Little full and cranky? Doctors offer tips for treating RSV at home

Little full and cranky?  Doctors offer tips for treating RSV at home

Doctors are reporting an increase in respiratory syncytial virus among young children, a common illness that usually emerges a little later in the fall and winter season.

Only a small proportion of cases are serious enough to require hospitalization (most children can be treated and recover at home), but RSV is fairly common among infants and young children, says Dr. Jesse Papenburg , pediatric infectious disease specialist at Montreal Children’s. Hospital.

By the age of one, half of children will have been infected with RSV, and about two percent of cases end up in the hospital, he says. By the age of two, 90 percent of children will have had RSV.

A very small proportion of children are at risk of severe RSV, mainly infants with heart or lung disease or those who were born prematurely, it says.

Here are some tips on what to do when your little one starts showing symptoms of RSV.

HOW DO I KNOW IT IS RSV?

Children with RSV often have the same symptoms as a common cold. The Canadian Pediatric Society says it can include cough, runny nose, fever, and loss of appetite and energy. Some children, especially very young babies, can develop an infection called bronchiolitis that causes wheezing and shortness of breath.

Dr. Mélissa Langevin, an emergency medicine pediatrician at CHEO in Ottawa, says nasal and respiratory congestion is common.

“You can imagine that the smaller you are, the more congestion affects your ability to breathe, to eat and drink, and to be comfortable,” says Langevin.

HOW LONG DOES IT LAST?

Expect an RSV attack to last more than a week, Langevin says, with a fever typically lasting a day or two and the peak of illness coming on days four and five.

“This usually gets worse before it gets better. And that is a natural course of RSV. And after that peak, kids usually turn the corner and start doing much better,” says Langevin.

HOW DO WE TREAT RSV AT HOME?

Dr. Antonio D’Angelo, chief of the pediatric emergency department at Montreal’s CHU Sainte-Justine, says maintaining hydration and comfort is key. For babies, it is especially important to clean the nose because they depend on a liquid diet and have to breathe while drinking and swallowing.

“If they are completely congested, what happens is that they take a lung full of air out of their mouth and as they breathe they can choke,” he says.

He suggests cleaning a baby’s nose with saline solution so he can drink properly. The drops can cause a cough, and that’s a good thing, he adds.

“Sometimes they even cough to the point of throwing up some secretions and that’s good because you want those secretions out of their bodies,” he says.

Langevin recommends a “snot pacifier” for children under six months who are very congested. If clearing your nose and clearing secretions doesn’t help, see your primary care provider.

“I always tell families not to worry too much about solids, your kids may not be very hungry for solids, but you want to drink a lot very often.”

Langevin says babies should be watched closely for signs of difficulty breathing. That can include pulling between the ribs or pulling on the neck.

WHEN SHOULD WE GO TO THE ER?

Take your child to an emergency department if he’s having trouble breathing or his lips look blue, says the Canadian Pediatric Society.

Babies younger than three months with a fever should always be taken to the emergency room, CPS adds, or if they can’t suck or drink.

For those a little older, the society says symptoms that warrant a doctor’s attention include fever for more than 72 hours, loss of appetite or vomiting, or coughing to the point of choking or vomiting.

Watch for any signs of shortness of breath and monitor for fatigue, eating and drinking, D’Angelo says.

“If they can’t drink half as much as they normally would, or if they’re so distressed that they get fatigued… then obviously they need to be seen by the emergency department,” he says.

HOW CAN WE PREVENT INFECTION?

Papenburg recommends many of the tips we’ve learned in protecting ourselves against COVID-19: wash your hands often and stay home when you’re sick.

“Don’t go to visit young children if you are sick, even if it is just a minor cold. Avoid visiting newborns especially,” she says.

“When in crowded indoor areas, wearing a mask can help reduce risk for children and adults as well.”

For babies at very high risk of serious infection, a monthly injection of a monoclonal antibody called palivizumab can be given during RSV season to help cut the risk of hospitalization in half, says Papenburg.

— With Jordan Omstead Archives in Toronto

This report from The Canadian Press was first published on October 26, 2022.

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