Flu season is at its peak in the late winter months. Flu symptoms in children usually start to occur around two days after exposure to the virus. These symptoms typically last five to seven days, though they can last up to two weeks.
Symptoms of flu in children are mostly the same as in adults. These symptoms include:
- abrupt onset
- decreased appetite
- muscle or body aches
- chest congestion
- chills and shivering
- sore throat
- runny nose
- earache in one or both ears
In babies, toddlers, and nonverbal children who can’t tell you about their symptoms, you may also see increased fussiness and crying.
The common cold and the flu are both respiratory illnesses, but they’re caused by different viruses. Both types of illnesses share many symptoms, so it can be hard to tell them apart.
Colds often come on gradually, whereas flu symptoms come on quickly. In general, your child will seem sicker if they get the flu than they will if they get a cold. The flu also includes symptoms that colds typically do not, such as chills, dizziness, and muscle aches. Learn more about the differences between a cold and the flu.
If you think your young baby may have the flu, contact their pediatrician as soon as possible. For toddlers and older children, see their doctor if they seem particularly ill or are getting worse instead of better. Their doctor may make a diagnosis based upon your child’s symptoms, or give them a diagnostic test which checks for flu viruses.
Even if your child has already been seen by a doctor, if their symptoms worsen, take them back to the doctor or go to an emergency room immediately.
Other symptoms which signal an immediate need for urgent medical attention, no matter your child’s age, include:
- symptoms of dehydration, and refusal to drink or breastfeed
- a blue tinge around the lips or nail beds of the hands or feet, or an all-over bluish tint to the skin
- an inability to wake your child up
- difficulty breathing
- a spike in fever after the original fever has gone away
- a severe headache
- a stiff neck
- extreme fussiness, in babies
- irritability or crankiness, in toddlers and older children
- refusal to be held or touched, in babies and toddlers
Your child may be home with the flu for up to two weeks. Even after their initial symptoms subside, they may feel tired and unwell. Here are some ways you can care for them at home and help improve their recovery.
Keep your child comfortable
One of the main things you can do for your child if they have the flu is to help them feel more comfortable. Bed rest is important, so you’ll want to help them get adequate rest.
Your child may alternate between feeling hot and cold, so be prepared to have the blankets come off and on throughout the day and night. Blankets aren’t recommended for babies as they pose a smothering risk. Instead, you may want to consider a lightweight sleep sack.
Offer over-the-counter (OTC) medications
Based upon your child’s age and weight, OTC medications, such as ibuprofen (Children’s Advil, Children’s Motrin) and acetaminophen (Children’s Tylenol), can help your child feel better by reducing fever and muscle aches. Talk to your child’s pediatrician about which types you can use, and never exceed the recommended dosage, even if the medication doesn’t appear to be helping.
Don’t give your child aspirin. Aspirin can cause a serious complication in children, called Reye’s syndrome.
Ask your doctor if cough medication is recommended. Cough medications aren’t usually considered necessary or effective for children and may have significant side effects.
Keep your child hydrated
Your child may not have much of an appetite while they have the flu. They can go without much food while sick, but it’s important they take in fluids to avoid dehydration. In babies, dehydration can present as a sunken soft spot on the top of the head.
Other signs of dehydration include:
- urine that’s darker in color than normal
- crying without tears
- dry, cracked lips
- dry tongue
- sunken eyes
- dry-feeling skin or blotchy skin on hands, and feet which feel cold to the touch
- difficulty breathing or very rapid breathing
A decrease in urine output is another symptom of dehydration. In infants, that’s less than six wet diapers per day. In toddlers, it’s no wet diapers over an eight-hour period.
Offer your children fluids, such as water, clear soup, or unsweetened juice. You can also give toddlers and children sugar-free popsicles or ice chips to suck on. If you’re breastfeeding your baby, continue to try feeding them normally.
If you can’t get your child to take in fluids, let their doctor know immediately. In some instances, intravenous fluids (IVs) may be required.
In severe cases, there are prescription medications called influenza antiviral drugs available. Babies, toddlers, and children diagnosed with flu are often prescribed these medications if they’re severely ill, hospitalized, or are at a high risk for complications from the flu.
These medications slow or halt the ability of the flu virus to continue reproducing within the body. They may help reduce the severity of symptoms, as well as shorten the length of time your child is sick. Most importantly for high-risk children, they may also reduce the incidence of complications, including:
Children should start taking these medications as quickly as possible after diagnosis, as they’re most effective if started within the first two days of showing symptoms. They’re often prescribed for children who are only suspected of having the flu, even if a definitive diagnosis hasn’t been made.
Influenza antiviral drugs come in several forms, including pills, liquid, and as an inhaler. There are even drugs available for infants as young as 2 weeks old.
Some children experience side effects from these drugs, such as nausea and vomiting. Some medications, including oseltamivir (Tamiflu) can sometimes cause delirium or self-injury in children and teens. Talk to your child’s pediatrician about the benefits and risks of these medications so you can decide what’s best for your child.
Children under age 5, and especially those under age 2, are considered at high risk for getting complications from the flu. This doesn’t mean your child will definitely get a serious complication. It does mean you need to be especially vigilant about their symptoms.
Children of any age who have an additional diagnosis of asthma, HIV, diabetes, brain disorders, or nervous system disorders, are also at a higher risk of complications.
The flu season starts in the fall and continues through winter. It typically peaks somewhere between November and March. Flu season is generally over at the end of March. However, cases of the flu can continue to occur.
The virus strain which causes the flu varies from year to year. This has been shown to have an impact upon the age groups most affected. In general, people over age 65 and children under age 5 are the most vulnerable to getting the flu, as well as to getting flu-related complications.
The flu is very contagious and can be transmitted through touch, on surfaces, and through microscopic, airborne droplets created by coughing, sneezing, and talking. You’re contagious one day prior to feeling any symptoms and will remain contagious for about a week or until your symptoms are completely gone. Children may take longer to recuperate from the flu and may remain contagious for a longer period of time.
If you’re a parent and have the flu, limit your child’s exposure to you as much as possible. This is often easier said than done. If you can enroll a family member or good friend to help out, this is the time to call in that favor.
Other things you can do include:
- Wash your hands often, especially before preparing food or touching your child.
- Throw out dirty tissues immediately.
- Cover your mouth and nose when sneezing or coughing, preferably into the crook of your arm rather than your hand.
- Wear a face mask over your nose and mouth. This may help limit the spread of germs when you cough, sneeze, or talk.
- The flu can live on hard surfaces for 24 hours. Wipe down doorknobs, tables, and other surfaces in your home with hydrogen peroxide, rubbing alcohol, detergent, or iodine-based antiseptics.
Should my child get the flu shot?
The Centers for Disease Control and Prevention (CDC) recommends that everyone who is 6 months old or older get a seasonal flu vaccine, even during years when it’s not as effective as other years. Children under 6 months old cannot get the flu vaccine.
It can take several weeks for the vaccine to become fully effective. It’s recommended that children start the vaccine process early in the season, preferably in early October.
Children under 8 years old who have never been vaccinated before and those who have been vaccinated only once before, usually require two doses of the vaccine, though this recommendation can vary slightly year to year. These are given at least 28 days apart. The first vaccine dose provides little, if any, protection against the flu. It’s given to ready the immune system for the second vaccine, which does provide protection. It’s imperative that your child gets both vaccines.
The flu vaccine is safe for all children to take unless they have one of a very few medical conditions. Since babies under 6 months old can’t get the vaccine, it’s important to avoid exposing your baby to people who may have the flu. All caregivers should get the flu vaccine.
What are other ways I can protect my child?
There’s no foolproof way to completely limit your child’s flu risk, but there are some things you can do:
- Keep them away from people with flu-like symptoms, including people who are coughing.
- Coach them on washing their hands often and on not touching their faces.
- Get them a hand sanitizer they’ll want to use, such as one with a fruity scent or that has a bottle featuring a cartoon character.
- Remind them not to share food or drinks with their friends.
If your child does get the flu or has flu-like symptoms, seek out medical support. Ask your child’s doctor if antiviral medications are recommended for your child. If they are, your child will need to start taking these medications within 48 hours of their first symptoms.
Getting the flu vaccine is your child’s best defense against getting the flu, even if it’s not fully effective. Getting the flu vaccine may help reduce the severity of your child’s symptoms and decreases their chance of serious complications from the flu.
If your child has the flu and becomes dehydrated, or their symptoms worsen, get immediate medical help.