The Centers for Disease Control and Prevention (CDC) estimate that 20,000 children under the age of five are hospitalized for influenza each year--a figure that does not include visits to the emergency room, urgent care centers or physicians' offices. Children under one year, according to the American Academy of Pediatrics, are especially susceptible to flu-related complications such as ear infections, croup, bronchiolitis (an infection of the lungs' small breathing tubes) and/or pneumonia. However, flu symptoms often present differently in this age group compared to older children.
Systemic Symptoms
Systemic symptoms of flu in people of all ages include fever, chills and sweats, headache, muscle aches and fatigue. Children under one year can't communicate these symptoms verbally, so parents and caregivers need to monitor for other cues such as irritability, lethargy, food or drink refusal, increased need for sleep and decreased responsiveness. Fever can be measured objectively, but the CDC defines it a little differently for infants: 100 degrees Fahrenheit or higher for under the arm, 101 degrees Fahrenheit or higher orally, or 102 degrees Fahrenheit or higher rectally. The CDC also warns that the absence of flu does not necessarily rule out flu. The immune systems of infants, particularly those under six months, may not be developed enough to mount a fever in response to infection.
Respiratory Symptoms
Respiratory symptoms of the flu such as cough, runny nose and nasal congestion present the same in children under one year as they do in people in general. Unfortunately, breathing problems develop much more quickly in infants because their airways are so much smaller. According to the CDC, fast breathing, labored breathing, turning blue, inability to wake up and respiratory symptoms that start to improve only to become suddenly worse mean it's time to go to the emergency room.
Gastrointestinal Symptoms
Flu produces vomiting, diarrhea or both in 40 percent of people, according to a 2009 report in the "New England Journal of Medicine." In children under one year, it may be difficult to differentiate vomiting from spit-up, which usually resembles breast milk or formula, and occurs shortly after feedings. Vomiting may appear brown or green (bilious), may occur unrelated to feedings and may happen more frequently than spitting-up. Similarly, infant stools normally differ from adult stools, making diarrhea difficult to diagnose. Stools that occur more frequently than normal, or look different from the infant's usual stools are probably diarrhea. Dehydration develops quickly in this age group, so it's important to pay attention to the signs. Dark urine and fewer wet diapers signal a problem. Sunken eyes or fontanels, and dry mucous membranes mean it's time to go the emergency room.
References
- CDC: What To Do If You Get Sick - 2009 H1N1 and Seasonal Flu
- American Academy of Pediatrics: Flu (Influenza)
- "New England Journal of Medicine;" Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans; Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team; June 18 2009
