Your baby and the flu
Babies and the flu; Your infant and the flu; Your toddler and the flu
The flu is an easily-spread disease. Children under age 2 have a higher risk of developing complications if they get the flu.
The information in this article has been put together to help you protect children under age 2 from the flu. This is not a substitute for medical advice from your health care provider. If you think your baby may have the flu, you should contact a provider right away.
Information
FLU SYMPTOMS IN INFANTS AND TODDLERS
The flu is an infection of the nose, throat, and (sometimes) lungs. Call your baby's provider if you notice any of the following signs:
- Acting tired and cranky much of the time and not feeding well
- Cough
- Diarrhea and vomiting
- Has a fever or feels feverish (if no thermometer available)
- Runny nose
- Body aches and general ill feeling
HOW IS THE FLU TREATED IN BABIES?
Children younger than 2 years old will often need to be treated with medicine that fights off the flu virus. This is called antiviral medicine. The medicine works best if started within 48 hours after symptoms begin, if possible.
Oseltamivir (Tamiflu) in liquid form will likely be used. After talking about the risk of side effects versus the possible complications of the flu in your baby, you and your provider may decide to use this medicine to treat the flu.
Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help lower fever in children. Sometimes, your provider will tell you to use both types of medicine.
Always check with your provider before giving any cold medicines to your infant or toddler.
SHOULD MY BABY GET THE FLU VACCINE?
All infants 6 months or older should get the flu vaccine, even if they have had a flu-like illness. The flu vaccine is not approved for children under 6 months old.
- Your child will need a second flu vaccine around 4 weeks after receiving the vaccine for the first time.
- There are two types of flu vaccine. One is given as a shot, and the other is sprayed into your child's nose.
The flu shot contains killed (inactive) viruses. It is not possible to get the flu from this type of vaccine. The flu shot is approved for people age 6 months and older.
A nasal spray-type flu vaccine uses a live, weakened virus instead of a dead one like the flu shot. It is approved for healthy children over 2 years.
Anyone who lives with or has close contact with a child younger than 6 months old should also have a flu shot.
WILL THE VACCINE HARM MY BABY?
You or your baby cannot get the flu from either vaccine. Some children may get a low-grade fever for a day or two after the shot. If more severe symptoms develop or they last for more than 2 days, you should call your provider.
Some parents are afraid the vaccine could hurt their baby. But children under 2 years of age are more likely to get a severe case of the flu. It is hard to predict how ill your child may get from flu because children often have a mild illness at first. They may become sick very fast.
A small amount of mercury (called thimerosal) is a common preservative in multidose vaccines. Despite concerns, thimerosal-containing vaccines have not been shown to cause autism, ADHD, or any other medical problems.
However, all of the routine vaccines are also available without added thimerosal. Ask your provider if they offer this type of vaccine.
HOW CAN I PREVENT MY BABY FROM GETTING THE FLU?
Anyone who has flu symptoms should not care for a newborn or infant, including feeding. If a person with symptoms must care for your child, the caretaker should use a face mask and wash their hands well. Everyone who comes in close contact with your baby should do the following:
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue away after using it.
- Wash your hands often with soap and water for 15 to 20 seconds, especially after you cough or sneeze. You may also use alcohol-based hand cleaners.
If your baby is younger than 6 months old and has close contact with someone with the flu, inform your provider.
IF I HAVE FLU SYMPTOMS, CAN I BREASTFEED MY BABY?
If a mother is not ill with the flu, breastfeeding is encouraged.
If you are sick, you may need to express your milk for use in bottle feedings given by a healthy person. It is unlikely a newborn can catch flu from drinking your breast milk when you are sick. Breast milk is considered safe if you are taking antivirals.
WHEN SHOULD I CALL THE DOCTOR?
Contact your child's provider right away or go to the emergency room if:
- Your child does not act alert or more comfortable when the fever goes down.
- Fever and flu symptoms come back after they have gone away.
- The child does not have tears when crying.
- The child's diapers are not wet, or the child has not urinated for the last 8 hours.
- Your child is having trouble breathing.
How do you treat congestion in babies? I'm Dr. Alan Greene and particularly when over-the-counter decongestants became clear they're not good for babies, parents have been wondering all the more how do you deal with it then? There are a few things. First of all, there's the bulb syringe which you probably went home from the hospital with. And it actually can be effective at helping to pull some of the mucous out - some of the viral load out as well of the nose. They're very easy to use. The trick is you just squeeze everything as much air as you can out of the bulb syringe to start, then gently push it as far as it will go up into the nose and release. Then it will pull both virus and mucous out. You can get more out if you put a few drops of saline nose drops in first. That'll help make it more difficult for the virus to reproduce. It'll help loosen things up so you can pull more out. They can act a bit as a natural decongestant as well. Do the nasal drops, wait maybe 10 minutes, and then do the bulb syringe. Other things that help - gravity can be your friend. All of us tend to be more congested when we're lying flat when our head is about the same level as our heart. And that's even more true for babies. They're more responsive to gravity. So if you're holding the baby upright against your shoulder with their head above their heart, they will naturally and quickly be less congested. Another thing that can be very helpful is a vaporizer. And the way that works a vaporizer humidifier by putting extra moisture in the air will help to thin the mucous so the mucous will draw that extra moisture in and will be thinner and easier to get out either by the bulb syringe, by sneezing, or just the baby's own mechanisms. So there are gentle and natural ways you can help relieve congestion in your young baby.
References
Centers for Disease Control and Prevention website. Influenza (flu): frequently asked influenza (flu) questions: 2022-2023 season.
Grohskopf LA, Blanton LH, Ferdinands JM, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices - United States, 2022-23 influenza season. MMWR Recomm Rep. 2022;71(1):1-28. PMID: 36006864
Havers FP, Campbell AJP. Influenza viruses. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 285.
Version Info
Last reviewed on: 7/1/2023
Reviewed by: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 01/16/2024.
