Flu and Your Baby

Symptoms, Treatment, and Prevention of Flu in Premature and Full Term Babies

Mum administering syrup to baby in bedroom
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When the weather gets cooler and older kids return to school, cold and flu season begins. Keep your baby safe from the flu and its more serious side effects by vaccinating early, knowing the symptoms of the flu, and getting treatment for the flu right away.

What is the Flu?

Influenza, or the flu, is a virus that can be mild or severe. There are several different types of flu, including influenzas A and B, which cause regular, seasonal flu.

There's also H1N1, a strain of influenza A that causes "swine flu."

Symptoms of Flu in Babies

Flu can be very serious for infants, especially those who were born early, those with long-term health problems related to prematurity, and those with weakened immune systems. Early detection and treatment of the flu can help prevent serious complications. Take your baby to the doctor if he or she shows any of the following flu symptoms:

  • Fever of 100° F or higher
  • Cough
  • Vomiting
  • Diarrhea
  • Runny nose
  • Irritability or crankiness
  • Acting more sleepy than usual
  • Poor feeding

If your baby has signs of the flu, your pediatrician can check to see whether he/she has the flu or another illness. The test is quick and doesn't require withdrawing blood; the doctor or nurse will simply swab the inside of your baby's nose.

In some cases, the flu can cause serious respiratory symptoms. If your child is having trouble breathing, call 911 or take your baby to the hospital immediately. Signs of respiratory distress include:

  • Labored breathing
  • Chest retractions
  • Flared nostrils
  • Breathing faster than 60 breaths per minute
  • Bluish lips or skin

Treating Flu in Infants

When adults get the flu, their doctor will usually prescribe an antiviral medication like oseltamivir (Tamiflu) or zanamivir (Relenza)—prescription medicines available only through a doctor.

There are no FDA-approved antiviral medications to treat seasonal flu in infants younger than one, but oseltamivir (Tamiflu) has successfully been used in infants and preemies, and is FDA-approved to treat swine flu in infants.

Note: On December 21, 2012, the FDA approved Tamiflu (oseltamivir) to treat flu in infants 2 weeks to 1 year old who have had flu symptoms for 2 days or less.

If your baby has the flu, he or she might also have a fever high enough to require medicine. Always check with your doctor before giving any type of medication to an infant. Your pediatrician might recommend ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) to treat your baby's fever.

Preventing the Flu in Your Baby

To protect your baby from the flu, you'll have to protect your family from the flu. The flu vaccine can't be given to babies under 6 months of age. Your baby is most likely to get the flu from a sick family member or a caregiver, so protect her/him by making sure everyone who spends time with the baby gets a flu shot.

In addition to making sure your baby's family and friends get the flu shot, keep your hands clean to help prevent the spread of flu germs. Wash your hands often, especially after:

  • Blowing your nose
  • Touching your nose or mouth
  • Spending time around anyone who seems to feel sick

If your baby is over 6 months old, then the flu vaccine is the best way to prevent the flu. Children getting the flu vaccine for the first time will need to get 2 separate shots about 1 month apart to be fully protected.

If your baby was premature, you do not need to wait until he's 6 months corrected age for the flu shot. The vaccine is well tolerated and has good protection at 6 months after birth, even if your baby was born very early.


Centers for Disease Control. "Protecting Against Influenza (Flu): Advice for Caregivers of Children Less Than 6 Months Old." Retrieved from http://www.cdc.gov/flu/protect/infantcare.htm

Medline Plus. "Your baby and the flu." Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/007444.htm

Pannaraj, PS., Tam, B., & Akan, D. (2011). "Oseltamivir treatment and prophylaxis in a neonatal intensive care unit during a 2009 H1N1 influenza outbreak." Journals in Perinatology 7:487-493.

D'Angio, C., et. al. (2011) "Immunogenicity of Trivalent Influenza Vaccine in Extremely- Low-Birth-Weight, Premature versus Term Infants." Pediatric Infectious Disease 30(7): 570–574.

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