Answers to Parents' Questions about the Flu

Put your mind at ease with answers from an expert at the Cleveland Clinic

By Charles B. Foster, MD

Q: Are H1N1 flu symptoms different in children versus adults?

A: The symptoms of H1N1 influenza or flu are similar in children and adults, and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some children and adults will have diarrhea and vomiting. Not all children will have every symptom. Young babies may have more subtle symptoms, such as fever alone.

Q: What can parents do to treat flu symptoms?

A: Keep sick children at home for at least 24 hours after they no longer have fever or do not have signs of fever, without using fever-reducing drugs. Keeping children with a fever at home will reduce the number of people who may get infected.

Do not send children to school if they are sick. Use supportive care measures, such as rest, fluids, and fever reducing medication.

Q: When should we call the doctor?

A: For most children, H1N1 flu is a mild illness similar to seasonal flu. Some children, however, may develop complications such as pneumonia, so call your doctor if your child:

develops rapid breathing
has fewer wet diapers or decreased urine output
develops a fever that goes away, then suddenly returns
refuses to play
seems too sleepy

Q: Are some children at higher risk of flu complications?

A: Yes. Any children under age 5 — particularly young infants — are at greater risk, as are children with underlying medical problems, including:

asthma
heart disease
diabetes
cancer
cerebral palsy
muscular dystrophy
prematurity
immune problems such as HIV

Children who are taking steroids or aspirin are also at greater risk for flu complications. For all at-risk children, call your doctor as soon as you think your child has the flu or is exposed to a family member with flu at home. (Moms: If you are pregnant, you are also at greater risk for flu complications.)

Q: Which fever-reducing medicines are safe for children?

A: Generally it is OK to give a child acetaminophen (Tylenol®) or ibuprofen (Motrin®) to treat fever. Be careful to give the correct dose — always read the label. Avoid other cold medicines in young children, especially those under age 2. Never give aspirin to a child with the flu. Children should not be given aspirin because it increases their risk of developing the rare but potentially fatal disease called Reye’s syndrome.

Q: How long does flu last in children, and when can they go back to school?

A: In most children, symptoms last for less than a week. Do not send your child to school if he or she has flu symptoms. Keep kids home until they feel better and their fever has been gone for at least 24 hours without the aid of acetaminophen or ibuprofen.

Q: Can any medicine make flu go away faster in children?

A: Antiviral medicines may shorten the length of time a child with H1N1 flu is sick by a day or two, but most children will not need them. Parents with children under age 5 should discuss the need for antiviral therapy with their pediatrician because young children are at risk for complications. Antiviral medicines may also be used if:

the H1N1 flu persists or worsens in an otherwise healthy older child
the child has any of the underlying medical problems listed above
the child is hospitalized with flu

Q: Does the seasonal flu shot protect children against the H1N1 virus?

A: Not this year; children need two different types of flu vaccine. The current seasonal flu shot protects children against three influenza strains, but not against the new H1N1 strain. A separate H1N1 vaccine is needed to protect your child against H1N1.

Q: At what ages should children receive flu shots?

A: Each year, seasonal flu vaccine is recommended for all children between 6 months and 18 years of age. The H1N1 vaccine is recommended for all children and young adults between 6 months and 24 years of age.

Q: What if my baby is too young for a flu shot?

A: One way to help protect young infants from the flu is to make sure that all family members and caregivers get both the seasonal flu and the H1N1 flu vaccines.

Q: If I think my child has had H1N1 flu, will he or she still need the vaccine?

A: Yes. The current recommendation is that all children and young adults 6 months to 24 years of age get the H1N1 flu vaccine.

Q: I’m breastfeeding; if my baby gets the flu, is it OK to nurse?

A: Yes, please continue to breastfeed. Breast milk is the ideal food for babies, and is especially helpful for sick infants because it may give them protective antibodies. If your baby is too sick to breastfeed or doesn’t seem to be getting enough fluid, call your pediatrician.

Q: What if I get the flu — is it OK to breastfeed?

A: If you are breastfeeding, don’t stop. Your antibodies may provide your baby with some protection. If you are taking medicine to treat the flu, the milk is safe for your child. Be sure to wash your hands well and consider wearing a surgical mask so as not to sneeze or cough on your child.

Dr. Charles Foster is a physician in the Center for Pediatric Infectious Diseases at Cleveland Clinic Children’s Hospital. www.clevelandclinic.org/flu

For details on the H1N1 virus and other information, visit the Centers for Disease Control and Prevention website at www.cdc.gov.