Your baby, infant, or toddler and the flu
During every flu season, children younger than 2 years old 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 your baby under 2 years old from the flu. This is not a substitute for medical advice from your doctor, and if you think your baby may have swine flu you should contact a physician immediately.
WHAT ARE THE SYMPTOMS I SHOULD WATCH OUT FOR IN MY INFANT OR TODDLER?
The flu is an infection of the nose, throat, and (sometimes) lungs. If your baby shows any of the following signs, you should call your pediatrician:
- 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)
- Runny nose
WHAT WILL THE TREATMENT BE IF MY BABY HAS THE FLU? ARE BABIES AND INFANTS GIVEN ANTIVIRAL MEDICATIONS? ARE THEY SAFE?
Children younger than 2 years old will usually need to be treated with antivirals. Oseltamivir (Tamiflu) in liquid form will likely be used. These medicines work best if started as soon as possible after symptoms begin, and preferably within 48 hours.
Although oseltamivir is not approved for use in children younger than 1 year of age, serious side effects are quite rare. It may be recommended for use in this age range because doctors and parents must balance the risk for rare side effects against the risk that children under 1 year of age can become quite sick and even die from the swine flu.
Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help lower fever in children. Sometimes doctors advise you to use both types of medicine.
You should always check with your doctor or nurse before giving any cold medicines to your infant or toddler.
SHOULD MY BABY GET VACCINATED AGAINST THE FLU?
All infants 6 months or older should receive 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 first vaccine.
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 have a flu shot also.
WHAT ABOUT SIDE EFFECTS OF THE VACCINE?
It is not possible to get the flu from either the injection or shot flu vaccine. However, some children do get a lowgrade 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 doctor or nurse.
WILL THE VACCINE HARM MY BABY?
Many parents are hesitant to have their young child receive a vaccine and may ask their doctor or nurse to wait.
They may be worried about the vaccine harming their baby. However, it is important to think about risks for not treating also.
Children under two years of age are more likely to get a severe case of the flu. This does not mean that your child will have a severe infection. It is hard to predict because children who become more ill with flu often have mild disease 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.
Nevertheless, if you have concerns about mercury, all of the routine vaccines are also available without added thimerosal.
HOW CAN I PREVENT MY BABY FROM GETTING THE FLU?
Preferably, anyone who has flu symptoms should not care for a newborn or infant, including feeding. At the very least, caretakers with symptoms should use facemasks when caring for a child, and use strict handwashing techniques.
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 less than 6 months and has close contact with someone with the flu, inform your doctor or nurse.
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’s 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 doctor or go to the emergency room if:
- Your child does not act alert or more comfortable when their fever goes down
- Fever and flu symptoms come back after they had gone away
- There are no tears when they're crying
- Their diapers are not wet, or they have not urinated for the last 8 hours
Reviewed By: Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.