Flu (Seasonal Influenza) in Kids

What are flu symptoms in children?

Flu symptoms in children can include:

• High fever
• Cough
• Sore throat
• Body aches
• Chills
• Fatigue
• Headache
• Runny nose
• Vomiting (most common in young children)

If your child has trouble breathing, is breathing rapidly or is severely dehydrated (especially from vomiting), call your child’s doctor or seek medical care immediately.

Learn how to spot the differences between flu symptoms and symptoms of other respiratory infections.

How do we diagnose the flu?

Your child’s doctor can typically diagnose the flu based on symptoms and a physical exam. If they are concerned that your child’s symptoms are the result of a bacterial infection (and not a viral infection like the flu), they may take a sample of mucus or a throat swab. There are tests that identify flu viruses. We typically only flu-test children who require hospitalization.

How do we treat the flu?

Most children recover from the flu with at-home care. We do not prescribe antibiotics for children with the flu because the flu is a viral infection and antibiotics only treat bacterial infections.

Depending on your child’s age, condition and overall health, their doctor may recommend antiviral medication. These can help shorten the duration of the flu and make symptoms less severe.

How can treat my child’s flu symptoms at home?

Home treatment for flu depends on your child's main symptoms. Nasal saline washes can help open a blocked nose. For a cough, use one to two teaspoons of honey (do not use for children under 1 year old). Use ibuprofen (Advil or Motrin) or acetaminophen (Tylenol) to treat headache and sore throat or reduce fever. To prevent dehydration, your child should drink extra fluids.

Should my child get the flu shot?

Yes. Children’s Hospital Colorado, along with the American Academy of Pediatrics, recommend annual flu vaccines for all children older than 6 months. The number of doses they need depends on their age.

• Children between the ages of 6 months and 9 years will need two doses of this year's influenza vaccine if they have never received a flu shot before or if they have only received one dose of vaccine before or if you aren’t sure whether they received a flu vaccine in earlier years. The two doses are given four weeks apart. If they have received two or more doses previously, then they only need one dose this season.
• All children 9 and older only need one dose of flu vaccine annually

Contact your child’s doctor about getting vaccinated or find a flu clinic near you.

For more information, please call the Children's Colorado Flu Hotline: 720-777-4358.

How can I help prevent the flu?

• Get vaccinated. The CDC recommends all adults and children older than 6 months receive a flu shot.
• Hand washing is one of the most important things you can do to protect yourself and others.
• Avoid close contact with people who are sick. If you are sick, stay away from other people to protect them, too.
• Stay home when you are sick to prevent others from catching your illness. If possible, stay home from work, school, or public places until at least 24 hours after a fever has ceased without the use of fever-reducing medications. (A fever is defined as 100ºF/37.8ºC or higher.)
• Cover your mouth and nose when coughing or sneezing. A tissue is the best cover, but if you don't have a tissue, cough or sneeze into your sleeve. It may prevent those around you from getting sick.
• Wash your hands after coughing, sneezing or blowing your nose. Use soap and water or an alcohol-based hand cleaner.
• Don’t touch your face. Germs can spread if you touch a surface that has contaminated with germs and then touch your eyes, nose or mouth.

Helpful resources

• The Flu Vaccine Finder can help you find a flu clinic in Colorado.
• The Colorado Department of Public Health provides broad-based health and environmental protection programs and activities, which includes providing information prevention or diseases such as influenza.
• Centers for Disease Control (CDC) (English) is a science-based, data-driven, service organization that protects the public’s health, which includes working to prevent communicable diseases like influenza. The information is also available in Spanish, here: Centros para el Control y la Prevención de Enfermedades (CDC) (Español)
• Vaccinate Your Family is a national nonprofit organization that strives to protect people of all ages from vaccine-preventable diseases by raising awareness about the importance of timely immunizations and the benefits of immunization and ensuring that people have access to immunizations.

Does my child need to be tested for the flu?

The classic symptoms of the flu are fever with a cough and sore throat. If your child has flu symptoms, and the flu is widespread in your community, they probably have it. Your child doesn't need any special tests. Currently, we only test patients who need hospitalization.

If your child has a sore throat with a fever and doesn't develop a cough, they may have strep throat.

My child hurts everywhere. Is that serious?

The flu can cause soreness everywhere: headache, back pain, chest pain and leg pain. To soothe sore muscles, give ibuprofen every 6 hours, up to 4 times a day as needed. To prevent stomach irritation, always have your child eat some food along with their medication. If pain is severe and lasts more than 90 minutes after taking ibuprofen, you should call your doctor.

Does my child need to see a doctor for the flu?

For serious symptoms such as trouble breathing, rapid breathing or dehydration, bring your child to the doctor immediately. For non-urgent symptoms such as an earache or sinus pain, go to the doctor within 24 hours. Most healthy children with the flu don't develop any of these complications and you can easily treat them at home.

Does my child need Tamiflu?

The CDC recommends Tamiflu (an antiviral drug) for anyone who develops severe symptoms and for high-risk children with any flu symptoms. High-risk children are those with underlying chronic health problems or healthy children under 2 years old.

Tamiflu is not helpful if more than 48 hours have passed since the start of the flu symptoms, unless your child is hospitalized or has high-risk medical conditions. If your child is otherwise healthy and over age 2, they should recover well without Tamiflu.

How should I treat a fever?

Fevers are not harmful and do not need treatment. In fact, they turn on the body's immune system and help fight infections. But if your child is not feeling well while they have a fever, you can use either Tylenol or ibuprofen to help relieve symptoms.

H2: It's been three days, so why does my child still have a fever?

Fever caused by the flu viruses normally lasts two or three days. If the fever lasts more than three days (72 hours), your child may need to see a doctor. More importantly, if the fever goes away for more than 24 hours and then returns, bring your child to the doctor. They may have a secondary bacterial infection, such as an ear infection.

Can I alternate Tylenol and ibuprofen to treat flu symptoms?

It's rarely necessary to rotate these two medicines, and we don't recommend it without a doctor’s direction. If your child's doctor does recommend it, we suggest you only rotate the medicines for fevers over 104˚F that do not come down 2 degrees with one medicine alone.

To safely alternate fever medication, get proper dosing information from your doctor or pharmacist.

Give acetaminophen (Tylenol) every 4 hours, and alternate with ibuprofen every 6 hours. To avoid the risk of overdose, do not alternate medicines for more than 24 hours.

Do not give aspirin if your child or teen has the flu. Using aspirin is linked to developing a condition called Reye’s syndrome — a rare disease that can damage the brain and liver.

What should I do if my child is vomiting?

Have your child drink small amounts of clear fluids every 5 to 10 minutes. If your child becomes dehydrated, or if vomiting without diarrhea lasts more than 48 hours, your child should see a doctor. If your child is taking Tamiflu (known to cause nausea and vomiting), try to hide the bitter flavor in foods, such as chocolate syrup. If vomiting continues, your doctor may ask you to stop the Tamiflu.