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How to care for your child at home

Most children in Ontario who develop flu will be sick for a few days with fever and cough, and then get better. Children may have different flu symptoms than adults, and flu symptoms may vary for each child depending on their age and other factors.

Older children will likely have the same symptoms as adults: sudden fever or chills, cough or shortness of breath, sore throat, fatigue (lack of energy), and achy muscles or joints. Young children and infants may be irritable and eat poorly, or develop a hoarse cry and barking cough. Younger children – especially children under 6 months old – may also have diarrhea, vomiting and stomach pain. Sometimes children may not have a fever.

If your child develops flu symptoms, there are several things you can do to help your child feel better and keep flu from spreading :

• Take off heavy clothing and blankets.
• Dress the child in lightweight clothing and keep the room temperature at 20°C (68°F)
.
• Give acetaminophen or ibuprofen for fever and muscle pain in the dose recommended on the package (unless your doctor says otherwise). Do NOT give acetylsalicylic acid (ASA or Aspirin®), or any cold medicine that has ASA, to children or teenagers under the age of 18.
• Ask your pharmacist about appropriate over-the-counter medications for treating fever.
• Offer cool fluids frequently when the child is awake. Extra fluids are needed to replace what is lost in sweating. If your child’s urine is darker than usual, he/she needs more to drink.
• Give lukewarm sponge or tub baths. Avoid cool baths. NEVER USE ALCOHOL RUBS TO BRING DOWN A FEVER.

Some suggestions to treat your child’s other flu symptoms may include :

• Encourage your child to get plenty of rest.
• Use salt-water nose drops to treat a stuffy nose.
• Ask your pharmacist about any over-the-counter medicines for cough.

• Keep your child at home until his/her fever has been absent for at least 24 hours and your child is feeling well enough to resume normal activities. It is important for your child to stay home when they have a fever so that the virus doesn’t spread to other children.
• Remind and help your child to wash his/her hands often with soap and water or an alcohol-based hand sanitizer – especially after coughing, sneezing, or wiping his/her nose.
• Teach your child to cough or sneeze into their upper sleeve or a tissue, and then throw the tissue away and wash his/her hands.
• Don’t let your child share eating utensils (e.g., cups or straws), toothbrushes or towels.
• Keep the surfaces that your child touches clean and disinfected.

When can your child return to school?

Your child can return to school 24 hours after the fever has resolved and he/she is feeling well enough to resume normal activities.

It is common for a child to have a cough for days to weeks after a respiratory infection. If your child has a cough but no other symptoms, it is safe for him/her to go to school.

When should you seek medical care for your child?

Use Ontario’s influenza assessment tool to see whether your child needs medical care.

Call Telehealth Ontario (1-866-797-0000 or TTY 1-866-797-0007) or your health care provider or if your child is under age 5 and develops flu symptoms. The risk of complications from flu is higher for children under age 2.

Watch for any signs that your child’s symptoms are getting worse. Call 911 or take your child to the nearest hospital emergency department RIGHT AWAY if your child has any of the following symptoms :

• Difficulty breathing / shortness of breath when doing very little or resting.
• Blue lips, cold feet, hands and/ or toes; sudden paleness.
• Extreme lack of energy; limp or unconscious.
• Continuous vomiting or severe diarrhea with signs of dehydration such as dry tongue, dry mouth, decreased peeing (no urine for the past 6-8 hours), or very yellow/ orange urine.
• Stiff neck, sensitive to light.
• Seizures or convulsions.
• Confusion or disorientation.

Does your child have a fever?

The best way to measure your child’s temperature is with a digital thermometer (available at drug stores) or – for children over age one – an ear (tympanic) thermometer.

There are 3 ways to take a child’s temperature :

• By the mouth.
• Under the armpit.
• In the ear.

The best method to choose for an exact reading depends on your child’s age :

Mouth method, digital thermometer :

• Press the button to turn thermometer "on".
• Put thermometer tip under your child’s tongue and tell him/her to close the mouth.
• Wait for thermometer to beep.
• Read the temperature on the display.
• Press the button to turn thermometer off.
• Wash only the tip of thermometer with soap and warm (not hot) water and wipe off with alcohol after use. Dry well.

Armpit method, digital thermometer :

• Press the button to turn thermometer "on".
• Put thermometer under your child’s armpit. The silver tip must touch the skin.
• Hold the top of thermometer with one hand and hold down your child’s arm with the other hand.
• Wait for the thermometer to beep.
• Read the temperature on the display.
• Press the button to turn the thermometer off.
• Wash only the tip with soap and warm (not hot) water and wipe off with alcohol after use. Dry well.

Ear method, tympanic thermometer :

Note: NOT recommended for children under one year of age.

• Use a clean probe tip each time and follow the manufacturer’s instructions carefully.
• Gently tug on the ear, pulling it up and back. This will help straighten the ear canal, and make a clear path inside the ear to the eardrum.
• Gently insert the thermometer until the ear canal is fully sealed off.
• Squeeze and hold down the button for one second.
• Remove the thermometer and read the temperature.

If your child’s temperature is 38°C (100.4°F) or higher, your child has a fever.

Touching your child’s forehead or neck is not a reliable way to check for fever.

If your child has a fever seizure

A fever seizure is a convulsion (a fit) caused by a rapid rise of body temperature to over 39°C (102.2°F). Most seizures occur within the first day of a child becoming sick and not always when the fever is the highest. Sometimes a seizure is the first sign of a fever in an infant or child.

Signs of a fever seizure include :

• Sudden stiffness of the muscles of the face, arms, or legs on both sides of the body.
• Jerky movements.
• Falling if standing.
• Passing urine.
• Not breathing and starting to turn blue.
• Not responding to voice or touch.
• Crying or moaning.

A simple fever seizure will stop by itself with a few seconds to 5 minutes. It is followed by a brief period where the child is sleepy or confused.

A complex fever seizure lasts longer than 15 minutes, occurs unevenly affecting one part of the body more than the rest, or happens again during the same illness.

If your child has a fever seizure :

• Stay calm.
• Leave your child on the floor (you may want to slip a blanket under the child if the floor is hard).
• Loosen tight clothing, especially around the neck.
• Move items from around the child that may hurt them. Move the child only if he or she is in a dangerous location.
• Turn the child on his or her side or stomach to protect the head and to prevent the child from choking if he or she throws up.
• Don’t hold your child down.
• Don’t force anything into the mouth as this increases the risk of injury.
• Observe the child closely and time the fever seizure so you can tell the doctor what happened.

October 23, 2009

For More Information

Call the ServiceOntario INFOline at 1-877-844-1944
TTY 1-800-387-5559
TTY (Toronto) 416-327-4282
Hours of operation : 8:30am - 5:00pm

Visit Telehealth Ontario or call 1-866-797-0000
TTY: 1-866-797-0007
Hours of operation : 24 hours, 7 days a week

Visit ontario.ca/healthcareoptions or call 1-866-330-6206.

If you don’t have a health care provider, you can register for the Health Care Connect program. Visit ontario.ca/healthcareconnect or call 1-800-445-1822.

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