What To Do When Your Child Has the Flu

Parents of young kids are all too familiar with runny noses, coughs and low-grade fevers. Often, these illnesses are minor respiratory viruses that, unfortunately, have to run their course.

The flu is a different story, however. While most kids recover, the flu can cause serious complications, including hospitalization and death. Pediatrician Sabrina Ma, MD, explains the signs to watch for in your child and when it’s time to get medical care.

Flu symptoms in babies and toddlers

“It can be hard to spot the flu in children who can’t talk yet, so you need to watch them closely if they become sick,” says Dr. Ma. “Flu symptoms come on quickly — within hours — and are more severe than a typical cold.”

Symptoms of the flu in babies and young toddlers include:

• Chills or sweating
• Dry cough
• Fever, which may be 100.4 degrees Fahrenheit (38 degrees Celsius) or higher
• Fussiness or irritability
• Runny nose or congestion
• Sleeping much more than usual
• Vomiting or diarrhea

Flu symptoms in older children

“Symptoms in preschoolers and school-age children are similar to what babies experience,” states Dr. Ma. “The advantage is they can sometimes tell you what they’re feeling, so you have a better idea of what’s going on.”

Flu symptoms in children over 2 years include:

• Dry, hacking cough
• Fatigue
• Fever above 100.4 F (38 C)
• Headache
• Muscle aches
• Nausea, vomiting and diarrhea
• Runny or stuffy nose
• Sore throat

How long does the flu last in kids?

Miserable as it can be, most children bounce back from the flu in a week to 10 days.

“Flu recovery takes longer than a cold because the virus puts a greater strain on your body,” notes Dr. Ma.

And if your child attends daycare or school, you might wonder when they’re well enough to go back.

“The right time to return to daycare or school depends on your child and school policies,” Dr. Ma maintains. “Children can spread the flu for up to two weeks after they catch it, so it’s better to wait longer than to send them back right away.”

Usually, children can return to daycare or school once they’re well enough to participate in activities and are:

• Fever-free for at least 24 hours without using fever-lowering medications
• Free of vomiting or diarrhea for at least 24 hours

Flu complications in children

The flu isn’t just a “bad cold.” It’s an infection that can quickly become serious. Potential flu complications in babies and children include:

• Breathing problems
• Dehydration
• Changes in brain function, such as confusion, memory loss or muscle twitching (encephalopathy)
• Other infections, such as ear infections
• Pneumonia
• Worsening of existing health issues like asthma or heart conditions

Babies have a higher risk of flu complications than most older children and adults.

“Infants under 6 months old have the highest risk of any group, even if they don’t have any health issues,” Dr. Ma explains. “Their immune systems may not be able to fight off such a severe virus.”

Although older kids aren’t as susceptible as infants, they can still get dangerously sick from the flu.

“Many people assume only children with chronic health conditions develop serious flu complications, but this isn’t the case,” cautions Dr. Ma. “Thousands of children are hospitalized from the flu each year, and many of these are children with no other health issues.”

When to see a provider

Fortunately, you don’t have to be a doctor to spot possible signs of trouble. Seek immediate medical care if your child has:

• A fever of 100.4 F (38 C) or higher in babies under 6 months of age
• A fever over 103 F (39.44 C) in children over 6 months of age
• Intercostal retractions (ribs “pulling in” with breathing)
• No wet diapers or urinating for eight hours
• Pale or bluish lips, nails or skin
• Rapid breathing
• Seizures
• Sunken eyes or a sunken soft spot on the head in babies
• Wheezing

Does my child need a flu test?

If your child has flu-like symptoms, testing can tell you what virus you’re dealing with. However, it isn’t always necessary.

“Children with a high risk of serious flu complications might need testing so we can start them on antiviral medications,” says Dr. Ma. “Kids with milder flu cases often only need supportive care at home.”

That’s where you come in. Focus on helping your child rest and stay hydrated.

“Children over 1 year old may benefit from rehydration drinks such as Pedialyte®, but always speak to your doctor first,” Dr. Ma advises. “These beverages provide needed electrolytes. But don’t give these drinks to babies under 6 months of age. Instead, offer breast milk or formula.”

And don’t worry if your kid turns down their favorite chicken nuggets for now. “It’s normal for them to have a low appetite,” reassures Dr. Ma. “Hydration is more important.”

Finally, you can give fever-lowering medications that may make your child feel better.

“Children over 6 months of age can have ibuprofen or acetaminophen to lower fever and reduce symptoms like headache or body aches,” informs Dr. Ma. “Babies younger than 6 months can have acetaminophen. Follow the dosing instructions carefully to ensure you don’t accidentally give them too much.”

Be prepared this flu season

When flu starts making the rounds, it’s understandable if you feel a bit of dread. After all, kids aren’t always all-star handwashers, and the flu can spread through a school or daycare like wildfire.

But don’t panic. You can give your child the best defense against this illness with a flu vaccine.

“Children over 6 months of age should get a flu vaccine each year,” recommends Dr. Ma. “Research shows that the flu vaccine lowers your child’s risk of hospitalization and death from the flu. It can also reduce the severity of illness so they feel better sooner.”

And, of course, a sick child means you might get sick, too.

“Your child requires a lot of care when they’re sick, which means you’re exposed to the virus,” says Dr. Ma. “You probably can’t avoid the exposure, but being vaccinated gives you a better chance of a quicker, easier recovery. And that’s a great gift to give yourself and your child.”