Influenza in Children: Symptoms, Treatment, and When to Call a Doctor

The flu, or influenza, is a viral illness that affects children of all ages. Flu symptoms in kids can range from mild to more serious. Most children recover from influenza without problems, but sometimes the flu can cause serious complications. 

Understanding the stages of flu illness can help you figure out if your child is getting better. And knowing the symptoms of worsening flu can help you know when it’s time to get medical care for your child’s illness. 

Here’s what every parent and caregiver should know about flu symptoms in kids.

What flu symptoms do kids get?

When a child has the flu, they might have the following symptoms.

Fever 

Fever is one of the most common symptoms of the flu — in both adults and kids. A fever is a sign the body is fighting off an infection. The body’s normal temperature is around 98.6°F or 37°C (from 97.5°F to 99.5°F or from 36.3°C to 37.5°C). Any temperature above 100.4°F (38°C) is a fever. It’s not uncommon to see high fevers — 102°F (38.8°C) or higher — if your child has the flu.  

Sore throat

Early on, your child may develop a sore throat. If they’re young, they may not specifically complain of throat pain. Instead, they may not want to eat or drink as much as usual. A sore throat may last up to 1 week. Antibiotics won’t help a sore throat feel better, but home remedies like cool fluids or ice pops can help. 

Cough

Cough is a common flu symptom in kids. The flu can affect the upper and lower respiratory tracts. If your child develops an upper respiratory tract infection from the flu, they may develop a cough along with a runny nose and stuffiness.

A lower respiratory tract infection from the flu will also cause a cough. But your child might also develop trouble breathing or rapid breathing. If your child has asthma, cystic fibrosis, or lung disease from premature birth, a lower respiratory tract infection can make their lung condition worse. If your child has asthma, keep an eye out for symptoms of an asthma attack.

If your child has a cough, avoid over-the-counter (OTC) cough medication. Experts don’t recommend these medications for young children.

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Congestion

Children often develop a runny nose and congestion when they’re sick with the flu. In school-age kids, you may notice sniffling, sneezing, and an uptick in tissue use. But since infants and toddlers can’t blow their nose, you may only notice that they seem stuffy or that their voice or cry sounds different. Babies may have trouble eating if they’re congested. You may notice that your baby isn’t nursing for as long as usual or not finishing a bottle. 

Headache

Headaches are common symptoms of the flu in kids. Toddlers and preschoolers may not be able to verbalize a headache. Instead they may seem grouchy or more tired.

Your child’s headaches should go away with OTC pain medications like acetaminophen or ibuprofen. If your child has a headache that doesn’t get better with these medications — or they have a very intense headache with neck pain — see a healthcare professional right away. This could be a sign of a complication from the flu, like viral meningitis.

Muscle aches

Many children develop body aches or muscle pain with the flu. These symptoms are more common during the first 2 or 3 days. Warm baths can help soothe their aching muscles. OTC pain relievers can also offer relief.

Vomiting or diarrhea

Kids are more likely than adults to get vomiting and diarrhea from the flu. This can quickly lead to dehydration, especially in young children and infants.

How long does the flu last in toddlers and kids?

The flu usually lasts about a week. The worst days of the flu are often days 2 to 4. After that, the symptoms start to fade.

School-age kids will start to perk up a little more each day until they’re back to their usual selves after a week. But it might take several weeks for toddlers and babies to get all their energy back. Extra rest is important until they’re fully recovered.

Flu symptoms that aren’t getting better after a few days, or that start getting worse later in the illness, could be a cause for concern. 

Which flu treatments are helpful for kids?

A mild flu illness can often be treated at home without a prescription. You can use OTC treatments and home remedies to help ease your child’s symptoms. These treatments can help your child feel better while their body’s immune system fights the flu virus, but they won’t make the flu go away faster. 

OTC treatments for flu

The most helpful OTC medications for kids with influenza are acetaminophen (Tylenol) or ibuprofen (Motrin or Advil). These medications lower fever and help relieve pain or achiness. That’s often enough to get kids eating, drinking, and sleeping peacefully while they recover from the flu.

There are dozens of other OTC products marketed for young children with the flu. But they’re not recommended for toddlers and young children. And studies show they don’t fight the flu virus or make the flu go away any faster. And there’s a chance they can cause side effects that are worse than the symptoms they’re supposed to treat.

If your child is over 6 years old, there are some OTC cold and flu medications available, including:

• Pseudoephedrine (Sudafed)

• Guaifenesin (Mucinex)

• Chlorpheniramine (Chlor-Trimeton)

• Dextromethorphan (Robitussin)

If you’re going to try one of these flu medications for kids, be sure to follow these safety tips:

• Use the lowest dose for your child’s age and weight. 

• Stop using the medication as soon as your child starts feeling better.

• Stick to single-ingredient medications. 

• Check the labels to make sure you don’t accidentally double up on medications.

Home remedies for flu symptoms

Children’s immune systems are very good at fighting the flu virus. It’s helpful to focus on ways to get your child through the illness as comfortably as possible. Some treatments you can use at home are listed below.

• Fluids: It’s important to keep your child hydrated. Offer plenty of fluids like water, juice, or milk. You can also try Pedialyte or other electrolyte drinks. You can even make your own Pedialyte at home. 

• Humidifiers: A cool mist humidifier can soothe a cough and break up mucus, allowing your child to breathe easier.

• Honey: Children older than 12 months can take a teaspoon of honey to help calm a cough. You can also make cough syrup at home using honey and other natural ingredients. Just make sure not to give honey to babies younger than 1 year. 

• Rest: Rest gives the immune system time to fight off an infection. Make sure your child is getting enough sleep and taking it easy during the day.

• Nasal saline: Nasal saline rinses and sprays can help clear mucus and ease congestion. 

Prescription flu treatments

There are prescription flu medicines for kids. These medications are available for children as young as 2 weeks old and can help your child feel better faster:

• Oseltamivir (Tamiflu) is approved for children over 2 weeks old and comes as either a pill or liquid. 

• Zanamivir (Relenza) is approved for children 7 years and older, and comes as an inhaler. 

• Baloxavir (Xofluza) is approved for children over 12 years old and comes as a single-dose pill. 

Children should start these medications as soon as they develop flu symptoms. Not every child needs to take prescription flu medications. These medications are most helpful for children who:

• Have severe symptoms from the flu

• Also have a chronic medical condition, such as asthma, heart disease, or diabetes

• Have a weak or suppressed immune system, such as from cancer or an organ transplant

• Live with a newborn, an elderly person, or someone else who might be at risk for severe complications from the flu

How do I know my child has the flu and not something else?

It can be hard to tell if your child has the flu or another virus causing their symptoms. Flu symptoms can look a lot like COVID-19 or RSV. Getting your child tested for the flu is the only way to know for sure if your child has the flu. 

If it’s flu season and there’s flu in your community — or, especially, if someone else in your home has the flu — and your child has a fever, cough, and irritability, there’s a higher chance the flu is causing your child’s symptoms, too. 

When should you call the doctor about your kid’s flu?

Sometimes kids get very sick from the flu and need to be treated in the hospital with intravenous (IV) fluids and antiviral medications. So when should you be worried about the flu in your child? 

Here are signs that it’s time to get urgent medical care:

• Trouble breathing

• Rapid breathing

• Use of muscles in the chest to breathe

• Chest pain

• No urine production for more than 6 hours

• No tears when crying

• Dry mouth and cracked lips (a sign of dehydration)

• Excessive sleepiness

• Confusion

• Intense headache

• Fever over 102°F (38.8°C)

Your child should start to feel better after 3 to 4 days. If their symptoms aren’t improving after 3 or 4 days, or if they start to get better but then get worse, let a healthcare professional know. This can be a sign that they’ve developed another illness or more severe flu illness.

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Written by:

Kerry R. McGee, MD, FAAP

Kerry McGee, MD, FAAP, has over a decade of experience caring for babies, children, and teenagers as a primary care pediatrician. She has a special interest in adolescent health, particularly in adolescent mental health.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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