Kristie McNealy, MD

Since it’s both Prematurity Awareness Month and the start of RSV season for many of us here in the US, I thought I’d spend some time today talking about RSV and protecting your preemie once you leave the hospital.  Respiratory syncytial virus (RSV), is a common seasonal virus.  For most of the continental United States, RSV season begins around November, and ends in March or April, although this can vary somewhat from year to year, and from region to region.

RSV is both common and highly contagious.  Almost all babies contract RSV by the time they are two, and most people who have RSV just feel like they have a bad cold.  The problem is that preemies and young infants are highly susceptible to severe RSV infections.  Each year up to 125,000 infants and young children are admitted to the hospital as a result of RSV infection, and about 2% of these children die from complications of RSV.

Groups at high risk for developing life-threatening RSV infections include:

• Premature babies (35 weeks gestation or less)
• Infants under 6-8 weeks of age
• Infants or toddlers with cyanotic heart disease
• Infants or toddlers with chronic lung problems like asthma & bronchopulmonary dysplasia
• Multiples
• Infants with school age siblings
• Infants exposed to passive smoke exposure
• Infants who attend daycare.

You’ll want to protect your preemie or NICU baby from both RSV and influenza throughout the winter and into the spring.  Here are a few trips for avoiding these common illnesses:

• Wash your hands frequently, especially before picking up your baby.
• Keep an alcohol based hand sanitizer with you for times when you can’t get to a sink.
• If you have other children in preschool or daycare, consider pulling them out for the winter season.
• If at all possible, avoid sending your preemie to daycare.
• Avoid crowds and don’t let strangers touch your baby when you’re out in public.
• Avoid playgroups with kids who are in daycare or who have school-aged siblings.
• Get everyone in your family who’s old enough a flu shot, and encourage extended family and friends to do the same.
• Find out if your baby is a candidate for Synagis, a medication which helps prevent RSV, and if so, make sure they get it every month during the RSV season (typically Oct-March).
• Let family and friends know how dangerous RSV and the flu can be for your preemie, and ask them not to come over if they have a fever, cold or the sniffles.

Early symptoms of RSV look very much like a cold, and include a fever, runny nose and cough.  Babies with RSV can become very sick, very quickly.  If you’re concerned that your baby might have RSV, contact your pediatrician or take them to the emergency room right away.  Signs of worsening RSV infection include:

• Wheezing
• Rapid breathing
• Retractions – muscles in the neck and chest pulling to help the lungs expand
• Gasping for breath
• Bluish skin around mouth or fingernails.

If your friends and family think you are being over protective or worrying too much because you are taking steps to protect your baby from RSV, send them here, or to RSVProtection.com to learn more.  I’ll also be discussing some tips of my own for dealing with family later this month.  If you think your baby is at risk, visit the Synagis website to find out if your baby might be a candidate for monthly injections to help prevent RSV infection.

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