When adults get hit with the flu, there's no mistaking it. You're feverish, your head feels stuffed up, and you ache everywhere. But with kids, the signs aren't always as easy to detect. Young children with the flu can run the whole gamut of symptoms," says Dr. Martha Snyder, a pediatrician and assistant professor of pediatrics at Duke University School of Medicine."Some children have the mildest of mild symptoms, while for others, symptoms are very severe.”

Below is your guide to spotting flu symptoms no matter what your child's age, and ways to bring relief.

Infants Under Six Months
Babies in the first six months of life are at the greatest risk of complications from the flu, says Snyder, because their immune system is not fully mature yet and their very small airway makes it easy for them to experience respiratory distress.

If your infant has a fever, call your doctor and watch for other signs of illness, such as dehydration. "When babies this age don't feel good, they usually don't want to drink," she adds. Provide plenty of water to keep an infant hydrated.

 

Children Six Months to 2 Years
Kids under the age of 2 who come down with the flu often have respiratory symptoms (cough, runny nose, sneezing), high fevers (sometimes as high as 104 F), diarrhea and vomiting."But while many kids have all of these symptoms, others may only have one," says Snyder.

Recognizing the early signs in toddlers is especially important, she says, because they can also get dangerously dehydrated very quickly. In addition, because of their smaller airways, babies can quickly progress to having wheezing and labored breath, which requires medication. Signs that a child's breathing is compromised include wheezing, fast breathing or shortness of breath, and nose flaring.

Children 2 to 4 Years
A child who can't talk yet (or can't talk well) obviously can't tell you that his body aches all over, so you need to be alert for behavioral changes, says Snyder. For instance, in many cases, children with the flu will have shaking chills and refuse to walk, because their legs are very achy.

With kids under the age of 4, you really have to watch them to see how they're acting. Respond to anything that seems out of the ordinary," adds Snyder. "Young kids often have a limp look to them. Or they're so uncomfortable they just want to be held."

Children 4 to 6
Once kids can tell you how they feel, listen for complaints similar to an adult's. But be aware that if your child is under the age of 6, oral over-the-counter cold and flu medications are not recommended. "You should never give children this age decongestants, cough suppressants and other OTC cold remedies, because of the side effects," says Snyder.

But there are other things you can do. "It's OK to give your child acetaminophen or ibuprofen for fever or pain reduction," adds Snyder. It's also safe to apply topical soothers to help relieve symptoms. And some children don't mind saline nasal sprays for stuffy noses but be careful not to use them too often (more than six times a day), since overuse can cause swelling of a child's nasal passages.

Other beneficial non-drug treatments for colds and flu include chamomile tea with honey, and a cool mist humidifier. Just be sure to use one that has a humidity gauge and to keep the level at no higher than around 50 percent to avoid a mold problem.

Children Over 6
For children over the age of 6, symptoms are essentially the same as adults'. And at this point, OTC decongestants and cough suppressants are generally safe, although they're not recommended for children with certain health conditions. For instance, if your child is taking medication for ADHD, ask your doctor before giving your kid a decongestant, since the combination of the two drugs has been shown to cause heart problems.

In addition, kids with asthma or any kind of respiratory problem should stay away from cough suppressants, says Snyder, because these products may make it harder for them to clear secretions from their lungs, which can lead to pneumonia.

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This year, when you're hosting parties and relatives during the holidays, there's an extra challenge to add to the mix: the risk of spreading cold and flu germs. While we all love to celebrate with friends, family and co-workers, it's easy for germs to crash the party.

Luckily, you can be a gracious host and keep everyone healthy, says etiquette expert Anna Post, great-great-granddaughter of Emily Post, the American author on etiquette. "It's always important to have good manners, but it's especially important during cold and flu season," she says

Post has some valuable advice for how to handle six of the season's most common germ-spreading scenarios. Follow her lead, and no one will leave your home with hurt feelings -- or the flu.

Scenario No. 1: Your friends arrive for a long weekend, and their child regularly sneezes without covering her mouth.

It's not your place to correct someone else's child, says Post. It's better to speak to the parent -- be clear and calm, as you're more likely to offend if you sound upset. Make it easy on your guests by saying, "I know we're all extra-worried about the flu this season. I'd be happy to leave a stool in the kitchen so the kids can wash their hands." Their daughter might even be excited to wash her hands like a grown-up. Finally, you could offer to teach her a clean-hands trick, but once again, make your tone gracious:"My kids love this trick of sneezing into their sleeve. May I teach it to Sara?”

Scenario No. 2: At this year's holiday potluck, people will want to shake hands when they arrive, but you don't want to encourage the spread of germs.

It's OK not to shake hands as long as you convey a warm welcome with your words and body language," says Post. She recommends tailoring the greeting to the person:

Close friends and loves ones: Give a hug.

• Acquaintances: Give a welcoming smile but keep your hands to yourself as you say, "It's so great to see you!”
• Co-workers: It's best to shake hands with colleagues. Just slip away to wash your hands once greetings are over.

Scenario No. 3: During a weeklong visit to your home, a relative comes down with a cold.

The most important thing is not to make her feel like a pariah, says Post. "She's not suddenly persona non grata just because she got sick." Tell her how sorry you are that she is feeling under the weather. She may decide to leave early, but if not, help her feel as comfortable as possible in your home. Set her up in a cozy bedroom that is quiet and away from others so she can get plenty of rest. (This also helps keep germs from spreading.) Set up a TV in the room and bring her some books to keep her occupied. Finally, go beyond asking what she needs, because she may be embarrassed to make requests, says Post. Offer to bring her some tea, draw her a hot bath, or run to the drugstore for medicine.

Scenario No. 4: You're playing games after a holiday dinner, and a friend coughs on the Wii remote and then hands it to you.

There are two appropriate responses, says Post. If the cougher isn't overly sensitive, go the direct route. Jokingly say (with a smile in your voice),"John, that's gross -- go clean that thing up!" If you're not comfortable being so blunt, try a more diplomatic approach. Simply take the remote as you say, "With the flu going around, let me just wipe this thing down.”

Scenario No. 5: You host a holiday happy hour at your home for your co-workers. One of them starts helping prepare appetizers but doesn't wash her hands before touching the food.

As hostess, it's your responsibility to speak up for the well-being of all your guests. That said, no one likes to be corrected, so it's important to speak gently. "When we're worried or stressed, we often forget that tone of voice makes all the difference. You need to be direct but also kind," says Post. Smile at your friend and nonchalantly say, "Oh, Kate, since it's cold and flu season, do you mind washing up? We just want to be extra-careful. There's some soap at the sink."

Scenario No. 6: It's two hours before your annual holiday cookie swap, and you notice the first signs of the flu. You don't want to let everyone down by canceling, but you don't want to get anyone sick either.

Call a close friend who's coming to your party and ask her to step in as hostess. You could say, "Jen, I think I'm coming down with something. I know this is a lot to ask, but everything is all ready, and I was hoping you could play hostess. I'll stay upstairs, but I want everyone to enjoy themselves.”

If you're too sick to have people in your home, ask a neighbor who is invited if she could hold the party at her house. Say, "Pam, I know this is last minute, and I'm so sorry. But I've got the flu and don't want to get anyone sick. Could we redirect to your place?" If she agrees, ask her to help you call the other guests to spread the word, and have your husband answer the door for any you can't reach. All he has to say is, "We're so sorry -- we tried to reach you. But my wife is sick, and we don't want to pass it along, so the party's next door."

If you don't have a friend who can host, then you must call your guests and cancel, says Post. "It's unfortunate to cancel last-minute, but it's better than causing your friends to get sick.”

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For many families, battling the flu is a seasonal rite of passage: Up to one in five children will suffer through a bout this year, according to the Centers for Disease Control and Prevention. "But it can be a scary experience for any mom," says Dr. Kelly Orringer, a clinical professor of pediatrics at the University of Michigan. "Your child can get very sick, very fast."

To help ease your worries, we asked the experts to spell out what day-by-day flu symptoms to expect, how you should treat them, and when to call your pediatrician. By arming yourself with the flu facts, you can stop fretting -- and start taking charge!

Day 1: Initial Flu Symptoms Appear
The first signs of flu are a runny nose, chills and body aches," says Dr. Stanley Grogg, a professor of pediatrics at Oklahoma State University and a spokesman for the American Osteopathic Association. "A child will feel pretty miserable within a 24-hour span.” To prepare for the next few days, stock up on blankets and soft tissues that won’t irritate the area around your child’s nose and increase discomfort.

Be sure to call your pediatrician too: Your little one is already contagious, says Grogg, so if you have a family member who is at risk for complications of the flu -- for example, an infant under the age of 6 months, or a senior citizen older than 65 -- an antiviral medication may be necessary. The course of two pills, which prevent the spread of flu, is most effective within 48 hours of the onset of your child's symptoms.

In addition, Grogg says you should take your child to the doctor if, at any point during the duration of the flu, your child runs a fever higher than 105 F, experiences painful, labored breathing, or stops drinking. Moms have good instincts about their kids, so if something feels really wrong, trust your gut and call your pediatrician.

Day 2: Your Child Runs a Fever
On the second day, a child usually starts running a high fever," says Grogg. "She'll also experience fatigue and a wet cough." He advises bringing down her fever and easing aches with acetaminophen or ibuprofen -- but avoid aspirin."Giving a feverish child aspirin has been linked to a rare, but dangerous, condition called Reye's syndrome," he says.

To prevent dehydration, Grogg recommends making sure that your child is drinking enough: Place a water bottle next to her bed and give her ice pops made with 100-percent fruit juice. And because most children also lose their appetite, he also suggests feeding her calorie-dense treats, like chocolate milk and smoothies.

Days 3 to 5: Symptoms Worsen
Is your child super-sick? That's normal. "This is when flu symptoms are at their worst," explains Orringer. Your kid may also start experiencing gastrointestinal problems, like vomiting and diarrhea; continue giving your child plenty of fluids and ibuprofen or acetaminophen, says Orringer. "For children older than 6, over-the-counter oral medications can provide relief." Other methods she recommends to ease the suffering:

• Brewing tea with honey (can help soothe a sore throat and cough)
• Using a saline spray and running a humidifier (can lessen congestion
• Applying a topical cough-relief rub (can help your child sleep better)

Days 6 to 10: Recuperation Begins
At last -- your child should start feeling better. But if he's not showing improvement, call your pediatrician, says Grogg.

Your kid is also less contagious during this time, says Grogg, so it's safe to let him play with his siblings and friends again. Once your child's temperature is below 100 F for 24 hours (without the aid of acetaminophen or ibuprofen) and he no longer has an uncontrollable cough, Grogg recommends sending him back to school.

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Maybe your son suddenly developed a stomachache on the day of the big quiz. Or your daughter has a mysterious cough after playing back-to-back soccer games yesterday. For whatever reason, you're not sure if your child is really sick -- or just sick of school. In my experience as a school nurse, I've found that there are a few ways you can tell the difference. Be on the lookout for these telltale signs for when a child is faking sick:

• Inconsistent complaints. If your daughter complains of a stuffy nose one minute, followed by a stomachache and then a headache the next, it may be a sign she's pretending.
• Disappearing symptoms. In my office, I have a rule that I don't see non-emergency cases for the first hour of school. That's because when kids become engaged with activities and friends, they forget all about being "sick." So take note if you notice that your child's cough vanishes when he's playing with his brother. Kids who are under-the-weather also tend to doze off throughout the day, so be wary if your son seems completely alert while watching television or playing computer games.
• Sudden recovery. If a child seems fine after you decide to keep her home from school, that's a surefire red flag!

So should you let him stay home? My rule: If a child doesn't have a fever, hasn't vomited or doesn't have any obvious symptoms (such as diarrhea), I would send him to school. But don't discount his complaints: If he keeps mentioning a symptom, like a headache or stuffy nose, schedule an appointment with your pediatrician to rule out any illnesses or other health issues.

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Far too many of us treat our cars like second homes: We eat, drink, spill things and create piles of clutter inside.

But stop and think about it. When was the last time you really gave your car a thorough cleaning on the inside? And think back to the last time you hopped into your car with a bad cold and sneezed, spreading germs throughout your car's cabin. Did you bother to wipe down surfaces afterwards? Didn't think so.

Germs run rampant all around us, including in our automobiles. Fortunately, there's much you can do to keep those pesky little microbes in check. Here are some tips from the country's leading germ experts on how to sanitize your ride's interior.

Daily Wipe-down
When you and your kids get in your car, you inevitably come into contact with surfaces that are covered with germs," says Donna Duberg, assistant professor of clinical laboratory science at Saint Louis University's Doisy College of Health Sciences."Then you touch your eyes, nose and mouth. That's how little germies from unclean surfaces make their way into our bodies."

Stay healthy by wiping down the frequently touched areas with a disinfectant (e.g., a sanitizing or disinfecting wipe) that kills viruses and bacteria. (You may have to read the fine print on the label to be sure.) Look for a wipe that does not contain bleach -- some are labeled as being "bleach-free" -- so you can use them to clean hard, nonporous surfaces like steering wheels, dashboards, knobs, chrome accents, door handles and even mirrors.

Make wiping down the interior of your vehicle part of a daily routine, especially when someone in your family has been sick.

Sneeze on Wheels
We are becoming a nation of families eating on the go -- most often in our cars. Inevitably, food particles end up on the vehicle's upholstery, floor, seat belts, steering wheel and knobs. These crumbs are a breeding ground for bacteria, which love a warm, dark and moist environment.

What's more, during allergy season you're also likely tracking irritating outdoor allergens into your car, exacerbating those sniffles and sneezes.

Vacuum what you can with a handheld portable vac after returning home from any outing during which you or the kids were eating in the car. "Then wipe down surfaces with a disinfectant wipe and dry them completely to eliminate any lingering moisture," says Philip Tierno, M.D., Ph.D., director of clinical microbiology and immunology at New York University Langone Medical Center and the author of The Secret Life of Germs: Observations and Lessons From a Microbe Hunter. "Failing to do so allows organisms like mold to grow, which can make you and your children sick," warns Tierno.

And even if your family doesn't eat in the car, make a regular habit of vacuuming the floor and seats to pick up pollen and other sneeze-inducers you might have inadvertently welcomed into your car.

Sanitizer at the Ready
Once you get into the habit of wiping surfaces and vacuuming food spills in your car, why not attack germs' main entry point into your car: your hands?

Hand sanitizers should be kept in every single vehicle, advises Duberg. After you use the handle at the gas pump or press the buttons on the ATM, your hands are covered with germs from the people who touched these surfaces before you.

After touching commonly used surfaces, apply a hand sanitizer to avoid passing germs onto the surfaces inside your car. Go with sanitizers that contain at least 60 percent alcohol concentration. Look at the list of active ingredients for ethyl alcohol, ethanol, isopropanol or another variation. Apply to all parts of the hands (i.e., palms, nails, knuckles) and continue to rub your hands together until they are completely dry.  

Car Seat Care
Little ones can equal big messes in the car -- bottle spills, leaky diapers, unidentifiable crumbs. Luckily, the majority of child safety seats are made from fabric that can be removed and washed. A recent study conducted by Charles P. Gerba, Ph.D., professor of environmental microbiology at the University of Arizona and a leading authority on germs, found that car seats often have bacteria on them -- and enough to make a child sick with an ear infection or strep throat.

And that's not all. They also typically have some mold growth, which can be particularly worrisome if you or your child suffers from allergies or asthma. Gerba suggests washing your child safety seat cover a few times per month.

He also recommends wiping down the plastic shell and harness of the child safety seat with water and a mild soap on a weekly basis -- or more often if your child is sick. Between washings, be sure to vacuum or shake out the car seat as often as possible to remove food droppings.

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