Influenza (Child)

Your child has the flu (influenza). It's a viral illness that affects the air passages of your child's lungs. It's different from the common cold. The flu can easily be passed from one child to another. It may be spread through the air by coughing and sneezing. Or it can be spread by touching the sick person and then touching your own eyes, nose, or mouth.

Symptoms of the flu may be mild or severe. They can include extreme tiredness (wanting to stay in bed all day), chills, fevers, muscle aches, soreness with eye movement, headache, and a dry, hacking cough.

Your child may be treated with an antiviral medicine if there is risk for or signs of complications. Your child may need antibiotics but only if they have a bacterial infection along with the flu. This might be an ear or sinus infection or pneumonia. Antiviral medicine works best if started within 48 hours of the first symptoms.

Home care

Follow these guidelines when caring for your child at home:

  • Fluids. Fever increases the amount of water your child loses from his or her body. For babies younger than 1 year old, keep giving regular feedings (formula or breast). Talk with your child’s healthcare provider to find out how much fluid your baby should be getting. If needed, give an oral rehydration solution. You can buy this at the grocery or pharmacy without a prescription. For a child older than 1 year, give him or her more fluids and continue his or her normal diet. If your child is dehydrated, give an oral rehydration solution. Go back to your child’s normal diet as soon as possible. If your child has diarrhea, don’t give juice, flavored gelatin water, soft drinks without caffeine, lemonade, fruit drinks, or frozen ice pops. These may make diarrhea worse.

  • Food. If your child doesn’t want to eat solid foods, it’s OK for a few days. Make sure your child drinks lots of fluid and has a normal amount of urine.

  • Activity. Keep children with fever at home resting or playing quietly. Encourage your child to take naps. Your child may go back to daycare or school when the fever is gone for at least 24 hours. The fever should be gone without giving your child acetaminophen or other medicine to reduce fever. Your child should also be eating well and feeling better.

  • Sleep. It’s normal for your child to be unable to sleep or be irritable if he or she has the flu. A child who has congestion will sleep best with his or her head and upper body raised up. Or you can raise the head of the bed frame on a 6-inch block.

  • Cough. Coughing is a normal part of the flu. You can use a cool mist humidifier at the bedside. Don’t give over-the-counter cough and cold medicines to children younger than 6 years of age, unless the healthcare provider tells you to do so. These medicines don’t help ease symptoms. And they can cause serious side effects, especially in babies younger than 2 years of age. Don’t let anyone smoke around your child. Smoke can make the cough worse.

  • Nasal congestion. Use a rubber bulb syringe to suction the nose of a baby. You may put 2 to 3 drops of saltwater (saline) nose drops in each nostril before suctioning. This will help remove secretions. You can buy saline nose drops without a prescription. You can make the drops yourself by adding 1/4 teaspoon table salt to 1 cup of water.

  • Fever. Use acetaminophen to control pain, unless another medicine was prescribed. In babies older than 6 months of age, you may use ibuprofen instead of acetaminophen. If your child has chronic liver or kidney disease, talk with your child’s provider before using these medicines. Also talk with the provider if your child has ever had a stomach ulcer or digestive bleeding. Don’t give aspirin to anyone younger than 18 years old who is ill with a fever. It may cause severe liver damage.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

  • Fever (see Fever and children, below)

  • Fast breathing. In a child age 6 weeks to 2 years, this is more than 45 breaths per minute. In a child 3 to 6 years, this is more than 35 breaths per minute. In a child 7 to 10 years, this is more than 30 breaths per minute. In a child older than 10 years, this is more than 25 breaths per minute.

  • Earache, sinus pain, stiff or painful neck, headache, or repeated diarrhea or vomiting

  • Unusual fussiness, drowsiness, or confusion

  • Your child doesn’t interact with you as he or she normally does

  • Your child doesn’t want to be held

  • Your child is not drinking enough fluid. This may show as no tears when crying, or "sunken" eyes or dry mouth. It may also be no wet diapers for 8 hours in a baby. Or it may be less urine than usual in older children.

  • Rash with fever

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds of digital thermometers. They include ones for the mouth, ear, forehead (temporal), rectum, or armpit. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Use a rectal thermometer with care. It may accidentally poke a hole in the rectum. It may pass on germs from the stool. Follow the product maker’s directions for correct use. If you don’t feel OK using a rectal thermometer, use another type. When you talk to your child’s healthcare provider, tell him or her which type you used.

Below are guidelines to know if your child has a fever. Your child’s healthcare provider may give you different numbers for your child.

A baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

A child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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