Influenza (flu) and your baby

KEY POINTS

  • The flu can be dangerous for all babies, even healthy babies.

  • Babies younger than 6 months shouldn’t get a flu vaccine.

  • Parents, other family members and caregivers need a flu vaccine every year to help protect young babies from the flu.

  • Babies 6 months and older need a flu vaccine every year. 

  • If you think your baby has the flu, call her provider right away. Quick treatment can help prevent serious flu complications. 

What is the flu?

Influenza (also called flu) is a virus that can cause serious illness. It’s more than just a runny nose and sore throat. The flu can make a baby very sick. It’s really important to protect babies and young children from the flu. In rare cases, flu can cause death. In 2017, the flu caused a record number of deaths in children. Most of the children who died didn’t get a flu vaccine.

How does the flu spread?

The flu spreads easily from person to person. When someone with the flu coughs, sneezes or speaks, the virus spreads through the air. Your baby can get infected with the flu if she breathes the virus in or if she touches something (like a toy) that has the flu virus on it and then touches her nose, eyes or mouth.

Does your baby need a flu vaccine?

Yes. The best way to protect your baby from the flu is to make sure he gets a flu vaccine each year before flu season (October through May). Even though your baby’s more likely to get the flu during flu season, he can get it any time of year.

There are two ways for your baby to get the flu vaccine:       

  1. Flu shot. Children 6 months and older can get the flu shot. 
  2. Flu nasal spray. This is a spray you put in your child’s nose. Most children 2 years or older can get the flu nasal spray. But it’s not recommended for children who have certain health conditions, like asthma, heart and lung problems, or a weak immune system that doesn’t protect them well from infection. The flu nasal spray also isn’t recommended for children who take certain medicines for a long time, like aspirin (called long-term aspirin therapy).

The first time your baby gets the flu vaccine, he gets two doses to give him the best protection from the flu. Your baby gets one dose of the vaccine every year after.

The American Academy of Pediatrics (also called AAP) recommends the flu shot as the first choice for children. If you’re not sure which vaccine is best for your baby, ask his health care provider. Visit flu.gov to learn more about flu vaccines.

The flu vaccine is safe for most children. But if your baby had a bad reaction to the flu vaccine in the past, tell his provider. The provider may want to watch your baby closely after getting the vaccine to check for a reaction. If your child is allergic to eggs, talk to his provider to decide if it’s OK to get the flu vaccine. Some flu vaccines are made from eggs.

There are many different flu viruses, and they’re always changing. Each year a new flu vaccine is made to protect against three or four flu viruses that are likely to make people sick during the upcoming flu season. With the vaccine, protection from the flu only lasts about a year, so it’s important to get your baby vaccinated each year. Your baby can get the vaccine from his provider or other places, like pharmacies, that offer it. Use the HealthMap Vaccine Finder to find out where you can get a flu vaccine for your baby. 

The Centers for Disease Control and Prevention (CDC) and the AAP recommend that everyone 6 months and older get the flu vaccine each year. It’s especially important for children younger than 5 to get it because they’re more likely than older kids to have serious health problems caused by the flu. The flu can be dangerous for all children, even healthy children.

Are some children more likely to have serious health problems caused by flu than others?

Yes. Babies and children up to 5 years old are more likely than older children to have complications from the flu. Any child older than 6 months with chronic health conditions, like asthma, heart disease or blood disorders, also are is at high risk of complications from flu.

Complications from flu in children younger than 5 years old include:

  • Making chronic health conditions, like heart disease or asthma, worse
  • Brain problems, like encephalopathy. Encephalopathy is any brain disease that affects the brain’s structure or how the brain works.
  • Dehydration. This means not having enough water in your body.
  • Pneumonia. This is an infection in one or both lungs.
  • Sinus problems and ear infections. Sinuses are hollow air spaces within the bones around the nose. Sinus infections can happen when fluid builds up in the sinuses.
  • Death. Flu complications can sometimes lead to death, but this is rare.  

What are signs and symptoms that your baby has the flu?

Signs of a condition are things someone else can see or know about you, like you have a rash or you’re coughing. Symptoms are things you feel yourself that others can’t see, like having a sore throat or feeling dizzy. If your baby has any of these signs or symptoms of the flu, call his health care provider right away or take him to see his provider:

  • Being very tired
  • Cough
  • Fever (100 F or above), chills or body shakes. Not everyone who has the flu has a fever.
  • Headache or muscle or body aches
  • Runny or stuffy nose
  • Sore throat
  • Vomiting (throwing up) or diarrhea

The flu often comes on quickly. Fever and most other signs and symptoms can last a week or longer. While your baby can’t tell you how she’s feeling, babies who have the flu often are sicker, fussier and seem more uncomfortable and unhappy than babies with a common cold. If you think your baby has the flu even if she got a flu vaccine, call her health care provider.

If your baby has any of these signs or symptoms, take her to a hospiral emergency room:

  • Being so fussy that she doesn’t want to be held
  • Bluish or gray skin color
  • Fast breathing or trouble breathing 
  • Fever with a rash
  • Flu symptoms that improve but return with fever and worse cough
  • Not drinking enough fluids or not making as much urine as she normally does
  • Not waking up or not interacting with you 
  • Vomitting (throwing up) that's severe or doesn't stop

How is flu treated?

Your baby’s provider may prescribe an antiviral medicine to prevent or treat the flu. An antiviral is a medicine that kills infections caused by viruses. Antivirals can make your baby’s flu milder and help your baby feel better faster. Antivirals also can help prevent serious flu complications, like a lung infection called pneumonia. For flu, antivirals work best if used within 2 days of having signs or symptoms. 

If your baby is at high risk for flu, his provider may prescribe an antiviral as soon as he begins to have flu symptoms. All children younger than 5 are at high risk for flu, especially children younger than 2. Children who were born prematurely (before 37 weeks of pregnancy) or who have chronic health conditions, like asthma or sickle cell disease, also are at high risk.

Three medicines are approved in the United States for preventing or treating the flu in children:

  1. Oseltamivir (Tamiflu®) for children as young as 2 weeks. This medicine comes as a capsule or liquid.
  2. Zanamivir (Relenza®) for children older than 5. This medicine is a powder that your child breathes in by mouth. It isn’t recommended for people with breathing problems, like asthma.
  3. Peramivir (Rapivab®) for children at least 2 years old. This medicine is given through a needle into a vein (also called IV) by a health care provider.

If your child has the flu, help him get lots of rest and drink plenty of fluids. He may not want to eat much. Try giving him small meals to help his body get better.

If your baby seems uncomfortable from a fever, ask her provider if you can give her infant’s or children’s acetaminophen (Tylenol®) or ibuprofen (Motrin® or Advil®). Don’t give her aspirin without checking with her health care provider. Aspirin can cause a rare but life-threatening liver disorder called Reye syndrome in children with certain illnesses, such as colds, the flu and chickenpox. If your baby has a cough or a cold, don’t give her over-the-counter cough and cold medicine. These are medicines you can buy without a prescription from a health care provider. AAP says these medicines can cause serious health problems for children. Talk to your baby’s provider before you give your baby any kind of medicine. 

How can you stop the flu from spreading? 

Everyone 6 months and older needs to get a flu vaccine. This means you, especially if you have or take care of a baby younger than 6 months. Getting a flu vaccine can help keep you from spreading the flu.

If you or your baby has the flu, you can spread it to others. Here’s how to help prevent the flu from spreading:

  • Limit your baby's contact with other people.
  • Don’t kiss your baby on or around the mouth. But a hug is a good thing!
  • Teach your child to cough or sneeze into a tissue or his arm. Throw used tissues in the trash.
  • Wash your hands with soap and water before and after caring for your baby. You also can use alcohol-based hand sanitizers. Use enough hand sanitizer so that it takes at least 15 seconds for your hands to dry. 
  • Use hot, soapy water or a dishwasher to clean your baby’s dishes and utensils.
  • Don’t share any of your baby’s dishes, glasses, utensils or his toothbrush.  

More information

Last reviewed: October, 2018

See also: Flu and pregnancyYour baby’s vaccinations