RSV, Flu & COVID-19: Practical Steps to Protect Your Newborn This Season

Why this matters now

Newborns (especially infants under 3 months) are uniquely vulnerable to respiratory viruses. Their airways are small, their immune systems are immature, and they can deteriorate quickly with infections such as respiratory syncytial virus (RSV), seasonal influenza, and SARS‑CoV‑2 (COVID‑19). RSV is a leading cause of infant hospitalization during respiratory virus seasons, and public‑health tools now exist to lower the risk for many infants. This article gives practical, clinician‑oriented steps families can take this season—and the red flags that require urgent care.

Key sources for the prevention options and clinical signs used in this guide include U.S. public health and professional organizations. Please read the prevention checklist and talk with your baby’s pediatrician about what applies to your household’s health history and local virus activity.

Practical prevention checklist

1. Ask your clinician about RSV protection options

Two primary tools are now used to reduce severe RSV in young infants: maternal RSV vaccination during pregnancy and a single‑dose long‑acting monoclonal antibody given to infants (for example, nirsevimab/Beyfortus). ACIP/CDC guidance recommends maternal RSV vaccine or infant antibody to protect most infants; health systems recently added a second monoclonal option for some infants. These products are time‑sensitive and are usually given before or during the infant’s first RSV season—talk to your obstetrician or pediatrician about timing and eligibility.

2. Vaccines that protect newborns indirectly

• Influenza: Pregnant people should get an inactivated flu shot during flu season; vaccinating household members also reduces infant risk (a “cocooning” effect). Ask providers about timing—ideally before or early in flu season.
• Pertussis (Tdap): Tdap in pregnancy (recommended during each pregnancy) helps protect the newborn from whooping cough, which can be severe in young infants. Ensure caregivers are up to date.

3. COVID‑19: vaccination and household protection (guidance in flux)

Guidance on COVID‑19 vaccination for pregnant people and children changed in 2025 and remains under review; recommendations may differ from previous seasons. Because national policy has evolved, talk with your OB and pediatrician about the current local recommendations and whether vaccination for family members or the infant (if age‑eligible) is advised for your household. Regardless of vaccine policy shifts, keeping household members up to date when recommended and avoiding sick contacts helps protect newborns.

4. Day‑to‑day measures that make a big difference

• Wash hands and encourage visitors to do the same before holding the baby; use alcohol‑based sanitizer if soap and water aren’t available.
• Keep anyone with symptoms (runny nose, cough, fever) away from the baby until cleared by a clinician or symptoms resolve.
• Limit large, crowded indoor visits during peak respiratory season; prefer short visits and keep them in well‑ventilated rooms.
• Breastfeed when possible—breastmilk delivers antibodies and supports infant immunity. Discuss lactation support with your provider if you need help.
• Reduce smoke exposure and indoor irritants (no smoking indoors, use HEPA filters if household members have allergies/asthma) to lower the risk of more severe respiratory illness.

Recognizing warning signs — when to call your pediatrician or seek emergency care

Newborns can progress quickly from mild symptoms to dehydration or breathing trouble. Use conservative thresholds—if you are worried, call your baby’s pediatrician or your local urgent care. Key red flags include:

• Difficulty breathing: fast breathing, nose‑flaring, chest retractions (skin pulling in between ribs or above the breastbone), grunting, audible wheeze. Call right away.
• Poor feeding or fewer wet diapers: infant refuses two or more feeds or you notice significantly fewer wet diapers (possible dehydration).
• Apnea or pauses in breathing (especially in very young infants).
• Blue, gray, or very pale skin or lips; limpness or hard‑to‑wake behavior—these are emergency signs; call 911 or go to the nearest emergency department.
• Fever in a newborn under 3 months: any rectal temperature ≥100.4°F (38°C) warrants immediate medical attention.

If your baby is breathing poorly, not drinking, or worsening over hours, do not wait—seek urgent care or emergency services.

Questions to have ready when you call

• When symptoms began and how they have changed.
• Feeding amounts and wet diaper counts in the last 24 hours.
• Any recent exposures to sick people (household, childcare, visitors).
• Baby’s birth history (gestational age, NICU stay, underlying conditions) and current medications.