The flu (influenza) is a common respiratory viral illness, distinctly more severe than the common cold, particularly in children. It often presents suddenly with high fever, body aches, chills, and significant fatigue. While influenza can sometimes lead to serious complications, most cases in children are safely managed at home with supportive care. This guidance focuses on practical home management strategies, including the proper use of over-the-counter medications and knowing when to seek professional medical help.
Managing Fever and Pain with Medication
Fever and body aches are the most common symptoms of the flu in children, managed effectively with two primary over-the-counter medications: acetaminophen and ibuprofen. The correct dose is based strictly on a child’s current weight, not their age. Using a recent weight measurement is necessary to prevent accidental under or overdosing. Parents should always use the dosing syringe or cup provided with the medication, as household spoons are inaccurate and can lead to errors.
Acetaminophen (Tylenol) is generally safe for infants as young as two or three months old, but a doctor should be consulted before administering it to a baby under 12 weeks with a fever. Doses can be repeated every four to six hours, but must not exceed five doses within a 24-hour period. Ibuprofen (Advil or Motrin) functions as a non-steroidal anti-inflammatory drug (NSAID), which may provide greater relief for muscle aches.
Ibuprofen is not recommended for infants under six months of age. Doses are administered less frequently than acetaminophen, typically every six to eight hours, and should not exceed four doses in 24 hours. A significant safety concern is that many multi-symptom cold and flu products already contain one of these active ingredients, often acetaminophen. Parents must check all product labels carefully to ensure a child is not receiving a double dose of the same drug from two different products.
In cases of high, persistent fever causing significant discomfort, a healthcare provider may suggest alternating between acetaminophen and ibuprofen. This practice is controversial due to the risk of confusion and dosing errors, but it is sometimes used for continuous symptom relief. If alternating is recommended, parents must keep a detailed log of the exact time and amount of each medication given to maintain proper spacing between doses.
Non-Pharmaceutical Supportive Care
Symptom relief extends beyond medication and relies heavily on non-drug interventions that support the body’s healing process. Maintaining adequate hydration is a top priority, especially because fever and vomiting can quickly lead to fluid loss. Offering small, frequent sips of clear fluids, such as water, electrolyte solutions, or broth, is more effective than trying to force large amounts at once.
Signs of dehydration include a lack of tears when crying, a dry mouth, and decreased urination. For babies and toddlers, this means fewer than three to four wet diapers in 24 hours. Providing a humid environment can help alleviate the dry cough and congestion associated with influenza.
A cool-mist humidifier placed in the child’s room can moisten the air and soothe irritated airways. For infants and younger children, congestion can be addressed using saline nasal drops or spray, followed by gentle suction with a bulb syringe or nasal aspirator. Saline helps thin the mucus, making it easier for the child to breathe, especially before feeding or sleeping.
Comfort measures and rest are restorative elements of care. Encouraging complete rest allows the body to dedicate energy to fighting the viral infection. For cough relief in children over one year old, a small amount of honey can be given, as it is a safe and effective cough suppressant.
Serious Safety Warnings and Red Flags
Certain medications and symptoms require immediate attention and strict avoidance during a bout of the flu. The most absolute prohibition is against giving aspirin, or any product containing salicylates, to children and teenagers. Aspirin use during a viral illness, such as the flu or chickenpox, is strongly associated with Reye’s syndrome.
Reye’s syndrome is a rare but extremely serious condition that causes swelling in the liver and brain, potentially leading to permanent damage or death. Given this risk, parents must carefully check labels of all over-the-counter medications to ensure they do not contain aspirin. Parents should also avoid giving standard over-the-counter cough and cold medications to children under four years old.
The ingredients in these combination products, such as decongestants and cough suppressants, have not been proven effective in young children. They also carry a risk of serious side effects and accidental overdose. Home care must transition to professional medical care if specific red flag symptoms appear, signaling a potentially severe complication.
Immediate medical attention is required if the child exhibits any of the following signs:
- Difficulty breathing, such as rapid breathing, shortness of breath, or if the ribs pull in with each breath.
- Bluish or gray lips, face, or nail beds, indicating poor oxygen circulation.
- Severe or persistent dehydration.
- An inability to wake up or interact, or seizures.
- A fever in any infant under 12 weeks of age.
- A fever that returns or worsens after seemingly improving (known as a “double sickening”).