RSV: 5 things to try
RSV is all over the news. Here is what to do if your child tests positive for RSV bronchiolitis.
The most important thing
Do not panic.
Remember, most children have been infected with RSV by the age of 2 years and recover just fine. We worry most about those children who are very young (under 6 months) or have underlying medical issues, such as prematurity, lung or heart disease, or immunosuppression.
Don’t overlook the impact on the elderly as well. Anyone can catch the infection - most adults and older children will have congestion and a mild cough, but the elderly and very young can have serious symptoms.
The Pediatrician Mom Tip: Remember, symptoms are likely to be worst on days 3-5 of illness.
5 things to try
Nasal suction
Use saline mist and a nose frida or a netipot (older kids) to clear out mucus. Remember: congestion interferes with breathing, sleep or feeding, so these are the most important times to clear out the nose.
Humidified air
Cool mist humidifiers or sitting in a warm steamy bathroom can both help. In the hospital, hypertonic saline nebulizer treatments have been shown to improve airway clearance. While I do not recommend hypertonic saline at home, you can also try to use nebulizer treatments with regular (sterile) saline to see if this is helpful.
See my medicine cabinet recommendations for info on the hand-held nebulizer we keep at home.
Honey
Only for children over 12 months of age! We have good evidence that shows honey is effective to decrease night-time cough and improve symptoms for children with upper respiratory symptoms. I have a post with details on my instagram page, but practically, this is what I recommend:
For kids under 1 year: NO HONEY
For kids 1-2 years: use between 0.5 - 1 teaspoon as needed (can be given directly or thinned out with water, or as below). Can be done a few times per day.
For kids over 2y: 1-2 teaspoons as needed
Other ways to use honey:
As part of an herbal tea (no caffeine!)
Mixed with turmeric. This is an old Ayurvedic remedy (half teaspoon turmeric mixed with honey — can also mix with warmed milk, called Haldi Doodth)
Mixed with pedialyte
The Pediatrician Mom Tip: If you give honey, make sure you’re brushing teeth well, especially at the end of the day!
Hydration
This is KEY. Dehydration is a common reason children with RSV are admitted to the hospital. Cough, rapid breathing and fever increase fluid loss - and therefore fluid requirements. Additionally, most children are not as enthusiastic about feeding/drinking when they are sick. Focus on smaller, more frequent feeds and sips. Watch urine output. See here for more.
Manage fever
Remember, your goal is comfort. Don’t obsess over numbers, but recognize that when children have fever they often are less comfortable, breathe more rapidly, and refuse fluids.
Preventing snowballing:
The Pediatrician Mom Tip: RSV is transmitted via contaminated surfaces as well as contact with respiratory droplets. It can live on surfaces for several hours (including hands).
Unfortunately, RSV is very contagious. Virus can be shed for a week after symptom onset, and even longer in young infants and immune compromised individuals.
Some basic things you can do to prevent transmission within your household are:
Effective, frequent hand washing with soap and water for at least 20 seconds
Make sure you wash hands after diaper changes!
Hand sanitizers are ok in a pinch but they don’t work as well as good old-fashioned soap and water
Wiping down frequently touched surfaces such as door-knobs, counters, etc
Wipe them with paper towels and then disinfect using a bleach-based household cleaner.
For toys: either run them through the sanicycle in your dishwasher, or if they are more delicate, wash with soap and water or a cleaning product that contains bleach.
