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 health care provider immediately.
Babies and the flu; Your infant and the flu; Your toddler and the flu
FLU SYMPTOMS IN INFANTS AND TODDLERS
The flu is an infection of the nose, throat, and (sometimes) lungs. Call your baby’s health care provider if you notice any of the following signs:
Acting tired and cranky much of the time and not feeding well
Diarrhea and vomiting
Has a fever or feels feverish (if no thermometer available)
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. Although this drug is not approved for use in children younger than 1 year of age, serious side effects are quite rare. After talking about the risk of side effects against the possible complications of the flu in your baby, you and your health care provider may decide to use this medicine to treat the flu.
Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help lower fever in children. Sometimes your health care provider will tell you to use both types of medicine.
Always check with your health care 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 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 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 can NOT 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 health care 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 health care 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 the child, the caretaker should use a face mask and wash 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 - 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 health care 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?
Talk to your child's health care provider 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.
Fiore AE, Fry A, Shay D, et al; Centers for Disease Control and Prevention (CDC). Antiviral agents for the treatment and chemoprophylaxis of influenza -- recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011;60:1-24.
Dawood FS, Subbarao K, Fiore AE. Influenza Viruses. In: Long SS, ed. Principles and Practice of Pediatric Infectious Diseases. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 229.
Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.