Flu Symptoms in Kids

What is the flu?

The flu is a highly contagious respiratory illness caused by influenza viruses, mainly influenza A and B.

Kids—and you—are most likely to get sick from the flu during the winter. It’s usually from another person’s cough or sneeze, or by touching objects that someone with the flu has touched.

While the flu generally causes mild symptoms in most healthy children, younger children or kids with chronic health conditions could have complications. The flu shot is the best—and safe—way to protect children from the flu.

How do you know if your child has the flu?

Your child may have several of these classic symptoms, or just a few.

• Sudden fever
• Headache
• Body aches
• Cough
• Runny or stuffy nose
• Sore throat
• Decreased appetite
• Nausea and/or vomiting
• Diarrhea
• Fatigue

Younger children may not have classic flu symptoms. Your baby or young child could have fewer respiratory symptoms (like a cough or runny nose) and more digestive tract symptoms, including nausea, vomiting, diarrhea, and decreased appetite, or taking fewer bottles.

Flu symptoms often overlap with symptoms of other infections. In otherwise healthy children, symptoms should gradually get better in a week. However, your child may have a cough and fatigue that linger for several weeks.

The flu may be confused with the COVID-19 virus (coronavirus). Both viruses can cause similar symptoms including fever, chills, body aches, fatigue, cough, headache, and sore throat.

One unique symptom of the coronavirus is a loss of taste or smell. Another key difference is that the flu tends to come on suddenly, while COVID-19 typically develops and worsens over several days.

When should I take my child to the doctor for flu symptoms?

Viral illnesses are extremely common and mostly mild in healthy children. If your child is older, especially over the age of 5, and otherwise healthy, contact your pediatrician to ask about flu symptoms. You may be able to treat symptoms at home.

If your child has underlying health conditions such as asthma, diabetes, or chronic neurologic issues and you think they have the flu, see your pediatrician.

Call your pediatrician if your child’s symptoms improve and then they become sick again. This could be a sign that they have developed flu-related pneumonia.

Bring your child to the emergency room if the child is an infant (especially younger than 3 months) with flu symptoms, or if your child of any age has:

• Difficulty breathing: Can include fast breathing; working hard to breathe with belly breathing and ribs showing from using extra chest muscles; flaring of nostrils; and bobbing of the head with each breath, especially for younger infants.
• Dehydration: Refusing to drink all liquids, having fewer wet diapers or not peeing for eight hours, not producing tears, and/or not being alert or responsive.
• Seizures.
• Chest pain.
• Difficulty walking with muscle pain.
• Fevers lasting for 5 days.

How do you treat the flu in children?

Supportive care—treating symptoms at home—is recommended for most children with mild flu symptoms.

• Make sure your child drinks plenty of fluids (water, juice, Pedialyte, etc.)
• They should get plenty of rest.
• For fevers, you can try fever-reducing medication, such as acetaminophen (Tylenol) every 4 to 6 hours, or, if your child is over 6 months old, ibuprofen (Advil) up to every 6 hours.
• Do not give aspirin to children younger than 18 years old. It could lead to death (through a reaction called Reye’s syndrome). Always check with your pediatrician before giving any medications to a child.
• Unfortunately, there is no effective cough medicine for children. You can give honey to children older than one year. (Honey is not safe in children younger than one year because of the risk of botulism.) You can discuss with your pediatrician possibly using allergy medication or an over-the-counter cough suppressant for older children.

Your child may also need antiviral medicines (such as Tamiflu), particularly if they are younger than 2 years old or have underlying medical conditions. Although they may shorten the time of being sick by 1 to 2 days, they are often not given to healthy people because they can cause nausea, vomiting, and diarrhea.

Antivirals should be taken within 48 hours of the start of symptoms to be able to lessen the length and severity of the symptoms.

Complications from the flu, such as pneumonia or ear infections, may need to be treated with antibiotics. Call your pediatrician if your child has a worsening fever or starts to get better but then has a worsening cough, fevers, or difficulty breathing.

Before sending your child back to school or daycare, be sure that they are feeling healthy again, and eating and drinking. Your child should be fever-free for at least 24 hours before returning to school or daycare.

What should you do as a parent so you don’t catch the flu too?

• Protect yourself and your family with the flu vaccine! Especially if you have underlying conditions or have elderly people around children. Everyone must get a flu shot to reduce the risk of getting the flu or having severe symptoms.
• Encourage everyone in the house to wash hands often with warm soap and water.
• Avoid sharing drinks and having shared meals while your child is sick.
• If possible, try to keep the child in a separate room—away from other children and family members—until better.
• Wipe down contaminated surfaces (the ones your family touches often, like door handles, faucets, phones, TV remotes, and light switches) regularly with a disinfectant spray cleaner or disinfecting wipes.

How to prevent the flu in children

• Give your child a flu vaccine: The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics recommend that children 6 months and older should get a flu shot every year. The flu shot is made with strict safety precautions and has been safely given to millions of people.
  There are flu shots and also nasal spray flu vaccines, depending on your child’s age. The flu shot may help cut your child’s risk of getting the flu by about half, and if she or he still gets the flu, the shot may reduce the risk of complications. Every member of your household should get a flu shot.
• Try to avoid people who are sick: It’s often difficult advice for children, but try to avoid having them around people who are sick, including other kids.
• Wash hands: Everyone in your household should wash their hands often with warm soap and water and cover their coughs and sneezes with a tissue or their elbow.
• Avoid touching your face as much as possible to reduce your risk of catching the virus.