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Courtney Rust/Stocksy United

The dreaded flu season is here — and the flu virus can spread and strike quickly. Children and babies are especially susceptible to the flu virus, and children under 5 are at higher risk of complications related to influenza.

Normally, the flu keeps children in bed (and babies in your lap) for a few days before they bounce back. Most little ones recover from flu symptoms at home and don’t need medical attention.

In some cases, the flu can lead to more serious symptoms and complications in children. Your child might need emergency care if this happens.

The flu and Covid-19

With COVID-19 affecting many people, especially older adults, it’s even more important to understand when to take your child to the hospital for serious flu-like symptoms and when you can ride it out at home.

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Here’s what to look out for and what to do if your child has serious flu or flu-like symptoms.

In some cases, the flu can lead to serious complications in children.

Go to the emergency room or call 911 if your child has any of these flu complication signs and symptoms:

  • shortness of breath
  • difficulty breathing
  • blue lips
  • excessive vomiting
  • dehydration (decreased urination, sunken eyes, dry lips)
  • stiff neck
  • severe lethargy
  • nonresponsiveness
  • seizures or convulsions

In newborns, severe flu symptoms might look a bit different:

  • difficulty breathing
  • fast breathing
  • blue-tinged skin
  • refusing to feed
  • dehydration (crying without tears, dry lips, sunken spot on head, diaper hasn’t been wet for more than 8 hours)
  • acting unresponsive, limp, or “floppy”
  • febrile (fever) seizures
  • bulging soft spot (fontanel) on baby’s head

The flu is caused by a common virus. This virus can sometimes cause different or more serious symptoms in babies, toddlers, and children under age 5 because of their small size and new, inexperienced immune systems.

Small children are more likely to catch the flu because they touch everything — including their mouths and noses — without washing their hands often. Babies may catch the flu from parents, siblings, and caregivers.

A child with typical flu-like symptoms can usually be cared for at home with fever-reducing medication like Tylenol or Advil, clear fluids, and rest.

Typical flu symptoms that can be cared for at home

  • mild to high fever (always call the doctor if your newborn or very young baby has a fever, though)
  • chills or shakes
  • sore or red eyes
  • muscle aches
  • headache
  • sore throat
  • dry cough
  • loss of appetite
  • fatigue or extreme tiredness

General rule: Most kids with a cold will still want to play and be interested in their favorite foods, while the flu will likely wipe them out and they’ll want to stay in bed.

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Children with some chronic health conditions have a higher risk of getting serious symptoms or complications from the flu. These include:

  • asthma
  • diabetes
  • kidney disease
  • heart disease
  • neurologic conditions (like epilepsy)
  • neuromuscular disorders (like cerebral palsy)

Newborns, babies, and smaller children may also have other flu symptoms:

In most cases, babies and children recover from flu symptoms in less than a week. Sometimes, your little one may be fighting the flu longer or it may seem like symptoms keep coming back.

Call your pediatrician right away if your child has serious symptoms. These may mean that the flu is worsening and causing other complications. Look out for:

  • Dehydration. Signs include low urine output, decreased tears, and a very dry mouth.
  • Severe cough or difficulty breathing. Young children can get lung infections like pneumonia from the flu virus.
  • Muscle pain. Older children may complain of severe pain. The flu can lead to muscle swelling, causing serious leg or back pain in children.

The flu and Covid-19

The flu can be more worrying in the middle of a pandemic. Medical studies on how the SARS-COV-2 virus affects babies and kids are still ongoing. However, most research shows that children with this coronavirus typically get mild, flu-like symptoms.

Keep your child at home if they have the flu or mild flu-like symptoms and call your pediatrician if you suspect COVID-19 exposure.

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If your child needs treatment for very serious flu symptoms, or they are at higher risk for complications, they may be given medications to help them fight the flu. Treatment depends on what kind of flu complication your child has.

Treatments may include:

  • antiviral drugs (Tamiflu)
  • antibiotics (ear infections)
  • oxygen therapy (lung problems)
  • intravenous (IV) saline (dehydration)
  • anti-inflammatory drugs (lung inflammation)

Complications of the flu include secondary bacterial infections. This can happen in a baby or child when the immune system gets tired fighting a prolonged flu infection, and other germs creep in.

Or the flu virus may worsen symptoms of an underlying condition. Complications that can happen in children due to the flu include:

Most kids get over the flu within 7 days, but they may still feel tired or achy for up to 4 weeks.

More serious bouts of the flu may last weeks and be complicated by secondary infections, which are a more serious concern.

If your child has flu complications, they may need medical treatment or even need to be in the hospital for urgent attention. Do not ignore serious flu symptoms.

Children with underlying health conditions like asthma are at higher risk of flu complications. Ask your pediatrician about whether the flu vaccine is right for your child.

Speak with your pediatrician about the flu vaccine, which is recommended for all children 6 months and older except in rare cases. Consider these statistics:

  • Up to 80 percent of influenza-related deaths in children 6 months and older happen in kids who didn’t have the flu vaccine.
  • The flu vaccine reduces the risk of severe flu requiring ICU admission by 75 percent.