Dr Phil Kieran: Worried my baby niece will get RSV
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Breathing problems are among the scariest emergencies in medicine, and during my first few years working as a GP they often kept me awake with worry.
We all fear a sudden severe breathing illness in someone we are responsible for and worry that either we will miss it or underestimate it and something tragic will happen.
RSV, or respiratory syncytial virus, is the most common cause of lower respiratory infections in children in Ireland. During the winter months, the virus accounts for a significant portion of my workload in smaller kids.
Thankfully, most cases are mild and never need to be seen by a doctor.
RSV tends to follow seasonal patterns, being far more common in the autumn and winter months than in the summer, and it tends to be more severe in those younger than a year.
It is also more likely to be more severe in children who were born premature, those with lung or heart issues, and kids who live in a house with people who are smokers.
For most children, RSV looks like any other cold: runny nose, mild cough, fever, and sometimes a bit of breathing discomfort.
As this is a virus, there is no treatment, such as antibiotics, so the immune system must fight it.
For children who are hospitalised with RSV, the main things we do for them are help them breathe and feed them through a tube if they can’t feed themselves. This gives their bodies time to fight off the virus.
Given that your niece ended up in hospital, it’s understandable that you are worried this will happen during the night while you are minding her. However, the chances of her going from perfectly well to needing hospital in such a short period is incredibly low.
The most common issue that lands children in hospital with RSV is dehydration as they are unable to feed due to rapid breathing or they are too tired to keep up with the fast breathing that can come with an infection. Both these scenarios take some time to develop.
Warning signs to look out for are very rapid breathing (more than 50 breaths per minute), something we call increased work of breathing, where the patient seems to have to put a lot of effort into their breathing and is experiencing excessive fatigue or unexpected drowsiness. These signs are pretty noticeable, so I think you can trust yourself.
Parents often ask me for specific warning signs, but I encourage them to trust themselves.
If you think the child needs medical attention, get them checked, and if you think they are all right, you are probably correct.
Also, if your niece already had RSV this season, she is unlikely to get a severe case again. Although you don’t gain long-term immunity to RSV from infection, there does appear to be some protection within the same season.
- If you have a question for Dr Phil Kieran, please send it to parenting@examiner.ie