor ventilation, and congested areas.


• Seasonal surges: In India, RSV burden contributes to many cases of infant bronchiolitis or pneumonia.

In India, RSV contributes significantly to hospitalisations in infants.







When RSV progresses:

• Bronchiolitis: inflammation of small airways


• Pneumonia: infection of the lung tissue


• Respiratory distress: difficulty breathing, use of extra muscles.


• Dehydration: due to feeding issues or fluid loss

When to See a Doctor — Red FlagsIf you observe any of these signs, seek medical help without delay:

• The baby is breathing fast (in infants, > 60 breaths per minute)


• Laboured breathing: retractions (skin pulling under ribs or around neck), flaring nostrils, grunting


• Lips, face, or nails turning bluish or greyish in tone.


• Severe dehydration: fewer than one wet nappy in 8 hours, dry mouth, sunken fontanelle


• Apnoea: frequent or prolonged pauses in breathing


• Poor feeding or inability to suckle


• Lethargy or reduced response to stimuli


• High fever that doesn’t improve after 2–3 days

Also, if symptoms worsen rather than improve, always consult your paediatrician.







What Happens at a Doctor VisitDoctors will evaluate your baby using:

• Clinical exam (listening to chest, checking breathing)


• Oxygen saturation monitoring


• Possibly a nasal swab test to detect RSV


• In severe cases: chest X-ray, blood tests, or hospitalisation for supportive care

Treatment is mostly supportive (no specific antiviral cure).







What doctors may do:

• Provide oxygen support


• Give intravenous (IV) fluids if feeding is not possible.


• Use humidified air or nebulisers to ease breathing.


• Monitor carefully for complications.

Most infants recover with good hospital care over a few days.







How You Can Support Your Baby at HomeAlways follow the doctor’s guidance. But some home care helps:

• Clear nasal passages gently (saline drops + bulb suction)


• Use a cool-mist humidifier in the room.


• Keep the baby hydrated. Breastfeeding is beneficial because breast milk contains antibodies.


• Ensure the baby is resting and comfortable.


• Avoid exposure to sick people; practise good hygiene.


• Clean toys, surfaces, and surroundings regularly

Remember, these steps can help manage symptoms, but they are not a substitute for medical care in serious cases.







RSV in babies often starts like a common cold but may escalate quickly. Detecting early signs—such as runny nose, cough, or feeding difficulty is vital. Knowing which risk factors to watch and being alert to red flags like laboured breathing or dehydration ensures your baby gets timely care. While many infants recover with supportive care, serious cases require medical supervision. Your calm awareness, swift response, and collaboration with healthcare providers could make all the difference in helping your baby emerge safely.








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FAQs on Respiratory Syncytial Virus (RSV) in Babies: Early Signs, Breathing Difficulties, and When to See a Doctor

Can RSV be prevented?

Yes, there are steps you can take to reduce the risk. These include avoiding crowded places during RSV seasons, practising good hand hygiene, limiting close contact with sick people, and cleaning surfaces regularly. For high-risk infants such as premature babies doctors may recommend preventive antibody therapy.

How long does RSV illness last in babies?

Symptoms typically last 7 to 14 days, though the cough may persist for longer. The worst period is often days 3 to 5.

Will my baby get RSV again?

Yes. Babies can get RSV more than once. Later infections tend to be milder, as the immune system develops over time.