An infant diagnosed with respiratory syncytial virus is being discharged. Which instruction should the nurse include in caregiver education?

Choice A reason: Placing an infant in a prone position during sleep is unsafe and strongly discouraged because it increases the risk of sudden infant death syndrome (SIDS). The recommended sleep position for infants is supine (on the back), which promotes airway safety and reduces mortality risk. Although prone positioning may appear to improve breathing mechanics temporarily, it is not a safe or evidence-based discharge instruction. Choice B reason: Using a bulb syringe with nasal saline drops is the most appropriate intervention for an infant with RSV. Infants are obligate nose breathers, and nasal congestion can significantly impair feeding and oxygenation. Saline drops loosen thick secretions, and gentle suctioning clears the nasal passages, improving comfort and reducing respiratory distress. This is a safe, effective, and practical measure caregivers can perform at home. Choice C reason: Routine administration of albuterol nebulizer treatments every 4 hours is not recommended for RSV. RSV is a viral infection, and bronchodilators have limited efficacy unless the infant has underlying reactive airway disease such as asthma. Prescribing albuterol without clear indication may expose the infant to unnecessary side effects such as tachycardia and jitteriness. Choice D reason: Reclining the infant during feeding increases the risk of aspiration and worsens respiratory effort. Infants with RSV should be fed in an upright position to minimize aspiration risk and reduce the work of breathing. Reclining is unsafe and contraindicated in this context.