RSV in Babies and Young Kids: Signs to Watch, How to Prevent It and When to Get Help

Quick answer: RSV usually looks like a cold, with a runny nose, cough, sneezing and fever, but in babies it can cause wheezing and trouble breathing. Get urgent care if your child is breathing fast, the skin between the ribs pulls in with each breath, the lips or face look bluish, they pause in breathing, or they have far fewer wet diapers. The CDC recommends protecting every baby with either a maternal RSV vaccine at 32 to 36 weeks of pregnancy or an infant RSV antibody before or during the first RSV season.

Every fall and winter, respiratory syncytial virus, or RSV, spreads through homes, day cares and schools. For most older children and adults, it feels like a cold. For babies and some young children, it can be serious. The CDC says RSV is the leading cause of hospitalization in infants in the United States.

The good news is that protection for babies has improved a great deal in the past few years. This guide, part of our family safety guide, explains what RSV looks like, which signs need medical attention, the prevention options the CDC now recommends and how to care for a child at home. It is general information, not medical advice. Call your pediatrician with questions about your child.

Sources: Centers for Disease Control and Prevention (CDC) pages on RSV symptoms and care, immunizations to protect infants, and clinical guidance for infants and young children; CDC Morbidity and Mortality Weekly Report on ACIP’s 2025 clesrovimab recommendation; American Academy of Pediatrics (AAP) HealthyChildren.org information on RSV and bronchiolitis; U.S. Food and Drug Administration (FDA) guidance on cough and cold medicines for children. Checked November 2026.

What RSV Is

RSV is a common respiratory virus. Nearly all children catch it at least once by age 2, according to the CDC. It infects the nose, throat and lungs. In young babies, it can spread to the small airways of the lungs, causing bronchiolitis, or to the lungs themselves, causing pneumonia.

RSV season in most of the continental United States usually starts in the fall and peaks in winter, though timing can vary from year to year and by region.

How it spreads

RSV spreads when an infected person coughs or sneezes, through direct contact such as kissing a baby’s face, and by touching surfaces that have the virus on them and then touching the eyes, nose or mouth. The virus can survive on hard surfaces such as tables and crib rails for many hours.

People with RSV are usually contagious for 3 to 8 days. Some infants and people with weakened immune systems can keep spreading the virus for as long as four weeks, even after symptoms ease, according to the CDC.

RSV Symptoms in Babies and Young Children

In older babies and toddlers, RSV often starts like a cold. Common symptoms include:

• Runny nose
• Decreased appetite
• Coughing
• Sneezing
• Fever
• Wheezing

Symptoms usually appear in stages rather than all at once.

Symptoms in very young infants

In very young infants, the CDC notes that the only signs may be irritability, decreased activity and breathing difficulties. Some babies do not have a fever. This is one reason to pay close attention to how a young baby is eating, breathing and behaving during RSV season.

Emergency Warning Signs

Call your pediatrician right away, or seek emergency care, if your child has any of these signs:

• Fast breathing or working hard to breathe
• Retractions, where the skin between or under the ribs pulls in with each breath
• Flaring nostrils or grunting with each breath
• Pauses in breathing, sometimes called apnea
• Bluish or gray color around the lips, mouth or fingernails
• Signs of dehydration, such as far fewer wet diapers, no tears when crying or a dry mouth
• Trouble feeding or refusing to drink
• Unusual sleepiness or being hard to wake

Call 911 if your child is struggling to breathe, has blue lips or is not responding normally.

Who Is at Higher Risk

Any baby can become seriously ill from RSV, but the CDC identifies some groups at higher risk of severe illness:

• Premature babies
• Infants 6 months and younger
• Children younger than 2 with chronic lung disease or certain heart conditions
• Children with weakened immune systems
• Children with neuromuscular disorders, including those who have trouble swallowing or clearing mucus

Older adults and adults with certain chronic conditions are also at higher risk, which matters when grandparents and babies spend time together over the holidays.

How to Protect Your Baby: The Three Options

The CDC recommends that all babies be protected from severe RSV by one of these options. Most babies need only one.

Option 1: Maternal RSV vaccine during pregnancy

The maternal RSV vaccine, Pfizer’s Abrysvo, is recommended for pregnant people at 32 through 36 weeks of pregnancy during September through January in most of the United States. It takes about two weeks after vaccination for protective antibodies to develop and pass to the baby. According to the CDC, that protection lasts through about the baby’s first six months, when they are at highest risk.

Option 2: Infant RSV antibody, nirsevimab

Nirsevimab, sold as Beyfortus, is a long-acting antibody given as a single shot to the baby. It provides protection right away and lasts at least five months, according to the CDC. Dosing depends on the baby’s weight.

Option 3: Infant RSV antibody, clesrovimab

In June 2025, the CDC’s Advisory Committee on Immunization Practices recommended clesrovimab, sold as Enflonsia, as a second long-acting antibody option for infants. It is given as a single shot, and the dose is the same for all infants regardless of weight.

Which babies get an antibody

The CDC recommends an infant RSV antibody for babies younger than 8 months who are born during or entering their first RSV season if:

• The mother did not get the RSV vaccine during pregnancy
• The mother’s vaccination status is unknown
• The baby was born within 14 days of the mother’s vaccination

Antibodies are given October through March in most of the continental United States. Babies born during that window should ideally get the dose within their first week of life, often before leaving the hospital. Babies born from April through September should get it shortly before RSV season starts, usually in October or November.

A second-season dose for some children

A small group of children aged 8 to 19 months who are at higher risk of severe RSV are recommended to get nirsevimab before their second RSV season. This includes some children born prematurely with chronic lung disease, children with severe immunocompromise or severe cystic fibrosis, and American Indian and Alaska Native children. Clesrovimab is not recommended for this group.

Talk with your obstetric provider during pregnancy and your child’s pediatrician after birth about which option fits your family.

Everyday Ways to Lower the Risk

Immunization is the most effective protection, but everyday habits help too, especially during the peak of the season:

• Wash your hands often with soap and water for at least 20 seconds, and ask visitors to do the same before holding the baby.
• Keep people who are sick away from young babies, and avoid kissing a baby’s face if you have cold symptoms.
• Clean frequently touched surfaces, such as doorknobs, phones and toys.
• Cover coughs and sneezes with a tissue or your upper sleeve.
• Avoid smoking around children, since tobacco smoke exposure is linked to more severe respiratory illness.

Holiday gatherings bring many relatives together during peak RSV season. It is reasonable to ask guests with cold symptoms to skip holding the baby or to stay home. Our guide to winter home safety for families has more ideas for the colder months.

Day Care, School and Siblings

Older siblings often bring RSV home from day care or school, where it spreads easily among young children. A few habits can help protect a new baby:

• Have older children wash their hands as soon as they come home.
• Teach siblings to give gentle hugs and kisses on the feet or back of the head instead of the face, especially when they have a runny nose.
• Keep the baby’s bottles, pacifiers and toys separate from siblings’ things.
• Wipe down shared toys and surfaces more often during the peak of the season.

When to keep a child home from day care or school depends on the program’s rules and how your child feels. Many programs ask that children stay home with a fever or if they are too sick to take part in normal activities. Ask your child care provider about their illness policy before the season starts so you can plan backup care.

If you are pregnant or have a young baby and an older child gets sick, talk with your pediatrician about steps to protect the baby at home, especially if the baby has not yet received RSV protection.

Caring for a Child With RSV at Home

Most RSV infections go away on their own in a week or two. There is no specific antiviral treatment for most children with RSV, so care focuses on keeping your child comfortable and watching for warning signs.

Fluids

Keep your child well hydrated with breast milk, formula or, for older children, water and other fluids. Babies with stuffy noses may feed more slowly and in smaller amounts, so offer feeds more often.

Clearing a stuffy nose

Saline drops and gentle suction with a bulb syringe or nasal aspirator can help clear a baby’s nose, especially before feeds and sleep.

Fever and comfort

Ask your pediatrician about using acetaminophen or, for babies 6 months and older, ibuprofen to ease fever or discomfort, and follow the dosing guidance for your child’s weight. Never give aspirin to children. Call the doctor for any fever in a baby younger than 3 months.

Cough and cold medicines

The FDA advises against giving over-the-counter cough and cold medicines to children younger than 2 because of the risk of serious side effects. Many products are also labeled not for use in children younger than 4. Ask your pediatrician before using any of these medicines in young children.

Sleep

Keep following safe sleep practices even when your baby is sick. Place your baby on their back on a firm, flat surface without pillows, wedges or positioners. Our guide to safe sleep for babies explains the AAP recommendations.

When to Call the Pediatrician

Even if your child does not have emergency signs, call your pediatrician if:

• Your baby is younger than 3 months and has a fever or any cold symptoms
• Your child is drinking less than usual
• Symptoms are getting worse instead of better after several days
• A fever lasts more than a few days or comes back
• Your child has a high-risk condition and develops cold symptoms

Trust your instincts. If something seems wrong, call.

RSV and Holiday Travel

Travel during RSV season can bring young children into close contact with many people in airports, train stations and family gatherings. If your baby is eligible for RSV protection, try to make sure it is in place before travel. Pack saline drops, a nasal aspirator and a thermometer, and know how to reach a pediatric urgent care or emergency department at your destination. Our tips on traveling with kids can help with planning.

Frequently Asked Questions

Frequently Asked Questions

How do I know if my baby has RSV or a cold?

RSV often starts like a cold, so it can be hard to tell. Only a test can confirm it. What matters most is watching for warning signs such as fast or labored breathing, pauses in breathing, bluish lips or fewer wet diapers.

Does my baby need both the maternal vaccine and an antibody?

Most babies need only one. An infant antibody is generally recommended if the mother did not get the vaccine, her status is unknown, or the baby was born within 14 days of the vaccine.

How long does RSV last?

Most children recover in one to two weeks. Coughing can linger longer.

Can older kids and adults get RSV again?

Yes. People can get RSV more than once. In healthy older children and adults, it usually causes cold-like symptoms.

When is RSV season?

In most of the continental United States, RSV season typically starts in the fall and peaks in winter, though timing varies by year and region.