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2 days ago6 min read

What every parent needs to know about RSV- prevention

By Heather Cresswell, Neonatal Nurse Practitioner



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Respiratory Syntactical Virus (RSV) is a hot topic this time of year, and with good reason. October usually marks the beginning of “RSV season” - that time of year when emergency rooms and pediatric units start filling up with babies and young children who are sick with RSV. The good news is there is a lot we can do to protect babies most at risk for getting sick with RSV during winter viral season. And the time to get started is right now.


RSV is a common virus that affects the lower respiratory tract (the small passages that delivery air to the lungs). When someone becomes infected with RSV, the virus attaches to the cells in the small airway passages causing inflammation and swelling. Inflammation in the these tiny airway passages is called bronchiolitis and can cause severe coughing and difficulty breathing. Sometimes, RSV can also cause pneumonia (infection in the lungs).


Who is most at risk of getting sick with RSV?

Anyone can get RSV, but babies, young children with certain health conditions, and older adults are most at risk of getting very sick . RSV is so common that 95% of children will have had an RSV infection by 2 years of age.

It is important to know that any baby can get very sick from RSV, even if they were born at term and healthy. However, there are some babies and young children that are at higher risk severe illness. Those at highest risk include:

  • Premature babies (especially if they get RSV during the first 6 months of life)

  • Babies and young children with some types of congenital heart defects

  • Babies and young children with Down Syndrome

  • Babies and young children with chronic lung disease

  • Babies or young children with other health conditions that affect their immune system, lungs or airways.

If you are not sure if your baby is considered at higher risk of getting sick with RSV, talk to your baby’s NICU team or healthcare provider.





How can we protect babies from RSV?


There is a lot we can do to protect babies and young children from RSV this fall and winter. You’ve probably heard all of this before, especially if you’ve been through the NICU, but let’s review the basics:

  • Always clean your hands with soap and water or hand sanitizer before you touch your baby.

  • Clean your hands after you blow your nose, sneeze, or cough.

  • Do not smoke or let others smoke around your baby or in your home.

  • Keep your baby away from anyone who is sick.

  • If you are sick, do not kiss your baby.

  • Keep your baby away from crowded places.

  • Keep providing breastmilk if you are sick (antibodies you make to fight infection go into your milk and protect your baby)



All about RSV prophylaxis (prevention medicine) for babies


RSV prevention medicine (RSV prophylaxis) have been around for decades in Canada.

What is RSV prophylaxis?

RSV prophylaxis is an medicine given by an injection (needle), or a series or injections. The injection gives babies antibodies (proteins that fight viruses) that protect the baby from RSV right away. The antibodies are synthetic (made in a lab), and stop the RSV virus from attaching to cells in the respiratory tract.

RSV prophylaxis is not a vaccine.  Vaccines trick the immune system into making antibodies. RSV prophylaxis gives the body antibodies for immediate protection. RSV prophylaxis is not a treatment for RSV and is not given if a baby already has RSV-illness.

In Canada, we have 2 medications for RSV prophylaxis. The brand of prophylaxis and the eligibility criteria are different depending on where you live.

  • Synagis (palivizumab). Palivizumab is a once-a-month injection that prevents RSV-illness by providing RSV-blocking antibodies. The antibodies last just over a month, and babies who qualify should get an injection about once a month during RSV season (usually October until February or March). Palivizumab is usually only given to babies and young children considered at highest-risk of severe RSV-illness.

  • Beyfortis (nirsevimab). Nirsevimab also gives RSV-fighting antibodies though an injection, but the antibodies last for many months and only a single injection is needed. Currently, nirsevimab is available in Ontario, Quebec and Nunavit. If you live in one of these regions, nirsevimab s available to all babies born in 2024, and some older babies or young children with certain risk factors. Ask your child’s healthcare provider for more information.


About the RSV vaccine for pregnant moms

You may have heard some buzz about the RSV vaccine now available in Canada. This vaccine tricks the immune system into thinking it has been exposed to RSV, and stimulates antibody production. The vaccine is not approved for use in children or babies, but is available to older adults or those considered at high-risk of severe illness.

The RSV vaccine is also available to pregnant women in some circumstances - but it is actually given to protect the soon-to-be-born baby. When a mother makes antibodies against a virus, those antibodies travel across the placenta to the baby during the last weeks of pregnancy. To be effective, the RSV vaccine must be given at least 2 weeks before the birth of her baby.

In general, RSV prophylaxis (palivizumab or nirsevimab) given to the baby is more effective at preventing RSV-illness than a mother getting the vaccine before birth. If a mother does get the vaccine during pregnancy, the baby may not be eligible for RSV prophylaxis. If a baby will not be eligible for RSV prophylaxis, or parents know they will not want their baby to have RSV prophylaxis, maternal vaccination should be considered. All parents should talk to their healthcare provider during pregnancy about their options.


What to do if you think your baby may have RSV

Sometimes, despite our best efforts, babies get sick. If your baby gets a cold, it doesn’t mean that you did something wrong.

Some signs your baby may be getting sick are:

  • Fever (visit this Caring for Kids website if you are not sure how to take a temperature or what temperatures are normal)

  • irritability

  • Poor feeding

  • Stuffy or runny nose

  • Cough

Call your baby’s healthcare provider right away if your baby:

  • Has a decreased appetite

  • Has cold symptoms (nasal congestion, irritability, cough, or seems sick)

  • Has a fever and is older than 3 months (or 3 months past your due date for premature babies) - if you baby is younger than 3 months, see below.

Take your baby to the emergency department if your baby:

  • Will not eat or is having dry diapers

  • Has a fever and is younger than 3 months (or 3 months past your due date for preemies)

  • Has a bad cough (coughing so badly they are vomiting or can’t eat)

  • Is much sleepier than usual

Call 911 if your baby:

  • Has difficulty breathing or stops breathing

  • Looks blue

  • Will not wake up or is very difficult to wake

From the Canadian Premature Babies Foundation Booklet- Common Respiratory Illnesses: Reducing the risk (page 5):



Where to find more information

If you have questions about RSV, don’t hesitate to talk to your baby’s healthcare provider!

The Canadian Premature Babies Foundation website has many resources available including an information book about respiratory viruses, RSV information sheets in 18 languages and links to your province or territories RSV guidelines.

Other resources:

Other references:



“An ounce of prevention is worth a pound of cure” (Benjamin Franklin, 1735)



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Heather Cresswell is a Neonatal Nurse Practitioner and health writer. As a nursing student in 1995, Heather discovered the NICU during a clinical placement and never looked back. She has spent her entire nursing career (more than 25 years and counting) caring for NICU patients (premature babies are her favourite!). When not caring for her tiny patients, Heather is also a health writer and is happy to contribute to the Canadian Premature Babies Foundation.

Heather lives with her family in Burlington, Ontario, and is a proud mom to one son.

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