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The Flu: What Parents Need to Know

By: Flor M. Muñoz, MD, MSc, FAAP

Flu is the short term for influenza. It is an illness caused by a respiratory virus. The flu can spread rapidly through communities, as the virus is passed person to person.

When someone with the flu coughs or sneezes, the influenza virus gets into the air, and people nearby, including children, can inhale it through the nose or mouth.

The virus also can be spread when kids touch a contaminated hard surface, such as a door handle, and then put their hands or fingers in their nose or mouth, or rub their eyes.

When is flu season?

The flu season usually starts in the fall and ends in the spring. Ideally, children should get an annual flu shot before the end of October. But if your child did not get vaccinated yet, they still should.

When there is an outbreak or epidemic, usually during the winter months, the illness tends to be most frequent in preschool or school-aged children. Flu viruses are known to spread quickly among college students and teens, too.

In the first few days of illness, the virus is easily transmitted to other children, parents and caregivers.

It is important for anyone over 6 months of age to get the flu vaccine each year. Adults and children should also get COVID-19 vaccines and a COVID booster as soon as they are eligible. The COVID vaccine and flu vaccine can safely be given at the same time or at any time one after the other.

Flu symptoms include:

  • A sudden fever (usually above 100.4°F or 38°C)

  • Chills

  • Headache, body aches, and being a lot more tired than usual

  • Sore throat

  • Dry, hacking cough

  • Stuffy, runny nose

  • Some children may throw up (vomit) and have loose stools (diarrhea).

After the first few days of these symptoms, a sore throat, stuffy nose, and continuing cough become most evident. The flu can last a week or even longer. A child with a common cold usually has only a low-grade fever, a runny nose, and only a small amount of coughing. Children with the flu—or adults, for that matter—usually feel much sicker, achier, and more miserable.

Kids with chronic health conditions at greater risk

Children who appear to have the greatest risk of complications from the flu are those with an underlying chronic medical condition, such as lung, heart, or kidney disease, an immune system problem, malignancy, diabetes mellitus, some blood diseases, or conditions of the muscular or central nervous system.

As these children may have more severe disease or complications, it's important for them to be vaccinated and, when possible, avoid other children with the flu or flu-like symptoms. Their pediatrician may suggest additional precautions that should be taken.

If your child has any of these chronic health conditions and flu-like symptoms along with any difficulty breathing, seek medical attention right away. There can be serious complications, even death, from the flu, but thanks to the flu vaccine these are less common.

Flu treatment

Children may benefit from extra rest and drinking lots of fluids when they get the flu.

If your child is uncomfortable because of a fever, acetaminophen or ibuprofen in doses recommended by your pediatrician for his age and weight will help him feel better. Ibuprofen is approved for use in children six months of age and older; however, it should never be given to children who are dehydrated or who are vomiting continuously.

It is extremely important never to give aspirin to a child who has the flu or is suspected of having the flu. Aspirin during bouts of influenza is associated with an increased risk of developing Reye syndrome.

Antiviral medications: available by prescription to treat an influenza infection

Your pediatrician can help decide whether or not to treat the flu with an antiviral medicine. Antiviral medications work best if started within the first 1 to 2 days of showing signs of the flu. However, in some children with increased risk for influenza complications, treatment could be started later.

Call your pediatrician within 24 hours of the first flu symptom to ask about antiviral medications if your child:

  • Has an underlying health problem like asthma or other chronic lung disease, a heart condition, diabetes, sickle cell disease, a weakened immune system, a neuromuscular condition such as cerebral palsy, or other medical conditions.

  • Is younger than 5 years old, especially if less than 2 years old.

  • Has symptoms that are not improving.

  • Is in contact with others who are at risk for complications of the flu.

Flu recovery and complications

Healthy people, especially children, get over the flu in about a week, without any lingering problems. Talk with your child's doctor if you suspect a complication like ear pain, pressure in your child's face and head, or a cough and fever that will not go away.

When flu becomes an emergency

If your child has the flu and develops any of these symptoms, contact your pediatrician or seek immediate medical care.
  • Trouble breathing or unusually rapid breathing

  • Bluish lips or face

  • Ribs looking like they pull in with each breath

  • Chest pain

  • Muscle pain so severe that your child refuses to walk

  • Dehydration (no peeing for 8 hours, dry mouth, and no tears when crying)

  • While awake, your child is not alert or interacting with you

  • Seizures

  • Fever above 104°F

  • In children less than 12 weeks, any fever

  • Fever or cough that seem to improve but then return or worsen

  • Worsening chronic medical conditions, such as asthma

How to prevent the flu

Everyone needs the flu vaccine each year to update their protection. It is the best way to prevent getting the flu. Safe and effective vaccines are made each year.

The flu vaccine is especially important for:

  • Children, including infants born preterm, who are 6 months to 5 years of age,

  • Children of any age with chronic medical conditions that increase the risk of complications from the flu

  • Children of American Indian/Alaska Native heritage

  • All contacts and care providers of children with high risk conditions and children under 5 years old

  • All women who are pregnant, are considering pregnancy, have recently delivered, or are breastfeeding during the flu season. This is to protects both mother and baby, which is important since newborns and infants under 6 months old are not able to receive their own vaccination.

  • All health care workers

The flu virus spreads easily through the air with coughing and sneezing, and through touching things like doorknobs or toys and then touching your eyes, nose, or mouth.

Click here for some tips that will help protect your family from getting sick.

Flu vaccine

Both the inactivated (killed) vaccine, also called the "flu shot," given by injection in the muscle, and the live-attenuated nasal spray vaccine, can be used for influenza vaccination this season. There is no preference for a product or formulation. Any of these vaccines should be given as available in your area.

Flu vaccine side effects 

The flu vaccine has few side effects, the most common being fever and redness, soreness or swelling at the injection site for the flu shot, or runny nose, congestion and sore throat for the nasal spray vaccine.

Children with egg allergies can receive the flu vaccine. Children with a previous allergic reaction after a dose of flu vaccine should be seen by an allergist. The allergist can help parents decide if their child should receive an annual flu vaccination.

More information

About Dr. Muñoz

Flor Muñoz, MD, MSc, FAAP, is associate professor of Pediatrics and Infectious Diseases at Texas Children's Hospital and Baylor College of Medicine. She is an investigator in various projects focusing on vaccines and the epidemi ology of respiratory infections, including those supported by the National Institutes of Health and the Centers for Disease Control and Prevention. She has published extensively on topics related to vaccines and influenza. Dr Muñoz is a member of the American Academy of Pediatrics Section on Infectious Diseases. She also serves on the Influenza Work Group of the CDC Advisory Committee on Immunization Practices (ACIP).​

Last Updated
American Academy of Pediatrics (Copyright © 2021)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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