How to prevent RSV and bronchiolitis in babies

Respiratory syncytial virus is the most common cause of bronchiolitis, which happens when the tiny airways in the lungs, called bronchioles, become infected and fill with mucus.

Bronchiolitis is a common lower respiratory tract infection that often appears in children younger than 2 years old. Bronchiolitis develops when the tiny airways in the lungs, called bronchioles, become infected by a virus, swell and fill with mucus, making it more difficult for a baby to breathe. Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis.

Treatment for RSV and bronchiolitis

“Bronchiolitis often is caused by a virus, so antibiotics or steroids won’t help,” said Ronald L. Morton, M.D., pediatric pulmonologist at Norton Children’s Pulmonology, affiliated with the UofL School of Medicine. “However, parents can do several things to help ease their baby’s symptoms and help them feel more comfortable at home.”

Use saline drops to thin the mucus, followed by gentle nasal suctioning with a suction bulb to remove some of the clogged mucus and help the baby breathe easier. Do not use medicated nasal drops or sprays.

If the child is older than 6 months, recommended doses of acetaminophen or ibuprofen may help reduce fever. Do not administer aspirin because it can cause Reye’s syndrome, a serious condition that affects the liver and brain. Cough and cold medications also should be avoided.

Make sure your baby drinks plenty of fluids to avoid dehydration. They may prefer clear liquids over milk and may feed more slowly or not want to eat. Try the saline drops and suction bulb method prior to feeding, as it can help the baby breathe easier.

Norton Children’s Medical Group pediatrician offices and urgent care

With more than 20 pediatrician offices in the Louisville area, including Southern Indiana, our providers are close to home, school or work.

Preventing RSV and bronchiolitis

People infected with RSV are contagious for three to eight days, according to the Centers for Disease Control and Prevention, and symptoms typically appear two to eight days after exposure. However, some infants can be contagious for as long as a month, even if they are asymptomatic.

Families can take preventive action to avoid infection and limit the spread of the virus:

Good hand hygiene is the best form of defense against RSV and bronchiolitis. The virus is transmitted person to person, through infected respiratory droplets that enter the nose, eyes, or mouth, and by coming into contact with infected objects and surfaces. It can survive on unclean hands for at least 30 minutes.

Disinfect household objects on a regular basis. The virus can live for up to six hours on surfaces like countertops, doorknobs, keyboards, toys, furniture, bedsheets, etc. Children and adults should wash their hands with soap and water, for at least 20 seconds, throughout the day.

Use caution when bringing the baby around others. This includes exposure to crowds, to other kids in school or day care settings, or to anyone who has a cold, even if their symptoms are mild. If a child is sick, they should be kept home to prevent spreading germs to other children.

Do not expose the baby to secondhand smoke. Tobacco and other forms of smoke can increase inflammation and make respiratory symptoms worse.

Breastfeeding can offer extra protection. Breast milk has been shown to reduce infants’ risk of hospitalization for bronchiolitis.

When to be concerned

Some children with severe symptoms of RSV or bronchiolitis may require hospitalization for breathing issues or dehydration. Seek medical care if the baby has signs of respiratory distress including fast, shallow breathing, retractions (chest pulling in with each breath), nasal flaring (nostrils move in and out with breathing), color changes (especially bluish skin on face or extremities),has not had a wet diaper for six hours or longer, or is much more sleepy than usual.