Respiratory syncytial virus (RSV) is one of the most common causes of respiratory infections in infants and young children. Most infants experience mild, cold-like symptoms, but RSV can sometimes lead to severe RSV disease, especially in very young infants, premature babies, and children with underlying health conditions.
RSV symptoms can look different depending on a child’s age and stage of development. While many healthy babies recover with supportive care, some children are at a higher risk of severe RSV infection that affects the lower respiratory tract and causes breathing trouble. This page explains RSV symptoms in infants and toddlers, how symptoms may progress, and when medical attention is needed.
RSV Symptoms by Age
RSV is a respiratory syncytial virus that usually begins in the upper respiratory tract, causing symptoms similar to those of a common cold. In some children, especially during a child’s first RSV season, the infection can move into the lower respiratory tract and lead to more serious respiratory illness.
The chart below shows how RSV symptoms may appear from the newborn period through toddlerhood, along with signs that may indicate severe RSV disease.
| Age Range | Common RSV Symptoms | Warning Signs to Watch Closely |
|---|---|---|
| 0–3 months (very young infants) | Poor feeding, runny nose, mild congestion, sleepiness, fewer wet diapers | Pauses in breathing, rapid breathing, bluish lips or skin, extreme lethargy |
| 3–6 months | Cough, congestion, runny nose, low-grade fever, irritability | Wheezing, chest wall retractions, decreased feeding, signs of dehydration |
| 6–9 months | Persistent cough, fever, thick nasal mucus, trouble sleeping | Difficulty breathing, worsening wheeze, labored breathing |
| 9–12 months | Cold symptoms, cough, congestion, fatigue, reduced appetite | Breathing trouble, symptoms that worsen instead of improve |
| 12–18 months (young toddlers) | Runny nose, cough, fever, irritability, mild wheezing | Rapid breathing, chest retractions, poor fluid intake |
| 18–24 months (older toddlers) | Respiratory illness with cough and congestion, low energy | Worsening breathing difficulty, signs of lower respiratory infections |
Most infants and healthy children recover without complications. However, premature infants, babies with congenital heart disease, chronic lung disease, or a weakened immune system have an increased risk of severe RSV.
Why RSV Affects Infants and Toddlers Differently
Infants and young children have smaller airways, which makes it easier for swelling and mucus to block airflow during a respiratory syncytial virus disease. Their immune systems are still developing, so they may not fight respiratory viruses as effectively as older children.
RSV often causes more serious illness during a child’s first RSV season. Even during a second RSV season, some children, especially those with heart or lung disease, neuromuscular disorders, or a history of premature birth, may still be at higher risk of severe infection.
RSV Symptom Progression Timeline
RSV infection often starts with upper respiratory tract symptoms, such as a runny nose and a mild cough. Over several days, coughing may worsen and move into the lower respiratory tract, causing wheezing or breathing difficulty.
Symptoms often peak around days five to seven. While breathing usually improves first, cough and fatigue can linger as the respiratory tract heals. Worsening symptoms, especially breathing trouble, may signal severe RSV infection and should be evaluated.
When RSV Symptoms Become an Emergency
Seek immediate medical attention if an infant or toddler shows signs of respiratory distress or severe illness, including:
These signs may indicate severe RSV disease or a lower respiratory tract infection requiring urgent care. |
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When to Go to Urgent Care for RSV
Urgent care evaluation is appropriate when a child’s symptoms are concerning but not immediately life-threatening. Parents should consider a medical evaluation if a child has a worsening cough, wheezing, trouble breathing, persistent fever, or feeding difficulties.
Changes in a child’s symptoms, especially breathing, hydration, or energy level, are often the clearest signs that RSV infection needs medical attention. Trust parental instincts when something feels off.
How RSV Is Diagnosed in Infants and Toddlers
RSV is often diagnosed based on a child’s symptoms and a physical exam focused on breathing effort and lung sounds. Oxygen levels may be checked to assess airflow and oxygenation.
RSV testing may be performed in some cases to confirm RSV infection, particularly in young infants or high-risk babies. Imaging is not routinely needed unless a lung infection or other complication is suspected.
How RSV Is Treated in Infants and Toddlers
RSV is a viral illness, so treatment focuses on supportive care rather than antibiotics. Providers guide families on hydration, feeding, fever management, and home symptom monitoring.
In cases of severe RSV, children may need oxygen or breathing support. Antibiotics are only used if a secondary bacterial infection, such as an ear infection or sinus infection, is suspected.
RSV Prevention for Infants and Toddlers
While RSV cannot always be prevented, these steps help reduce the risk of severe RSV infection and protect babies during RSV season:
- Practice frequent handwashing and clean shared surfaces
- Avoid close contact with an infected person or people with respiratory symptoms
- Limit exposure to tobacco smoke, which increases RSV severity
- Encourage breast milk feeding when possible, as it provides immune support
- Ask a healthcare provider about RSV immunization, including maternal RSV vaccination during pregnancy and monoclonal antibody protection for high-risk infants
These strategies are especially important for high-risk babies, premature infants, and children with heart or lung disease.
Why Choose +MEDRITE Urgent Care for RSV
+MEDRITE Urgent Care for RSV provides same-day evaluation for children’s respiratory syncytial virus symptoms. Our providers are experienced in assessing RSV disease, identifying the risk of severe RSV, and guiding families through appropriate care. Walk-ins are welcome, and appointments are available.
Frequently Asked Questions
Is RSV contagious from babies to adults?
Yes. RSV can spread from babies to adults through close contact, respiratory droplets, and shared surfaces. While RSV often causes mild cold symptoms in healthy adults, it can be more serious for older adults or those with chronic medical conditions.
Can RSV cause a rash in babies or toddlers?
RSV itself does not typically cause a rash. If a rash appears, it may be related to another viral infection, fever, or skin irritation. A healthcare provider can help determine the cause.
Is there an RSV shot for babies?
Some babies may be eligible for RSV prevention options, including monoclonal antibody protection. Pregnant individuals may also receive a maternal RSV vaccine to help protect newborns. A healthcare provider can advise which options are appropriate based on risk factors.
How long does RSV last in babies and toddlers?
In most babies and toddlers, RSV symptoms last one to two weeks. Cold-like symptoms such as a runny nose usually appear first, followed by cough and congestion. Breathing-related symptoms often peak around days five to seven before gradually improving.
Some infants and toddlers may continue to have a lingering cough or fatigue for a few weeks as the respiratory tract heals. If symptoms worsen rather than improve, or if breathing or feeding becomes difficult, medical evaluation is recommended.