Influenza, or “the flu,” often comes on suddenly. A child who seemed fine in the morning may develop fever, aches, and exhaustion by that evening.
Most children with uncomplicated flu start feeling better within about a week, although cough and tiredness can last longer. Many recover with care at home. Others need treatment, and knowing when to call matters.
What the Flu Looks Like
Common symptoms include fever, chills, cough, sore throat, body aches, headache, and unusual tiredness. A runny or stuffy nose is also common. Some children have vomiting, diarrhea, or belly pain.
Babies may feed poorly or seem unusually fussy or sleepy. Not every child with flu has a fever, and symptoms can overlap with other viruses.
Caring for Your Child at Home
For a child with mild illness, focus on comfort and fluids:
- Offer frequent drinks. Small sips may be easier if your child feels nauseated
- Allow extra rest
- Use acetaminophen or ibuprofen for discomfort, following age- and weight-appropriate dosing instructions
- Use ibuprofen only from age 6 months unless your doctor advises otherwise. Avoid it when your child is dehydrated or vomiting repeatedly
- Never give aspirin for flu or a flu-like illness. It is associated with Reye syndrome, a rare but serious condition
When to Call Your Pediatrician
Call promptly when flu symptoms begin if your child is younger than 5 years, especially under 2, or has a condition such as asthma, heart disease, diabetes, a neurologic disorder, or a weakened immune system. Antiviral treatment may be recommended even when symptoms initially seem mild.
Also call for poor drinking, fewer wet diapers or trips to the bathroom, repeated vomiting, an unexplained rash with fever, or symptoms that are worsening. Fever lasting more than three days warrants a call; younger children may need advice sooner.
A child who improves and then develops renewed fever or a worsening cough needs prompt reassessment. Sometimes a second infection develops after the flu.
When to Seek Urgent or Emergency Care
Get medical help right away for breathing difficulty, chest pain, severe muscle pain or refusal to walk, significant dehydration, unusual confusion, or difficulty waking your child. No urine for eight hours is a warning sign; seek help sooner if a baby is feeding poorly or your child looks very ill.
When Antiviral Medicines Help
Antivirals such as oseltamivir (Tamiflu) treat influenza. Antibiotics do not treat the flu virus itself.
Antivirals can shorten illness and may reduce some complications. They work best when started within 48 hours, but that is not a strict cutoff for every child.
Treatment is recommended as soon as possible for children who are hospitalized, have severe or worsening flu, are younger than 5 years, or have a high-risk medical condition. These children may still benefit when treatment starts later.
For otherwise healthy children age 5 and older with mild flu, treatment is a decision to make with the pediatrician, particularly within the first 48 hours. Mention any household members who are very young or medically vulnerable.
A positive flu test is not always necessary before treatment. Oseltamivir can be prescribed even for newborns under medical supervision. Its most common side effects are nausea and vomiting. CDC antiviral guidance
Preventing Flu
A yearly flu vaccine is recommended for children age 6 months and older without a medical contraindication. Some children through age 8 need two doses at least four weeks apart, depending on their vaccination history.
Vaccinating parents, siblings, and caregivers also helps protect babies too young for vaccination. Ask your pediatrician which schedule your child needs. AAP vaccination guidance