Everything You Need to Know About the Flu in Kids

By Chesney Fowler, MD
Medically reviewed
April 21, 2021

Chances are you have heard of the flu or even had it yourself. But when your child or a child in your care has the flu, it is important to understand how the virus can affect them differently. Luckily, you have come to the right place. 

The flu results in 9-45 million illnesses in adults and children each year. This estimate is such a wide range because many patients who have the flu can treat their symptoms at home, so they don’t have confirmatory testing (and aren’t counted as confirmed flu cases).

This highly contagious viral infection is commonly characterized by a high fever, body aches, chills, and a cough, in addition to a list of other symptoms. 

While anyone can get the flu, infection rates are highest among children and can lead to hospitalizations, particularly in children younger than five. An average 20,000 children under the age of five are hospitalized due to flu complications each year.

When a child gets sick with the flu or any other illness, it can lead to a lot of questions, confusion, and worry for parents and caretakers. Take a deep breath, and read on to learn everything you need to know about flu symptoms and causes, how to prevent it, and when to contact a doctor.

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What Is The Flu?

Influenza, more commonly referred to as the flu, is a highly contagious viral infection that impacts the respiratory system, including the nose, throat, and lungs. Three known types of flu viruses can impact adults and children. 

  • Influenza Types A and B: These infections cause seasonal disease epidemics including the typical flu season. Influenza A is usually the culprit behind flu pandemics because of its ability to mutate and create unpredictable sub-types. Flu vaccines usually target strains of Type A and Type B in one annual shot.
  • Influenza Type C: This type of infection generally causes mild illness and is not known to cause human flu epidemics.

Flu Symptoms in Kids

Flu symptoms in children and adults often come on very suddenly. In most children, symptoms typically start to show about two days after exposure to the virus. Even though the flu is a respiratory disease, it can affect the whole body. 

Kids with the flu may show some or all of the following symptoms:

  • Fever, which can reach temperatures as high as 105°F (40.5°C)
  • Fatigue
  • Body aches
  • Headache
  • Cough
  • Sore throat
  • Runny nose
  • Muscle pain
  • Earache

In some cases, your child may also experience: 

  • Nausea
  • Vomiting
  • Diarrhea 
  • Chills and shivering

Flu symptoms in babies and toddlers may be revealed through increased fussiness, crying, and fatigue.

Cold vs. Flu

The flu is different from the common cold, but it is not always easy to tell the two apart. Both are respiratory viruses that share many of the same symptoms. The main differences between a cold and the flu are the speed at which symptoms occur, the severity of those symptoms, and recovery time. 

In most cases, cold symptoms develop slowly, while flu symptoms happen more suddenly. The flu also involves some symptoms not typically associated with the common cold, including body and muscle aches, chills, and dizziness.

For children, a cold usually consists of mild symptoms and often goes away after a few days. The flu can cause severe symptoms and last for a week or more. If you think your child may have a cold or the flu, you should contact his or her doctor for a diagnosis.

Neither a cold or the flu can be treated with antibiotics.

Causes of the Flu

The flu virus travels through the air in droplets. Like many other conditions, it is often passed from child to child through coughing and sneezing. The flu can also live on surfaces for a short time. If a child touches something that was touched by an infected person, it is common for them to transfer the germs to their eyes, nose, or mouth. 

Children are major flu spreaders because they may pass on more of the virus particles for a longer period of time compared to adults.

Flu Treatment for Kids

If your child is diagnosed with the flu, treatment will depend on their age, general health, and the severity of their symptoms. 

Flu treatment may include medicines such as:

  • Antiviral medicine: Medications like Tamiflu can help lessen symptoms and shorten the illness by about one day. Antiviral medication is not effective if started more than 48 hours after symptoms start, so contact your child’s doctor early if you are concerned about the flu.
  • Acetaminophen (Children’s Tylenol) or ibuprofen (Children’s Advil, Children’s Motrin): These medicines are given to help reduce body aches and fever and can be obtained over-the-counter (OTC). Do not give your child aspirin unless your doctor tells you to, as it can lead to a serious condition called Reye’s syndrome
  • Cough medicine: Honey (1 teaspoon before bed) can help with cough. However, do not give honey to children under 1 year of age. Dextromethorphan (Delsym) is an over-the-counter cough syrup for children over age 4. 

Whether you use prescription or OTC medications, follow the instructions carefully to ensure that you give your child the correct dosage.

Many over-the-counter cold and flu treatments contain combinations of medication, such as acetaminophen and dextromethorphan in the same syrup.

Be very careful not to give your child more than one treatment at a time unless directed by your doctor. Your pharmacist can also check the medicines before you purchase them to make sure that you’re not accidentally doubling up.

Caring for a child with the flu at home

Once your child’s doctor has given a flu diagnosis, it is important to start any prescribed or over-the-counter (OTC) medicines as soon as possible.

In addition to medicine, the following can help your child recover at home.

  • Keep your child in bed: Bed rest is a critical part of flu recovery. You want to make sure they get adequate sleep. When they are not sleeping, encourage your child to stay in bed with a supply of books, quiet music, or even a favorite movie or show. 
  • Keep your child hydrated: In order to avoid dehydration, make sure your child is drinking an abundance of fluids. Note that appetite loss is common with the flu. It’s okay if your child doesn’t have their usual appetite for solid foods, as long as they don’t have any underlying conditions such as insulin-dependent diabetes.
  • Keep your child comfortable: Your child may alternate between feeling hot and cold as well as experience body aches, fever, and chills. Be prepared with blankets and layers of clothing that are easy to add or remove. 

In addition to these key aspects of treatment, you can also:

  • Run a cool-mist humidifier to help relieve your child’s cough and runny or stuffy nose.
  • Give your child saline nasal spray to help clear a stuffy nose (follow instructions carefully).
  • Invest in a reliable thermometer to monitor your child’s temperature consistently. An ear or forehead thermometer works well.

It is easy to forget to take care of yourself when your child is sick. Try to get plenty of rest and wash your hands frequently—especially after caring for your child. It is important for children who are sick to stay home until they stop experiencing symptoms and have been fever-free for at least 24 hours without medicine. Because children take longer to recuperate from the flu and remain contagious longer, this could mean multiple weeks at home. 

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How to Prevent the Flu

Because the flu virus is highly contagious, a flu shot is the first line of defense for adults and children. In addition to the shot, there are several things you can do to help prevent your child from becoming infected: 

  • Limit your child’s exposure to someone with the flu.
  • Have your child wash his or her hands with soap and water frequently. (You should also do this.)
  • Disinfect hard surfaces—especially high-touch surfaces and toys—frequently with bleach wipes or rubbing alcohol.
  • When coughing or sneezing, teach by example: Cover your mouth with your elbow, not your hands.
  • Do not let your child share cups, utensils, towels, or blankets.

The Flu Shot

Children, especially those younger than five, are at a higher risk of developing serious flu-related complications. For this reason, the Centers for Disease Control and Prevention (CDC) highly recommends children six months and older get a flu vaccine by the end of October each year. (If this isn’t possible, vaccination after October can still be protective.)

Types of flu vaccines for kids

There are two types of flu vaccines for children. Your doctor will know which vaccine is right for your child. 

  • Injectable influenza vaccine (IIV): Approved for use in children six months and older, this vaccine is given with a needle.
  • Live inactivated influenza vaccine (LAIV): Approved for children ages two and older, this vaccine is given as a nasal spray. However, children and adults with certain underlying medical conditions should not get the LAIV. 

Flu vaccination instructions for kids

  • Some children will require two doses for adequate protection from the flu. Children six months to eight years old who are getting vaccinated for the first time or who have previously gotten only one dose of vaccine should get two doses spaced at least four weeks apart.
  • If your child needs the two doses, begin the process early. This will ensure that your child is protected before flu season begins.
  • Be sure to get your child a second dose if they need one. It usually takes about two weeks after the second dose for protection against the flu to set in.

When to See a Doctor

If your child begins to show any of the symptoms mentioned above and seems particularly ill, contact your doctor. Be prepared to share your child’s symptoms and medical history. Based on this information, during in-person visits, the doctor may perform a physical exam and additional tests. 

If your doctor prescribes medication, your child should start taking it as soon as possible.

Signs that your child needs emergency medical attention:

  • Severe headache
  • Stiff neck or refusal to touch their chin to their chest due to stiffness or pain
  • Trouble breathing
  • Severe fatigue or lethargy
  • Signs of dehydration
  • Trouble drinking or keeping fluids down
  • Bluish lips or face
  • Seizures

Call 911 if any of these symptoms occur.

Frequently Asked Questions

What should I do if my child has the flu?
If you think your child may have the flu, contact your doctor. Even if you are unsure, it is better to get advice from a medical professional to determine the right course of action and care.
When should I be concerned about my child’s flu?
Most children weather the flu fine, but in some cases, they become very ill. Look for warning signs and monitor the severity of their symptoms. If it appears that they are getting worse, even after speaking with a doctor and starting treatment, contact your doctor again or take your child to the emergency room.
What are the first signs of flu in toddlers?
For toddlers, sudden high fever, chills, and increased fatigue may be signs that your child has the flu. Irritability and crankiness can also be symptoms of the flu.
How many kids die from the flu each year?
While relatively rare, the Centers for Disease Control and Prevention (CDC) estimates 37-188 children die from the flu each year.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Chesney Fowler, MD

Dr. Fowler is an emergency medicine physician and received her MD from George Washington University. She completed her residency in emergency medicine at Christiana Care Health System. In addition to her work at K Health, Dr. Fowler is a practicing emergency medicine physician in Washington, DC.