Last updated: September 2026
RSV in babies usually starts like an ordinary cold, gets worst on days 3 to 5 when the cough and wheeze set in, and then clears over one to two weeks. The signs that mean a baby needs to be seen are about breathing and feeding: fast or labored breaths, pauses in breathing, blue lips, or too few wet diapers. In North Georgia the season typically arrives in October and peaks around December and January, so now is the time to line up prevention.
Key takeaways
- RSV symptoms peak on days 3 to 5. The first two days often look like a mild cold, so do not relax until you are past day 5.
- Babies under 6 months, premature infants, and children with heart or lung disease are at highest risk of hospitalization.
- Go to the ER or call 911 for struggling breaths, retractions, breathing pauses, or bluish lips. Call us the same day for breathing faster than 40 breaths per minute, refusing feeds, or fewer wet diapers.
- Two prevention tools now exist for infants: an antibody shot for the baby (nirsevimab or clesrovimab) or a maternal RSV vaccine given at 32 to 36 weeks of pregnancy.
What is RSV and why does almost every baby get it?
Respiratory syncytial virus infects the nose, throat, and, in young babies, the small airways deep in the lungs. In older children and adults it is a cold. In infants, whose airways are only a few millimeters wide, the same swelling and mucus can block airflow and cause bronchiolitis.
Almost all children get RSV before their second birthday. [Source: AAP HealthyChildren.org, RSV: When It’s More Than Just a Cold] Most are mild. The CDC estimates that two to three of every 100 infants under 3 months old are hospitalized with RSV each year. [Source: CDC, RSV in Infants and Young Children]
RSV spreads through coughs, sneezes, and surfaces. People with RSV are usually contagious for 3 to 8 days, though young infants can shed the virus longer. [Source: CDC, How RSV Spreads]
When is RSV season in Georgia?
Nationally, RSV spreads in fall and winter and usually peaks in December and January. [Source: CDC, About RSV] Timing varies by region and year. [Source: CDC, Clinical Overview of RSV] The Southeast typically runs ahead of the national curve, and in Georgia we typically start seeing positive rapid RSV tests in October, with the busiest weeks from December into January.
If your baby is due this fall or winter, or is under 8 months old now, the window to get protection in place is September and October, not December.
What do RSV symptoms look like day by day?
Symptoms usually appear 4 to 6 days after exposure.
Days 1 to 2: a cold. Runny nose, congestion, sneezing, mild cough, and sometimes a low fever. At this stage RSV looks like any other cold, which is why it helps to know how colds differ from flu.
Days 3 to 5: the peak. The cough gets deeper, breathing gets faster, and you may hear wheezing (a high-pitched whistle on the out breath). This peak on days 3 to 5 is typical. [Source: AAP HealthyChildren.org, RSV: When It’s More Than Just a Cold] In very young infants the only signs may be irritability, decreased activity, and trouble breathing, with little or no fever. [Source: CDC, Symptoms and Care for RSV]
Days 6 to 14: recovery. Breathing settles first, then appetite. The cough can linger two weeks or more. A baby getting worse instead of better after day 7 needs a visit.
When the small airways are involved, the illness is called bronchiolitis, and it is the reason RSV puts babies in the hospital.
Which babies are at highest risk from RSV?
The CDC lists these groups as highest risk for severe illness: infants under 6 months (especially under 3 months), babies born prematurely, children with chronic lung disease or congenital heart disease, children with weakened immune systems, and children with neuromuscular conditions that make it hard to clear mucus. [Source: CDC, RSV in Infants and Young Children] If your baby is in one of these groups, call us at the first cold symptom during RSV season.
What are the warning signs that RSV is serious?
Count breaths for a full minute while your baby is calm, and watch the bare chest and neck.
| What you see | What it means | What to do |
|---|---|---|
| Breathing faster than 40 breaths per minute, sustained | Working harder to move air | Call us the same day |
| Nostrils flaring with each breath | Increased effort | Call us the same day |
| Grunting sound at the end of each breath | Airways under strain | Go to the ER |
| Retractions: skin pulling in between or under the ribs, or at the neck | Significant distress | Go to the ER |
| Pauses in breathing (apnea), or struggling for every breath | Emergency | Call 911 |
| Blue, gray, or pale lips or face when not coughing | Not enough oxygen | Call 911 |
| Fewer wet diapers than usual, dry mouth, no tears | Dehydration | Call us the same day |
| Refusing feeds or too breathless to finish a bottle | Cannot keep up with fluid needs | Call us the same day |
| Any fever in a baby under 3 months, or fever above 104°F repeatedly | Needs evaluation | Call us or go to the ER |
The 911 and ER rows follow AAP guidance for bronchiolitis, which also flags breathing over 40 breaths per minute as a sign of concern and advises calling your doctor within 24 hours for any baby under 6 months who is worse in any way. [Source: AAP HealthyChildren.org, Symptom Checker: Bronchiolitis-RSV] Newborns normally breathe faster than older babies, so if you are unsure, call us.
A baby who is breathing hard often cannot feed well, and dehydration follows. Our guides on dehydration signs in babies and how many wet diapers a newborn should have give you a baseline. For fever by age, read child fever: when to worry.
How do you treat RSV at home?
There is no antiviral for routine RSV. Care is supportive, and done well it keeps most babies home.
- Saline and suction. Two or three saline drops in each nostril, then suction with a bulb or aspirator, before feeds and before sleep. A clear nose is the most useful thing you can do.
- Small, frequent feeds. Offer half the usual amount twice as often. If feeds fall well below normal, call us. Our guide on how often a newborn should eat gives normal ranges.
- Upright positioning while awake. Hold your baby upright on your shoulder to help drainage. For sleep, always place your baby flat on the back; do not prop the mattress.
- Fever control. Weight-based acetaminophen; ibuprofen only for babies over 6 months. Comfort helps feeding.
- No cough or cold medicine. The AAP is direct: always avoid cough and cold medications in babies and young children, and never give aspirin. [Source: AAP HealthyChildren.org, RSV: When It’s More Than Just a Cold]
What does not work for RSV?
In typical RSV bronchiolitis, neither antibiotics nor steroids help. Antibiotics treat bacteria, and RSV is a virus. [Source: AAP HealthyChildren.org, Bronchiolitis] Steroids have not been shown to shorten routine bronchiolitis, and the AAP notes that most children with bronchiolitis get little benefit from asthma-type medicines.
Some babies do respond to a bronchodilator, so if we hear wheezing we may try a nebulizer treatment. A hospitalized baby may need oxygen, IV fluids, or deep suctioning; most improve with that care and go home within a few days. [Source: CDC, RSV in Infants and Young Children]
How can Georgia parents prevent RSV in babies?
RSV is now preventable. The CDC recommends that every baby be protected through one of two routes (not both). [Source: CDC, RSV Immunizations to Protect Infants]
Option 1: an antibody shot for the baby. Nirsevimab (Beyfortus) and clesrovimab (Enflonsia) are long-acting antibodies, not vaccines. One injection gives at least 5 months of protection. The CDC recommends a dose for all infants under 8 months entering their first RSV season whose mother did not receive the maternal vaccine, given shortly before the season or within one week of birth for babies born October through March. Nirsevimab is also recommended for a second season in high-risk children 8 to 19 months.
Option 2: the maternal RSV vaccine. Abrysvo (RSVpreF) is given at 32 through 36 weeks of pregnancy, September through January in most of the country. Antibodies cross the placenta and protect the newborn for about 6 months, cutting the risk of RSV hospitalization by 57 percent. [Source: AAP HealthyChildren.org, RSV: When It’s More Than Just a Cold] If you received Abrysvo at least two weeks before delivery, your baby generally does not need the antibody shot.
If you are due this fall or winter, ask your OB about Abrysvo now and bring the record to your baby’s first pediatrician visit. Not sure which option fits? A conversation with your pediatrician sorts it out.
Everyday steps still matter. Wash hands before handling the baby, ask visitors with cold symptoms to wait, keep a sick sibling out of the baby’s face and off the baby’s toys, and wipe shared surfaces. [Source: CDC, How RSV Spreads]
How Sun Pediatrics can help
Sun Pediatrics offers in-office rapid tests for RSV, flu, strep, and COVID at all four offices, so you leave knowing what your baby has and what to watch for. If we hear wheezing, we can give a nebulizer treatment in the office. Every physician is board certified, and our team cares for children from birth through 18.
Same-day sick visits are held every day, and secure video visits work well for a “should I bring my baby in?” check. Offices are open Monday through Thursday 8:00 to 4:45, Friday 8:00 to 4:15, and we run a Saturday clinic from 9:00 to 12:00 on the first and third Saturday. We see children from birth through 18 in Marietta, East Cobb, Alpharetta, and Cumming.
Request an appointment online or call 678-501-5601. Same-day sick visits are held every day at all four offices.
Frequently asked questions
How long is a baby with RSV contagious?
Usually 3 to 8 days. Young infants and children with weakened immune systems can spread the virus for several weeks, so keep a recovering baby away from newborns.
Can my toddler get RSV twice?
Yes. RSV does not give lasting immunity. Repeat infections are usually milder because the airways are bigger.
Should I go to urgent care or the ER for RSV?
For retractions, grunting, breathing pauses, or blue lips, go to the ER or call 911. For fast breathing, poor feeding, or fewer wet diapers without those emergency signs, call us first; a same-day visit with a pediatrician is usually the better choice than urgent care for a baby.
My baby already had the antibody shot. Can she still get RSV?
Yes, but the illness is far more likely to stay a cold. The shot prevents severe lower-airway disease, not every infection. Watch for the same warning signs.
This article is for general information and is not medical advice. Contact your pediatrician for care specific to your child.
