Flu symptoms in kids: What are the early signs of flu symptoms in kids?

Overview: What do flu symptoms in kids look like?

Cold and flu season is an annual ritual filled with coughing, sneezing, fever, and runny noses. If it seems like a treadmill, it is. On average, young children get six to eight colds per year. Fortunately, they have the flu (meaning the influenza illness) less often—about once every other year. But the flu often makes them much sicker than a cold. Young children usually have worse symptoms than adults. In children, the most common early signs of influenza are a sudden fever, body aches, headache, dry cough, and extreme fatigue. The fever can be very high, especially in younger children. Newborns and infants may initially only have a high fever with no other symptoms. While adults typically feel mild body aches, the pain may be more severe in younger children. Eventually, the coughing gets worse and may turn into a productive cough with phlegm. The child might get a runny nose or sore throat, but not always. Children with the flu can also have digestive system complaints like stomach aches, nausea, diarrhea, or vomiting. As in adults, most flu symptoms in kids clear up in less than two weeks. However, a flu infection can be more serious in a child than an adult, so it’s important to watch the child closely.

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What are the early signs of flu symptoms in kids?

The most common early sign of flu in kids is the sudden onset of fever. High fever may be the only early sign of flu in newborns and babies. 

The early signs of flu symptoms in kids are:

• Sudden fever, sometimes high fever

• Tiredness, often extreme tiredness

• Body aches, sometimes severe body aches

• Headache

• Dry cough

Other flu symptoms in kids symptoms

The most common flu symptoms in kids are:

• Fever

• Chills

• Tiredness

• Body aches

• Headache

• Dry cough

Possible flu symptoms in kids include:

• Shortness of breath

• Sore throat

• Runny, stuffy nose

• Nausea

• Vomiting

• Diarrhea

• Stomach upset

• Stomach ache

• Ear pain

• Red or swollen eyes

Children with the flu are more likely than adults to have gastrointestinal symptoms, earaches, and eye swelling.

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Flu symptoms in kids vs. COVID-19 symptoms

As in adults, COVID-19 affects individual children differently. Some may show no symptoms or mild symptoms, something like a cold. That’s not true of influenza. On the other hand, COVID-19 could cause more severe symptoms that are equal to or worse than flu symptoms. However, COVID symptoms usually last longer than the flu and can worsen into a severe or life-threatening lung disease involving difficulty breathing, rapid breathing, and low oxygen. 

RELATED: How to tell if your coronavirus symptoms are mild, moderate, or severe

Stages of flu symptoms in kids: How can I tell which one I have? 

Flu infections follow a fairly predictable timeline from when a person gets infected: 

Incubation stage

• In the first few days after exposure to the virus, a person feels no symptoms while the virus replicates in the body. From the second day after exposure to the first appearance of symptoms, the infected person is contagious for the next five to seven days.

Peak stage

• Once symptoms start about four to five days after exposure, caregivers will have no doubt their child is sick. The child will quickly develop a fever, body aches, headache, and other symptoms. These symptoms will be at their worst for about three days. During this entire time, the child is contagious.

Recovery stage

• About four days after the onset of symptoms, the symptoms will start improving. The child will gradually feel better each day and engage in more activities. This recovery usually takes four or five days before the child feels normal. At an early point in recovery, the child will no longer be able to spread the infection. 

RELATED: What temperature is considered a fever?

When to see a doctor for flu symptoms in kids?

In many cases, a child with the flu can be treated at home with bed rest and symptom relief remedies. If the symptoms are severe or there are signs of an ear infection or sinus infection, take the child to see a pediatrician. Also, seek medical care if the child has problems drinking fluids, a fever that won’t break after five days, or other medical conditions such as heart disease, diabetes, or lung problems. A healthcare professional should always evaluate newborns and infants with a high fever. Finally, the Centers for Disease Control and Prevention (CDC) recommends that parents or caregivers contact a doctor if a child has symptoms of the flu.

Emergency room treatment is rarely needed for a flu infection. However, take the child to an emergency room if there are symptoms like:

• Trouble breathing

• Fast breathing

• Any sign of insufficient oxygen, like blue or pale skin, confusion, or unresponsiveness

• Chest pain

• Extreme muscle pain (inability to move)

• Excessive vomiting

• Signs of dehydration such as dry mouth, dry eyes, sunken eyes, or reduced urination (less than 3 times within 24 hours)

• A return of worsened flu symptoms

• Seizures

Healthcare providers usually suspect flu based on the symptoms and medical history and often perform a rapid antigen test to confirm the infection. If a child has a confirmed case of influenza, their close contacts may be offered a prophylactic dose of an antiviral to help decrease their chance of contracting the infection. A more expensive and time-consuming polymerase chain reaction (PCR) test may be used in severe cases or if the child is hospitalized.

Complications of flu symptoms in kids

Most flu infections resolve without problems within a week. Children younger than five are a high-risk group, especially those younger than two. Children with asthma, sickle cell disease, diabetes, or a weakened immune system are also at risk for serious illness or complications when infected with the flu.

In children and adults, the most common complications of a flu infection are:

• Croup

• Sinus infection

• Ear infections

• Pneumonia

Rare complications of a flu infection include:

• Heart inflammation (myocarditis)

• Swelling of the brain (encephalitis)

• Inflammation of the muscles (myositis)

• Kidney failure

• Respiratory failure

RELATED: What groups are at high risk for flu complications?

How to treat flu symptoms in kids symptoms

In most cases, all a kid with flu needs is rest and symptom relief. The fundamental treatments are bed rest, drinking plenty of fluids, bringing down a fever with medications or a cool bath, and using a humidifier. 

Store-bought drugs might help, but parents should be cautious, particularly in younger children. Children’s ibuprofen and acetaminophen can provide fever and pain relief. Cough suppressants may also provide some relief. As far as other drugs are concerned, such as expectorants, antihistamines, and combination flu medications, healthcare professionals aren’t sure they work. Parents should be cautious about over-the-counter cold and flu formulations. Before using one, carefully review the active ingredients to ensure you aren’t doubling up on some drugs. Above all, do not give a child with the flu any drug that contains aspirin because of the risk of Reye’s syndrome. Over-the-counter flu medications should not be given to children younger than three except under the instructions of a physician.

For children at risk of serious complications, a doctor may prescribe antiviral medicines that target the flu virus. As pediatric drugs, Tamiflu (oseltamivir) is FDA-approved to treat flu in children as young as two weeks old, Rapivab (peramivir) for children older than six months, and Relenza (zanamivir) for children older than seven years. Xofluza (baloxavir marboxil) is FDA approved to treat children 12 years of age and older. Studies have shown that Tamiflu can reduce the days that otherwise healthy children are sick with the flu, but all these medications must be started within two days of symptoms to work effectively.

Severe cases of the flu in children may require hospitalization.

RELATED: Does Tamiflu work? | 6 ways to treat your child’s cough naturally

Signs flu symptoms in kids are getting better

Flu symptoms usually start improving about four days after the onset of symptoms, although it may take a bit longer in younger children. Symptoms don’t improve rapidly, but the child will gradually feel better. The most obvious change will be in their energy levels. Once the immune system effectively fights the flu virus, the kids will start getting more and more active until they’re back to normal.

What’s next? Additional resources for people with flu symptoms in kids symptoms

Test and diagnostics

• Flu (influenza) test, Cleveland Clinic

• Influenza, StatPearls

Treatments

• Influenza (flu) in children, Johns Hopkins Medicine

• Influenza in children, Paediatrics Child Health

• Influenza treatments and medications, SingleCare

Scientific studies and clinical trials

• Oseltamivir for influenza in adults and children: a systematic review of clinical study reports and summary of regulatory comments, BMJ

More information on related health conditions

• Cold vs. flu: what’s the difference?, SingleCare

• Common cold treatments and medications, SingleCare

• Croup treatments and medications, SingleCare

• How to tell if your coronavirus symptoms are mild, moderate, or severe, SingleCare

• Pneumonia treatments and medications, SingleCare