Q: My 77-day-old baby has a mild fever, chest retractions, and a metallic cough after a sibling's RSV. Should we go to the ER?

Medically reviewed by Sang Hyun Ahn, MD

Content edited by Myeongchan Kim, MD

This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

Question:

My 77-day-old baby has a fever. My older child was diagnosed with RSV 6 days ago and is currently receiving outpatient treatment. The baby started having a wet cough on Thursday and we started them on prescribed medication on Friday. Since Saturday afternoon, the baby's temperature has been fluctuating between 37.6°C and 38.0°C. They are breathing rapidly, their chest is pulling in deeply when they breathe (chest retractions), and they have a metallic-sounding cough. I am hesitant to go to the emergency room because the fever is relatively mild. Should we go to the ER, or should I just give fever reducers, continue the prescribed medication, and observe at home?

Answer:

⚠️ Immediate emergency medical attention is required.

A 77-day-old baby experiencing chest retractions (the chest pulling in deeply with each breath) is showing a clear sign of respiratory distress.

You must take the baby to the emergency room right now due to the following critical factors:

• Chest retractions (labored breathing where the skin pulls in between or under the ribs)

• A metallic, barking-sounding cough

• A fever reaching 38.0°C in an infant under 3 months of age

• Direct exposure to a sibling with RSV

While on your way to the emergency room:

• Hold the baby in an upright position to help them breathe more easily.

• Keep a written record of their body temperature and respiratory rate.

• Make absolutely sure to inform the emergency room triage and medical staff that the older sibling was recently diagnosed with RSV.

Infants under 3 months old can deteriorate very rapidly. Even if a fever appears to be mild, any sign of respiratory distress or breathing difficulty warrants an immediate medical evaluation. RSV can be extremely dangerous for young babies, so please do not delay and seek urgent in-person medical care at the ER right away.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

https://fevercoach.us