What to Know if Your Child has the Flu
We’re seeing a lot of flu this season, and I know you have questions about how best to get through it. The flu can hit children hard, but with the right knowledge and care, you can help keep your child safe and manage their symptoms if they do get sick. Here’s what parents should know about the flu, from symptoms to when to seek medical help.
what to know
The flu, or influenza, is a contagious respiratory illness caused by flu viruses. It can affect anyone, but young children—especially those under 5—are more vulnerable to severe complications. The flu can lead to serious illness, including pneumonia, dehydration, and even hospitalization, which is why it's important for parents to be vigilant.
According to the CDC, flu activity in children tends to peak in the colder months, with the highest number of flu cases typically reported between December and February. In recent years, flu-related hospitalizations have affected children at a higher rate than adults, with younger children being at the greatest risk. The CDC recommends annual flu vaccination for children aged 6 months and older to reduce the risk of getting the flu and experiencing severe complications.
what it looks like
When your child gets the flu, symptoms usually develop suddenly and can be more severe than the common cold. Look out for the following signs:
Fever or chills
Cough (usually dry)
Sore throat
Runny or stuffy nose
Muscle aches or body aches
Headache
Fatigue or feeling very tired
Vomiting or diarrhea (more common in younger children)
Some children may also experience wheezing or trouble breathing, which could signal a more severe illness.
how long is it contagious?
If a child is exposed to the flu, they typically develop symptoms within 1-4 days. Children with the flu are usually contagious for about 5 to 7 days after symptoms begin. However, younger children and those with weakened immune systems may remain contagious for longer. The natural course of the flu typically lasts 5 to 7 days, but some symptoms like fatigue and cough can linger for up to two weeks. Most children start to feel significantly better within a week, especially with proper care, hydration, and rest. If your child’s symptoms are worsening or not improving after a week, it’s a good idea to check in with your pediatrician.
when do we test for the flu?
Not every child with flu symptoms needs to be tested. The CDC advises flu testing for children who fall into high-risk categories, such as:
Children younger than 5 (especially those under 2)
Children with chronic conditions, like asthma, diabetes, or heart disease
Children with weakened immune systems, such as those undergoing chemotherapy
Children with at-risk household members
If your child is in one of these groups, flu testing may help guide treatment decisions. Testing is typically done through a nasal swab, which is a quick and relatively painless procedure. The test looks for the presence of the flu virus in your child’s nasal passages.
If your child is not in one of these groups and has clear clinical symptoms of the flu, testing isn’t necessarily needed. In primary care, we follow the guidelines for testing. But often times, if your child goes to the Emergency Room or an Urgent Care, they may do testing more regularly to prepare in case your child has to be hospitalized or to help with triage. So, it may depend on the setting in which your child is seen.
what to do
Most children with the flu can be treated at home, but it’s important to manage symptoms carefully. Here are some things I always keep at home in our first aid kit for illnesses like this.
Fever management: Remember that fevers are our bodies’ way of managing an illness. Even if it is a high number, focus more on your child and how they appear to you. Many children are able to rest and stay hydrated at higher temperatures; other children might feel the effects more strongly at temperatures that are not that high. If your child is able to stay comfortable, rested, and well-hydrated, then you simply need to manage their symptoms. If, on the other hand, they are uncomfortable and not able to do these things, it’s perfectly fine to use medication like children’s ibuprofen or children’s tylenol as a tool in your toolbox.
Fluids: Keep your child well-hydrated by offering plenty of water, broths, soups, and electrolyte drinks (like Pedialyte - I like the dye free one a lot). Flu can lead to dehydration, especially if your child is vomiting or has diarrhea.
Rest: Encourage plenty of rest. This helps your child’s body fight off the virus and recover.
Humidifiers: Using a cool mist humidifier in your child’s room can help ease congestion and make breathing easier, especially at night. I also always use an air purifier in the boys’ room to help clear the air.
Saline nasal drops: These can help relieve a stuffy nose and make it easier for your child to breathe. Additionally, hypertonic nasal saline drops or sprays can help with cold symptoms according to a recent study.
when to seek medical help
You should call your pediatrician or seek medical care if:
Your child has difficulty breathing or is respiratory distress
Your child has a persistent high fever (over 102°F or 39°C) that isn’t improving after 5 days - we always want to check for secondary infection
Your child appears very drowsy or hard to wake up
Your child’s symptoms suddenly worsen, especially after appearing to improve
You notice dehydration, which can include dry mouth, not urinating, or a sunken soft spot (fontanel) on an infant’s head
You have any questions or concerns
In certain cases, especially if your child has a high-risk condition, hospitalization may be necessary to provide oxygen therapy or IV fluids.
tamiflu: when is it recommended?
Tamiflu (oseltamivir) is an antiviral medication that can shorten the duration of flu symptoms if taken within 48 hours of the onset of symptoms. It’s often used in children at high risk of complications, such as those with chronic medical conditions, weakened immune systems, or very young children.
However, it’s important to know that Tamiflu is not always recommended for all children. For healthy children who have mild flu symptoms, the benefits of Tamiflu are generally limited, and the risks (like side effects) might outweigh the benefits. In these cases, the focus is generally on managing symptoms and providing supportive care at home.
and just remember…
Flu season can be stressful for parents, but the more you know, the better you can protect and care for your child. If you’re ever in doubt, don’t hesitate to reach out to your pediatrician for guidance—your child’s health and safety are the top priority.
Sending you a big hug,
Anjuli
Disclaimer: For educational purposes only and should not be regarded as medical advice or replace the advice of your physician and medical care team.
References:
Centers for Disease Control and Prevention (CDC), Flu Symptoms and Testing.
CDC, Influenza (Flu) Vaccination Information.