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Pediatrics/Is RSV always serious in preemies?


I have a daughter who was born at exactly 33 weeks (after PPROM at 28 weeks and 5 weeks of hospital bedrest).  

She had no issues at birth, had healthy lungs and only had to stay in the NICU until she could eat on her own and has done well gaining about 2 lbs a month since birth (4 lbs 6 oz at birth).

After everything we went through to get her here healthy, I am terrified of her getting severely ill.  She doesn't qualify (in Canada) for Synagis.

She is currently 21 weeks actual age, 14 weeks corrected and to date, we have been able to keep her healthy.

I am scared to death of her getting ill as I read such terrible stories about preemies and RSV or other respiratory illnesses.  Currently her dad and I have a cold.  We are both wearing masks, washing our hands and hers obsessively and doing our best to avoid passing this onto her.  She is 100% breastfed and I hear conflicting reports as to whether this will help her.  As it is summer, it is possible this is not RSV, but any type of respiratory infection scares me.  At the advice of the NICU, we have done our best to isolate her, haven't taken her to large gatherings or shopping malls, etc., but this time it is us that has brought home the germs.

Is RSV always severe in preemies?  If she catches a respiratory illness at such a young age with 'preemie' lungs is she likely to suffer from asthma as I hear preemie lungs are never fully caught up until about 2 years of age?  How scared should we be (realistically) of her catching our cold?  I have read that SIDS is often more common when a child has a respiratory infection and based on her corrected age, she is at the prime risk time for SIDS so that scares me too.

Thank you,

Hi, Lisa,

She may have preemie lungs, but only in the sense of being born prematurely.  She did not have prolonged ventilation and apparently did now have lung disease of prematurity.  This greatly lessens her chances of a serious outcome due to an RSV infection.  

Synagist is fine, but not the panacea for infection that you might have heard.  Her lungs are fine and the asthma issue is only significant in those that have had a tough neonatal course.  She basically from your description, was a kid who had to put on weight and control her temp and otherwise was fine.

Breastfeeding is always helpful.  I'm not sure of a big protective effect against RSV, but the longer you do it, the better she will we.

I would start treating her as the healthy kid she is and have everybody around her get all their shots, including adult pertussis and influenza vaccines.

Good luck, Dr. Olson


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David Olson, MD


I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.

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