Respiratory Syncytial Virus (RSV) in Newborns: Keeping Little Lungs Safe

Newborns have small, delicate airways and developing immune systems, making them especially vulnerable to respiratory infections. Among the most common, and most concerning, is Respiratory Syncytial Virus (RSV). While older children often recover with mild symptoms, newborns can deteriorate rapidly, sometimes needing close monitoring or hospital care. This article explains what RSV is, how it affects newborns, and what parents can do to protect their little ones.

1. What Is RSV?

Respiratory Syncytial Virus (RSV) is a common virus that infects the nose, throat and lungs. It can infect people of all ages but infants and young children are more at risk of getting a severe illness if infected. Nearly every child encounter RSV before the age of two and nearly 9 out of 10 of these children who get RSV need hospital care. Occasionally, some of the children hospitalized due to RSV need intensive care.

RSV is highly contagious and spreads through:

1. Coughing and sneezing, where droplets carrying the virus enter the air
2. Touching contaminated surfaces. RSV can survive for hours on toys, tables, or clothing
3. Direct skin-to-skin contact (e.g. kissing a baby’s face)

RSV tends to circulate more during cooler months or rainy seasons but can occur year-round in warm climate countries like Malaysia.

Why RSV is often mistaken for a simple cold?

Early symptoms of RSV infection such as runny nose, low-grade fever and cough are mild and cannot be differentiated from other common viral infections.

This is why RSV can go unnoticed initially. However, in infants and young children, the RSV infection can worsen quickly as inflammation affects their small airways, leading to difficulty breathing.

2.Why Are Newborn Infants and Young Children at Higher Risk?

1. Smaller airways

A newborn’s air passages are extremely narrow.

When mucus, swelling, or inflammation occurs, these tiny airways can become blocked quickly, making it harder for babies to breathe or feed.

2. Immature immune system

A newborn’s immune system is still developing.

They cannot fight viruses as effectively, which means RSV symptoms may be more severe.

3. Higher breathing fatigue

Babies tire easily because:

• They breathe faster
• Their chest wall is softer
• Their muscles fatigue quickly

Once tired, they may not be able to maintain adequate oxygen levels.

4. Higher risk groups

Certain newborns have a significantly higher chance of severe RSV infection, which includes:

• Premature babies (due to their immature lungs)
• Babies with congenital heart disease
• Babies with chronic lung disease
• Babies with low birth weight

For these infants, RSV can quickly become life-threatening without prompt care.

3. Early Signs Parents Should Look Out For

RSV symptoms progress in phases. Knowing the early warning signs allows parents to seek help before the condition becomes severe.

Early symptoms, often mistaken for a common cold:

• Stuffy or runny nose
• Sneezing
• Mild cough
• Slight fever
• Difficulty or poor feeding because of blocked nose

At this stage, RSV may seem harmless, but close monitoring is crucial in young infants.

Severe disease caused by RSV can lead to complications such as bronchiolitis (infection of the smaller airways of the lungs) or pneumonia (infection of the lung tissues). The following symptoms are red flags, which signifies breathing compromise and the need for immediate medical attention:

• Rapid, shallow, or noisy breathing
• Chest indrawing (ribs pulling in during breathing)
• Wheezing - a whistling sound during breathing
• Pauses in breathing (apnoea), especially in premature babies
• Bluish lips or skin (cyanosis)
• Dehydration, fewer wet diapers

4. How is RSV Is Treated?

There is no specific antiviral cure for RSV, but supportive care helps young infants recover safely.

Treatment may include:

• Keeping your baby well-hydrated
• Saline drops and gentle suctioning in the presence of nose congestion
• Oxygen support
• Monitoring for complications like bronchiolitis or pneumonia

Babies who struggle to breathe or feed may need hospital monitoring to keep their oxygen levels stable and prevent dehydration.

5. Protecting Your Newborn

Parents can lower RSV risk with simple steps:

• Keep hands clean before touching the baby
• Limit visitors, especially during the newborn period
• Keep anyone sick away from the baby
• Clean pacifiers, bottles, and high-touch items
• Avoid crowded indoor places
• Discuss with your paediatrician about RSV preventive options

Protect Your Baby Early, Your Quick Action Matters

RSV is common, but its impact on newborns and young infants can be severe and fast-moving. Every parent should know the early warning signs, recognise when symptoms are worsening, and seek medical attention promptly.

If you’re concerned about your newborn’s breathing, feeding, or overall health, our Paediatric Specialists at Gleneagles Hospital Kuala Lumpur are here to help.