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What to Look For in RSV

by Sue Hubbard, M.D.

Boy oh boy, RSV is really here and so more thoughts on that topic. The office is just full of coughing and wheezing kids of all ages, much of which is RSV. But the ones I am really concerned about are the infants and babies under the age of one year. They have a harder time with the virus and this infant age group is the group that statistically gets hospitalized more often. The buzz among moms about RSV continues (but at least less buzz about vaccines). They are all concerned and confused about when they need to come and see the pediatrician and also what “they” as parents need to watch for. Both of these concerns are important.

As we talked about before, almost all children get RSV by one year of age. In most cases it will just be a bad cold, but in some babies they will develop bronchiolitis (or airway inflammation of the lower respiratory tract) and they have a classic, frequent, non-productive cough, lots of secretions and often have a wheeze when listened to with the stethoscope. In most cases these babies are fairly “pathetic” and cough and awaken throughout the night, may not eat quite as well, and just feel “puny” and require a lot of parental care and TLC. Babies and therefore their parents don’t get a lot of sleep when RSV is around.

The babies I worry about are those that have true difficulty breathing. They not only cough frequently, they have signs of increased work of breathing which is evident by “pulling or retracting” while breathing. When you take off their shirts (which is what you should do at home too to look at how they breath), you see their ribs pulling or their abdomens working to help them breath. They look uncomfortable, not just while coughing, but also while just trying to get a breath. If this gets worse they may even grunt with each breath. I also worry about the your-baby that coughs and coughs and has “duskiness” with their cough. Most parents report that their your-baby gets bright red with cough, and eyes water and they may even vomit with cough. But a your-baby that turns even A LITTLE dusky needs to be seen immediately. Remember, red is good, blue is bad!

Unfortunately RSV is here for a while. This is the peak season in most of the country and will be for weeks. Keep those young babies away from others and if your your-baby develops cold symptoms, look at how they breathe. If in doubt, take them in.

That’s your daily dose, we’ll chat again tomorrow.

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