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Archives

Inclined Sleepers and Other Baby Registry Items to Avoid

From American Academy Pediatrics:

Having a baby is an incredibly exciting time! Many parents set up baby registries for items that they believe their baby will need. However, it’s important to know that some popular products are unnecessary and can actually be dangerous for infants. Examples include inclined sleepers, positioners, and crib bumpers.

Each year, about 3,400 infants in the United States die unexpectedly during sleep. This can happen from accidental suffocation, sudden infant death syndrome (SIDS), or unknown causes.

To help prevent these deaths, the American Academy of Pediatrics recommends that all infants should sleep on flat and firm surfaces. Babies should sleep by themselves, without any bumpers, soft bedding, pillows, or stuffed toys. Crib bumpers and inclined infant sleeper products can cause a baby to suffocate. We also advise against using products that are for infant bedsharing with parents.

New safety standards on the way

A safe sleep environment is so important that the U.S. Consumer Product Safety Commission (CPSC) approved a federal safety standard for infant sleep products in June 2021. Starting in mid-2022, this standard will help get rid of potentially dangerous baby sleep products such as inclined sleepers, in-bed sleepers, loungers, and travel/compact sleepers. These products will have to meet the same CPSC standards that are already in place for cribs, bassinets, play yards, and bedside sleepers.

Here’s why these and other dangerous infant sleep products should stay off your registry and out of your home.

Inclined sleepers and positioners

These are sometimes called baby nests, docks, pods, loungers, rockers, or nappers. Infant positioners and inclined sleepers have been popular items on baby registry lists for years. But until mid-2022, these products are not regulated and have no safety standards.

The CPSC says that sleep products that incline more than 10 degrees are not safe. Soft and plush sleep surfaces are also dangerous. Inclined sleepers allow babies to sleep at a 30-degree angle. Infants placed in these products may fall asleep in a chin-to-chest position, which can restrict their airway. They can also roll out of the devices and become trapped under them. Inclined sleepers have been tied to at least 94 deaths.

With sleep positioners, babies can suffocate after rolling onto their stomachs since they can’t lift their heads. The soft padding can make it difficult to breathe if a baby’s face presses against it.

Crib bumpers

Crib bumpers were long considered staples of nursery décor. They were originally intended to cushion babies from the crib slats. Crib bumpers are dangerous because of the risk of suffocation, entrapment, and strangulation. Plus, older babies may use the bumpers to stand on and climb out of the crib, creating a fall risk. Crib bumpers have been linked to at least 83 infant deaths in the past 30 years.

In addition to traditional padded bumpers, stores now sell mesh bumpers and vertical crib liners. But even these can get loose and become a strangulation risk. Babies can also get trapped between them and the crib mattress.

There is no evidence that crib bumpers—of any kind—prevent injury in young infants.

Cribs today are regulated by the CPSC and have updated safety standards. The slats are closer together to prevent your baby’s head from getting stuck. This means that bumpers are not only dangerous, but unnecessary. Maybe you’re concerned about your child’s leg getting stuck between crib slats. If so, use a wearable blanket or sleeping sack that’s the right size for your baby.

Why are these products still sold?

Unfortunately, the new regulations don’t take effect until mid-2022, meaning that inclined sleepers and positioners will still be available. As for crib bumpers, the CPSC plans to review federal safety standards for them later this year. We continue to urge the CPSC to ban all these dangerous infant sleep-related products.

A bill that would prohibit crib bumpers was introduced in Congress in 2021 too. Known as the Safe Cribs Act, this bill would make it illegal to sell, distribute, manufacture, or import crib bumpers. The bill’s sponsors are concerned that parents will keep buying these products, not realizing that they’re potentially hazardous.

Some stores, online retailers, cities, and states, have already stopped selling or have banned inclined sleepers and crib bumpers. Some companies have also issued voluntary recalls of these products.

Remember

Even in areas where these dangerous products are banned, they can still turn up at secondhand stores or garage sales. It’s important to check the CPSC website to see if products have been recalled before using them. Also, make sure anyone who watches your child knows about recalled and unsafe products.

It’s also important to keep in mind that your baby should only sleep in products that are designed to be safe sleep spaces, like cribs, bassinets, and portable play yards. Other products like swings, reclined seats, bouncers, and other sitting or positioning devices are not safe for sleep. If your baby falls asleep in one of these, move her to a safe sleep space right away.

If you have any questions about safe sleep products for your baby, talk with your pediatrician.

More information

Georgetown Pediatrics
Newborn News

Colic Relief Tips for Parents

From American Academy Pediatrics:

Does your infant have a regular fussy period each day when it seems you can do nothing to comfort her?

This is quite common, particularly between 6:00 p.m. and midnight—just when you, too, are feeling tired from the day’s trials and tribulations. These periods of crankiness may feel like torture, especially if you have other demanding children or work to do, but fortunately they don’t last long. The length of this fussing usually peaks at about three hours a day by six weeks and then declines to one or two hours a day by three to four months. As long as the baby calms within a few hours and is relatively peaceful the rest of the day, there’s no reason for alarm.

If the crying does not stop, but intensifies and persists throughout the day or night, it may be caused by colic. About one-fifth of all babies develop colic, usually between the second and fourth weeks. They cry inconsolably, often screaming, extending or pulling up their legs, and passing gas. Their stomachs may be enlarged or distended with gas. The crying spells can occur around the clock, although they often become worse in the early evening.

What Causes Colic?

Unfortunately, there is no definite explanation for why this happens. Most often, colic means simply that the child is unusually sensitive to stimulation or cannot “self-console” or regulate his nervous system. (Also known as an immature nervous system.) As she matures, this inability to self-console—marked by constant crying—will improve. Generally this “colicky crying” will stop by three to four months, but it can last until six months of age. Sometimes, in breastfeeding babies, colic is a sign of sensitivity to a food in the mother’s diet. The discomfort is caused only rarely by sensitivity to milk protein in formula. Colicky behavior also may signal a medical problem, such as a hernia or some type of illness.

Although You Simply May Have to Wait It Out, Several Things Might Be Worth Trying:

  • First, of course, consult your pediatrician to make sure that the crying is not related to any serious medical condition that may require treatment.Then ask him which of the following would be most helpful.
  • If you’re nursing, you can try to eliminate milk products, caffeine, onions, cabbage, and any other potentially irritating foods from your own diet.
  • If you’re feeding formula to your baby, talk with your pediatrician about a protein hydrolysate formula. If food sensitivity is causing the discomfort, the colic should decrease within a few days of these changes.
  • Do not overfeed your baby, which could make her uncomfortable. In general, try to wait at least two to two and a half hours from the start of one feeding to the start of the next one.
  • Walk your baby in a baby carrier to soothe her. The motion and body contact will reassure her, even if her discomfort persists.
  • Rock her, run the vacuum in the next room, or place her where she can hear the clothes dryer, a fan or a white-noise machine. Steady rhythmic motion and a calming sound may help her fall asleep. However, be sure to never place your child on top of the washer/dryer.
  • Introduce a pacifier. While some breastfed babies will actively refuse it, it will provide instant relief for others.
  • Lay your baby tummy-down across your knees and gently rub her back. The pressure against her belly may help comfort her.
  • Swaddle her in a large, thin blanket so that she feels secure and warm. 

When you’re feeling tense and anxious, have a family member or a friend look after the baby—and get out of the house. Even an hour or two away will help you maintain a positive attitude. No matter how impatient or angry you become, a baby should never be shaken. Shaking an infant hard can cause blindness, brain damage, or even death. Let your own doctor know if you are depressed or are having trouble dealing with your emotions, as she can recommend ways to help.

Georgetown Pediatrics
Newborn News

Probiotics in Infant Formula

From American Academy Pediatrics:

Probiotics” (meaning “for life”) is a word you may see when shopping for infant formula and supplements. Some formulas are fortified with these probiotics, which are types of live bacteria. Doctors may also recommend probiotic drops or powders for breastfed infants. These are “good” or “friendly” bacteria already present at high levels in the digestive system of breastfed babies.

In formula-fed babies, probiotics in formulas promote a balance of bacteria in your baby’s intestines, and offset the growth of “unfriendly” organisms that could cause infections and inflammation.

Increasingly, parents can find probiotic supplements outside of formula, including for breastfed infants. Research on the benefits of probiotics is ongoing, with some pediatricians embracing their use for infants delivered by C-section or those whose mothers are given antibiotics during labor.

Possible health benefits of probiotics

The most common types of probiotics are strains of bifidobacteria and lactobacilli. Some research has shown these probiotics may prevent or treat disorders such as infectious diarrhea​ and atopic dermatitis (eczema) in children. Other possible health benefits are being studied as well, including the possibility of reduced risk of food-related allergies and asthma, prevention of urinary tract infections, and relief of symptoms of infant colic​.

More research is needed

With many of these health conditions, the evidence confirming any positive effects of probiotic use is limited and more research is needed. At this time, benefits appear to occur only as long as probiotics are being taken. Once your baby stops consuming probiotic-fortified formula, intestinal bacteria levels return to previous levels. This is different from in breastfed infants, where the bacteria in the gut resulting from breastfeeding​ are more resilient and set the stage for healthier outcomes. 

Remember

Before giving your child infant formula fortified with probiotics, discuss the issue with your pediatrician

More information

Georgetown Pediatrics
Newborn News

Tips for Coping with a New Baby During COVID-19

From American Academy Pediatrics:

All babies cry. Most babies cry a lot from two weeks to two months of age. Some cry more than others, and some cry longer than others. For many new parents, crying is one of the most stressful parts of coping with a newborn.

In some cases, extreme stress and a temporary lapse of emotional control in a caregiver can lead to actions that result in abusive head trauma. In fact, the most common trigger for abusive head trauma is simply a crying baby. As an American Academy of Pediatrics policy statement points out, actions that lead to abusive head trauma often happen when caretakers experience stress and get to the end of their rope.

However, there is a bright side: The key to preventing actions that lead to abusive head trauma is to understand how common feelings of frustration, isolation, and exhaustion are during the first few months of an infant’s life.

Helpful tips

Usually, new parents can seek out social supports and external help—but what happens when we are restricted in our movements and our contacts? What happens when grandparents can’t come over to help out, or when neighbors don’t stop by for a cup of coffee? What happens when families face job loss, childcare challenges, and more lingering fallout from the COVID-19 pandemic? Here are a few suggestions:

  • Try all the soothing tricks. Crying babies want to be soothed. You may need to try a few things, over and over, before they calm. Try holding them, feeding them, swaddling them, gently rocking them, singing to them. If these don’t work, put the baby down and take a break. Be sure your baby is in a safe sleep environment (on their back on a firm sleep surface with a tight-fitting sheet, away from soft blankets, toys, pillows, and other bedding materials). While some babies cry for a long time, many parents are surprised at how rapidly babies will cry themselves to sleep.
  • Pay attention to your own needs. The challenges of new mothers can certainly feel overwhelming sometimes. Rest as much as you can—try sleeping when the baby does. Find time for yourself when your partner or other caring adult watches the baby. Put on your headphones, give a friend or relative a call, have a cup of tea, or just relax.
  • Connect with others. Social distancing during the COVID-19 outbreak can be isolating. Try video chats or social media to stay in touch. If you’re a friend or relative on the receiving end of these calls, listen first before offering suggestions. Imagine you are with the young parent, they are crying on your shoulder, and you are offering reassurance without any words. Keeping this image in mind can help you provide the social support that all new parents need.
  • Use your “helpers.” Engage older siblings as much as you can by encouraging them to be your special helpers, so they can help out in developmentally appropriate ways.
  • Seek help. Depression is the most common mental illness in the United States. If you had a history of depression before your baby was born, you may be at higher risk for postpartum depression. Speak with your provider sooner rather than later to help foresee this potential condition. Many doctors, nurses, and mental health providers are now set up for telehealth visits and may be able to help you by video or phone.
  • Reach out. If you are a friend, relative, or neighbor to a family with a newborn, this is the time to reach out. Think about ways you can help. In addition to social support, can you buy diapers or other baby supplies? Can you drop off food or treats for the siblings or adults? Can you safely supervise older children outdoors? Maybe they could come along with you when you walk your dog!
  • Help a co-worker out. If you are a co-worker of a parent returning to work (especially during social distancing) after parental leave, be kind and supportive. If you see or hear the baby on the call, say Hi!
  • Find a forum. New mothers may find it helpful to discuss their experiences with other new mothers. In addition to seeking help from friends, relatives, neighbors, and medical professionals, look for discussion forums and communities of moms dedicated to sharing problems, stories, and tips with each other online (see the list of resources below).
  • Your pediatrician is here to help. Never hesitate to call for advice. Your pediatricians is an excellent resource for understanding your baby and your own needs, including those related to postpartum depression.
  • Resources. Here are a few key resources that may be helpful to you at home:
Georgetown Pediatrics
COVID Newborn News

Simple Ways to Entertain & Boost Your Baby’s Development at Home

From American Academy Pediatrics:

During social distancing to slow the spread of COVID-19, you may be looking for new ways to entertain and play with your young child. Thankfully, all you need is loving attention and some basic household items.

Try these time-tested activities, suggested by age, and let the fun happen!

Newborn to 3 Months

Puppet Play. Make a hand puppet using a sock. Move it up and down and back and forth where your baby can see it, doing a silly dance and singing silly songs. You can even have the puppet give her kisses!

Footloose. Gently dance with your baby positioned over your shoulder. She will enjoy the movement and at the same time will learn to tolerate the slight pressure against her tummy.

Pat-a-Cake. Hold your baby’s hands and gently clap them together to play a game of pat-a-cake:

Pat-a-cake, pat-a-cake, baker’s man (Take baby’s hands through the motions)

Bake me a cake as fast as you can

Roll it (Roll her hands around each other) and pat it (Clap)

and mark it with a B (Guide her finger to write a B in the air)

And put it in the oven for baby and me (Kiss your baby!)

​
Can’t Smile Without You. Lie down on the floor,tummy down facing your baby. Try to get her to smile by sticking out your tongue, smiling at her, and making other funny faces. You may even hear your infant’s first giggle!

4 to 6 months

Little Piggy Game. Hold your baby’s foot up and wiggle each toe while teaching the classic “This Little Piggy” poem in an animated, singsong way. Don’t forget to give your infant a tickle at the end!

This little piggy went to market (big toe)

This little piggy stayed home (second toe)

This little piggy had roast beef (third toe)

This little piggy had none (fourth toe)

And this little piggy went wee wee wee all the way home (little toe)


Mustang Sally. Sit on the floor with your baby sitting on your raised knees. While holding on to her, slowly move your legs side to side and sing “Ride a Little Horsey.” When you say, “don’t fall down,” slide your feet forward!

Ride a little horsey

Down to town

Oops, little horsey

Don’t fall down!


Crocodile Rock. Hold your baby securely, tummy down on your chest. Rock your body from side to side and sing a song like “Row, Row, Row Your Boat.”

​Homemade Toy: Stacking Baby BlocksCollect different-sized clean milk cartons, small boxes and toilet paper rolls. Stuff each with newspaper or tissue paper. Fold the ends down to create blocks​and cylinders, then close them with masking or duct tape. Use a variety of fun colors of contact paper or duct tape to cover each block. ​



Free Fallin’. Stack up some blocks and encourage your baby to bat at and reach for them. Most infants absolutely love to see and hear the blocks tumble to the ground!

7 to 9 months

Fly Me to the Moon. Carefully lift your baby up over your head and back down while playing or singing a song like, “Fly me to the moon!” If your child seems fearful, move more slowly and talk in a calm, soothing voice.

See You Later, Alligator. With your baby seated in front of you, hide a rattle under a blanket or behind your back. Shake the rattle while hiding it and see what happens. If your baby loses interest once it’s hidden, reveal part of the rattle and ask, “Where’s the toy?”

If the Hat Fits. Sit just in front of baby, place a colorful hat on your head and say, “Look! The hat is on my head.” Then remove it and say, “Now the hat is off.” Next, put the hat on and off your infant’s head! Encourage your baby to reach for the hat for more play.

The Humpty Dance. Sit your infant on your lap, either sitting up or tummy down, and gently bounce your legs up and down. For more fun, do this while using a rocking chair!

10 to 12 months

Be-Bop Baby. Seat your baby upright on the floor, legs separated just enough to place a medium-sized ball between them. Show your baby how to roll the ball in your direction, then roll the ball back. Continue taking turns.

Marching On. While seated, stand your baby on your thighs. Hold your baby’s hips and slowly make stepping motions by moving your legs up and down, one side at a time. Sing your favorite song.

You Light Up My Life. Shine a flashlight on the wall. Once your baby sees the light, move it slowly from one side of the room to the other and up and down to encourage visual tracking.

Homemade Toy:​Baby Drums​Cover an oatmeal box or coffee can with colorful contact paper and use plastic baby spoons as drumsticks. (Or, simply give your child a saucepan and a short wooden spoon.) ​



Beat It. Show your baby different ways to tap a drum using the palms of your hands, your fingertips, or a baby spoon. See if your baby can imitate you.

12-24 months

The Big Squeeze. Take colorful kitchen sponges and cut them into fun sizes and shapes to fit into your child’s hand at bath time. Show your little one how to sink a sponge underwater, watch it fill up, then hold it up and squeeze the water out.

​Homemade Toy: Toddler TambourineTape two sturdy paper plates securely together halfway around using colorful duct tape. Fill the tambourine half-full of dry cereal, tape the paper plates together the rest of the way, and shake!​​



Mr. Tambourine Man. Show your little one how to shake and tap a tambourine to make noise. Add more ways, like tapping it against your hip, over your head, and in various directions.

Poking Fun. Show your baby how to press numbers on an old phone or peck on an old keyboard. Glue different textures of fabric at the bottom of each section of an egg carton or old ice tray. Let your baby feel the various textures.

Remember

You have the knowledge and tools to make play a fun and stimulating part of your baby’s daily routine. Keep it simple, be flexible, and do what works for you and your child.

More Information

Georgetown Pediatrics
COVID Newborn News

Bringing Baby Home: How to Prepare for the Arrival of Your Newborn

From American Academy Pediatrics:

One of the most cautious drives you’ll ever take is the one bringing your baby home with you. Newborns look and feel fragile, and they represent a new of world of uncertainty. Here’s what you need to know to make your transition to parenthood easier.

It’s true: There’s no official instruction manual for becoming a parent.

But relax. You’re not the first parent to wonder why you’ve been entrusted with a little person without an instruction manual. The 40 weeks (give or take) of pregnancy allow time for more than just picking out names; it’s your opportunity to plan and prepare. The more you know about your newborn, the better equipped you’ll be when she arrives.

Once your baby is born, doctors will be looking for a few key signs that she is healthy and ready to go home, says Vinod K. Bhutani, M.D., FAAP, professor of pediatrics at Lucile Packard Children’s Hospital at Stanford University School of Medicine. “First they will want to see that the baby is able to breathe well and maintain her body temperature,” says Dr. Bhutani, who is also a member of the American Academy of Pediatrics (AAP) Committee on Fetus and Newborn.

Newborns must also demonstrate that they can feed well. Regardless of whether she’s breastfed or bottle-fed, all babies should be wetting at least three or four diapers in a 24-hour period, says Dr. Bhutani. And while many newborns have some jaundice — a yellowish tint to their skin — their jaundice will be evaluated before they’re sent home from the hospital. If necessary, your pediatrician will discuss a follow-up plan for monitoring your baby’s jaundice.

Healthy at Home

Most healthy newborns go home after two or three days, yet the transition for parents is just beginning. “It’s OK to be a little scared — the first week after babies are born is when they’re most vulnerable,” says Dr. Bhutani. “Newborns can have multiple medical problems that if left unattended can become serious.”

Dehydration is sometimes a concern for newborn babies that can continue once they’ve left the hospital. Your pediatrician will discuss dehydration with you so you’ll know what to look for, how to respond, etc.

Parents should also watch for signs of infection in their newborn. Infections can be picked up during birth or from people other than the parents handling the baby, such as visitors. “Most people think only of fevers, but newborns can have dropping temperatures or a low temperature that’s of concern,” says Dr. Bhutani. It’s always wise to watch for signs of infection around the belly button or circumcised foreskin, such as poor sucking during breastfeeding, a lack of appetite, poor weight gain, weak crying, and increasing irritability.

Jaundice happens in most every baby, peaking in the first week as newborns learn to excrete the yellow pigment called bilirubin in their stools. “Babies tend to have slow liver function at first and may have some evidence of jaundice as their livers quickly mature over the first several days,” write Drs. Laura Jana and Jennifer Shu in Heading Home With Your Newborn. “The bilirubin level generally peaks by about 5 days for term babies and about 1 week for those born prematurely.” If your baby continues to have signs of jaundice — very yellowish skin and eyes — after day four, consult your pediatrician.

Although most babies remain perfectly healthy after they’re discharged from the hospital, it’s important to watch for any signs of illness and take your child to the pediatrician for evaluation within a day or two of leaving the hospital. “Every baby needs to be seen by a pediatrician on day three, four, or five,” says Dr. Bhutani. “It’s a must.”

Finding a Pediatrician

As a new parent, it’s important to find a pediatrician with whom you feel comfortable. If your child becomes ill, you want to have a good working relationship with a doctor you trust and respect, and who will be there to support you.

Begin by evaluating the pediatrician practices in your local area. Determine whether it matters to you if you have a male or female pediatrician. Be aware that while it’s all the same to infants, some children as they get older feel more at ease working with a doctor of the same sex. If possible, visit the offices and meet the physicians in person. Or find out if your hospital has a “Meet the Doctors” night attended by area pediatricians.

Since you’ll be visiting a pediatrician shortly after bringing your child home, don’t leave this task until the last minute. “You have nine months to plan. You should always choose your pediatrician beforehand,” says Dr. Bhutani.

Quick Tips: Time to Call the Doctor

Watch for these signs that it’s time to call your pediatrician:

  • Your newborn’s breathing is faster or irregular
  • You notice blueness or a darkness on the lips or face 
  • Your newborn has a fever 
  • Your newborn’s body temperature has dropped
  • You see signs of dehydration (less than 3 to 4 wet diapers in a 24-hour period)
  • Your baby’s belly button or circumcision area looks infected
  • Your newborn’s jaundice does not decrease by the fifth day 
  • Your baby is crying a lot or appears sluggish
  • You think your baby is not looking or feeling well

Quick Tips: Choosing a Pediatrician

The following are a few questions from the AAP to help you select a pediatrician:

  • What are the office hours? Is emergency coverage available 24/7?
  • Which hospital does the pediatrician use?
  • Do they accept your insurance plan and how does the office process billing and claims?
  • What are the qualifications of the pediatrician? Is he or she an AAP member (i.e., “FAAP,” a Fellow of the American Academy of Pediatrics)?
Georgetown Pediatrics
Newborn News

Newborns and COVID-19

From American Academy Pediatrics:

Congratulations on the birth of your new baby! And kudos for getting fully immunized against COVID-19 during your pregnancy. This protects you—and also passes along protective antibodies that may reduce your baby’s risk of COVID-19 infection. In other words, you likely gave your little one some immunity against SARS-CoV-2, the virus that causes COVID-19, from the moment they were born!

Still, you should strongly consider limiting your newborn’s exposure to others. People who aren’t vaccinated against COVID-19 spread the virus, especially the more contagious Delta variant. Also keep in mind that people aren’t fully vaccinated against COVID-19 until two weeks after the last shot.
How likely are newborns to get sick from COVID?

While serious COVID-19 infections in newborns are uncommon, some babies in this age group have become severely ill. Your baby’s overall fragile immune system, as well as their small airways, developing lungs and breathing muscles leave them more vulnerable to all respiratory diseases, including COVID.

When young infants do get COVID or other airborne illnesses, it’s often because a close contact transmitted it to them. This can happen even if the person or contact doesn’t feel sick.Ways to protect your baby from the virus

  • Face masks. Non-household members over age 2 should mask-up, even if visiting the baby outside or in small gatherings.
  • Physical distancing. Even though everyone wants to hold a new baby, you should insist unvaccinated visitors remain at least 3 feet from the baby. These measures should also be kept in mind when you go out of the house with the baby.
  • Keep visits with your baby short. Also, limiting visits to under 15 minutes may also reduce your infant’s risk of becoming infected with COVID-19.
  • Vaccines. Encourage family members and friends who are eligible for COVID-19 vaccines to get fully vaccinated.

Remember

Having a new baby is a wonderful but exhausting time. Taking these common-sense steps can give you peace of mind that you are reducing your baby’s risk of COVID-19 infection. Vaccine trials are underway in infants 6 months of age and older. Keeping your baby up-to-date on all recommended vaccines is one of the most important ways to protect your baby’s health.

Georgetown Pediatrics
COVID Newborn

Similarities and Differences between Flu and COVID-19​

From the CDC:

What is the difference between Influenza (Flu) and COVID-19?

Influenza (flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a coronavirus first identified in 2019, and flu is caused by infection with influenza viruses.

COVID-19 seems to spread more easily than flu. However, as more people become fully vaccinated against COVID-19, the spread of the virus that causes COVID-19 should slow down. More information is available about COVID-19 vaccines and how well they work.

Compared to flu, COVID-19 can cause more serious illnesses in some people. COVID-19 can also take longer before people show symptoms and people can be contagious for longer. More information about differences between flu and COVID-19 is available in the different sections below.

Because some of the symptoms of flu, COVID-19, and other respiratory illnesses are similar, the difference between them cannot be made based on symptoms alone. Testing is needed to tell what the illness is and to confirm a diagnosis. People can be infected with both flu and the virus that causes COVID-19 at the same time and have symptoms of both influenza and COVID-19.

While more is learned every day about COVID-19 and the virus that causes it, there are still things, such as post-COVID conditions, that are unknown. This page compares COVID-19 and flu, given the best available information to date.

Signs and Symptoms

Similarities:

Both COVID-19 and flu can have varying degrees of signs and symptoms, ranging from no symptoms (asymptomatic) to severe symptoms. Common symptoms that COVID-19 and flu share include:

  • Fever or feeling feverish/having chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue (tiredness)
  • Sore throat
  • Runny or stuffy nose
  • Muscle pain or body aches
  • Headache
  • Vomiting and diarrhea
  • Change in or loss of taste or smell, although this is more frequent with COVID-19.

Flu Symptoms

COVID-19 Symptoms

How Long Symptoms Appear After Exposure and Infection

Similarities:

For both COVID-19 and flu, 1 or more days can pass between when a person becomes infected and when he or she starts to experience illness symptoms.

Differences:

If a person has COVID-19, it could take them longer to experience symptoms than if they had flu.

Flu

Typically, a person experiences symptoms anywhere from 1 to 4 days after infection.

Flu Symptoms

COVID-19

Typically, a person experiences symptoms about 5 days after being infected, but symptoms can appear 2 to 14 days after infection.

COVID-19 Symptoms

How Long Someone Can Spread the Virus

Similarities:

For both COVID-19 and flu, it’s possible to spread the virus for at least 1 day before experiencing any symptoms.

Differences:

If a person has COVID-19, they could be contagious for a longer time than if they had flu.

Flu

Most people with flu are contagious for about 1 day before they show symptoms.

Older children and adults with flu appear to be most contagious during the initial 3-4 days of their illness but many people remain contagious for about 7 days.

Infants and people with weakened immune systems can be contagious for even longer.

How Flu Spreads

COVID-19

How long someone can spread the virus that causes COVID-19 is still under investigation.

It’s possible for people to spread the virus for about 2 days before experiencing signs or symptoms (or possibly earlier) and remain contagious for at least 10 days after signs or symptoms first appeared. If someone is asymptomatic or their symptoms go away, it’s possible to remain contagious for at least 10 days after testing positive for COVID-19. People who are hospitalized with severe disease and people with weakened immune systems can be contagious for 20 days or longer.

How COVID-19 Spreads

How it Spreads

Similarities:

Both COVID-19 and flu can spread from person-to-person between people who are in close contact with one another (within about 6 feet). Both are spread mainly by large and small particles containing virus that are expelled when people with the illness (COVID-19 or flu) cough, sneeze, or talk. These particles can land in the mouths or noses of people who are nearby and possibly be inhaled into the lungs. In some circumstances, such as indoor settings with poor ventilation, small particles might be spread further than 6 feet and cause infections.

Although most spread is by inhalation, it may be possible that a person can get infected by touching (for example, shaking hands with someone who has the virus on their hands) or by touching a surface or object that has virus on it, and then touching their own mouth, nose, or eyes.

Both flu viruses and the virus that causes COVID-19 can be spread to others by people before they begin showing symptoms; by people with very mild symptoms; and by people who never experience symptoms (asymptomatic people).

Differences:

While the virus that causes COVID-19 and flu viruses are thought to spread in similar ways, the virus that causes COVID-19 is generally more contagious than flu viruses. Also, COVID-19 has been observed to have more superspreading events than flu. This means the virus that causes COVID-19 can quickly and easily spread to a lot of people and result in continual spreading among people as time progresses.

How Flu Spreads         How COVID-19 Spreads

People at Higher-Risk for Severe Illness

Similarities:

Both COVID-19 and flu illness can result in severe illness and complications. Those at highest risk include:

  • Older adults
  • People with certain underlying medical conditions (including infants and children)
  • Pregnant people

Differences:

Overall, COVID-19 seems to cause more serious illnesses in some people.

Serious COVID-19 illness resulting in hospitalization and death can occur even in healthy people.

Some people that had COVID-19 can go on to develop post-COVD conditions or multisystem inflammatory syndrome (MIS)

People at Increased Risk of COVID-19 Severe Illness

Complications

Similarities:

Both COVID-19 and flu can result in complications, including:

  • Pneumonia
  • Respiratory failure
  • Acute respiratory distress syndrome (fluid in the lungs)
  • Sepsis (a life-threatening illness caused by the body’s extreme response to an infection)
  • Cardiac injury (for example, heart attacks and stroke)
  • Multiple-organ failure (respiratory failure, kidney failure, shock)
  • Worsening of chronic medical conditions (involving the lungs, heart, or nervous system or diabetes)
  • Inflammation of the heart, brain, or muscle tissues
  • Secondary infections (bacterial or fungal infections that can occur in people who have already been infected with flu or COVID-19)

Differences:

Flu

Most people who get flu will recover on their own in a few days to two weeks, but some people will experience severe complications, requiring hospitalization. Some of these complications are listed above. Secondary bacterial infections are more common with influenza than with COVID-19.

Diarrhea is more common in young children with flu than in adults with flu.

Flu complications

COVID-19

Additional complications associated with COVID-19 can include:

Long COVID is a range of symptoms that can last weeks or months after first being infected with the virus that causes COVID-19 or can appear weeks after infection. Long COVID can happen to anyone who has had COVID-19, even if their illness was mild, or if they had no symptoms.

Approved Treatments

Similarities:

People at higher risk of complications or who have been hospitalized for COVID-19 or flu should receive supportive medical care to help relieve symptoms and complications.

Differences:

Flu

Prescription influenza antiviral drugs are FDA-approved to treat flu.

People who are hospitalized with flu or who are at increased risk of complications and have flu symptoms are recommended to be treated with antiviral drugs as soon as possible after illness onset.

Flu Treatment

COVID-19

The National Institutes of Health (NIH) has developed guidance on treatment of COVID-19external icon, which is regularly updated as new evidence on treatment options emerges.

The Food and Drug Administration (FDA) has approved one drug, remdesivir (Veklury®), to treat COVID-19. FDA has issued emergency use authorizationsexternal icon (EUAs) to allow healthcare providers to use investigational products that are not yet approved, or that are approved for other uses, to treat patients with COVID-19 if certain legal requirements are metexternal icon.

What to Do If You Are Sick with COVID-19

Vaccine

Similarities:

Vaccines for COVID-19 and flu are approved and/or authorized for emergency use (EUA) by FDA.

Differences:

Flu

There are multiple FDA-licensed influenza vaccines produced annually to protect against the 4 flu viruses that scientists expect will circulate each year.

Flu Vaccines

COVID-19

Three COVID-19 vaccines have been authorized for use by FDA under an EUA. Other vaccines to prevent COVID-19 are under development.

COVID-19 Vaccines

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Flu

Key Facts About Seasonal Flu Vaccine

From the CDC:

Flu Vaccination

Why should people get vaccinated against flu?

Influenza is a potentially serious disease that can lead to hospitalization and sometimes even death. Every flu season is different, and influenza infection can affect people differently, but millions of people get flu every year, hundreds of thousands of people are hospitalized and thousands to tens of thousands of people die from flu-related causes every year. An annual seasonal flu vaccine is the best way to help protect against flu. Vaccination has been shown to have many benefits including reducing the risk of flu illnesses, hospitalizations and even the risk of flu-related death in children.

How do flu vaccines work?

Flu vaccines cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with the viruses that are used to make the vaccine.

The seasonal flu vaccine protects against the influenza viruses that research indicates will be most common during the upcoming season. Most flu vaccines in the United States protect against four different flu viruses (“quadrivalent”); an influenza A (H1N1) virus, an influenza A (H3N2) virus, and two influenza B viruses. There are also some flu vaccines that protect against three different flu viruses (“trivalent”); an influenza A (H1N1) virus, an influenza A (H3N2) virus, and one influenza B virus. Two of the trivalent vaccines are designed specifically for people 65 and older to create a stronger immune response.

Who Should Not Be Vaccinated?

Different influenza (flu) vaccines are approved for use in different age groups. In addition, some vaccines are not recommended for certain groups of people. Factors that can determine a person’s suitability for vaccination, or vaccination with a particular vaccine, include a person’s age, health (current and past) and any allergies to flu vaccine or its components. For more information, visit Who Should and Who Should NOT get a Flu Vaccine.

When should I get vaccinated?

You should get a flu vaccine before flu viruses begin spreading in your community, since it takes about two weeks after vaccination for antibodies to develop in the body and provide protection against flu. Make plans to get vaccinated early in fall, before flu season begins. CDC recommends that people get a flu vaccine by the end of October. However, getting vaccinated early (for example, in July or August) is likely to be associated with reduced protection against flu infection later in the flu season, particularly among older adults. Vaccination should continue to be offered throughout the flu season, even into January or later. Children who need two doses of vaccine to be protected should start the vaccination process sooner, because the two doses must be given at least four weeks apart.

Where can I get a flu vaccine?

Flu vaccines are offered in many doctor’s offices, clinics, health departments, pharmacies and college health centers, as well as by many employers, and even in some schools.

Even if you don’t have a regular doctor or nurse, you can get a flu vaccine somewhere else, like a health department, pharmacy, urgent care clinic, and often your school, college health center, or workplace.

Why do I need a flu vaccine every year?

A flu vaccine is needed every season for two reasons. First, a person’s immune protection from vaccination declines over time, so an annual vaccine is needed for optimal protection. Second, because flu viruses are constantly changing, flu vaccines may be updated from one season to the next to protect against the viruses that research suggests may be most common during the upcoming flu season. For the best protection, everyone 6 months and older should get vaccinated annually.

Does flu vaccine work right away?

No. It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza virus infection. That’s why it’s best to get vaccinated before influenza viruses start to spread in your community.

Flu and COVID-19

Does a flu vaccine increase your risk of getting COVID-19?

There is no evidence that getting a flu vaccine increases your risk of getting sick from a coronavirus, like the one that causes COVID-19.

You may have heard about a study published in January 2020 that reported an association between flu vaccination and risk of four commonly circulating seasonal coronaviruses, but not the one that causes COVID-19. This report was later found to be incorrect.

The results from that initial study led researchers in Canada to look at their data to see if they could find similar results in their population. The results from Canada’s study showed that flu vaccination did not increase risk for these seasonal coronaviruses. The Canadian findings highlighted the protective benefits of flu vaccination.

The Canadian researchers also identified a flaw in the methods of the first study, noting that it violated the part of study design that compares vaccination rates among patients with and without flu (test negative design). This flaw led to the incorrect association between flu vaccination and seasonal coronavirus risk. When these researchers reexamined data from the first study using correct methods, they found that flu vaccination did not increase risk for infection with other respiratory viruses, including seasonal coronaviruses.

Vaccine Effectiveness

Influenza (flu) vaccine effectiveness (VE) can vary. The protection provided by a flu vaccine varies from season to season and depends in part on the age and health status of the person getting the vaccine and the similarity or “match” between the viruses in the vaccine and those in circulation. During years when the flu vaccine match is good, the benefits of flu vaccination will vary, depending on factors like the characteristics of the person being vaccinated (for example, their health and age), what influenza viruses are circulating that season and, potentially, which type of flu vaccine was used. For more information, see Vaccine Effectiveness – How well does the Flu Vaccine Work. For information specific to this season, visit About the Current Flu Season.

Can I get seasonal flu even though I got a flu vaccine this year?

Yes. It’s possible to get sick with flu even if you have been vaccinated (although you won’t know for sure unless you get a flu test). This is possible for the following reasons:

  • You may be exposed to a flu virus shortly before getting vaccinated or during the period that it takes the body to gain protection after getting vaccinated. This exposure may result in you becoming ill with flu before the vaccine begins to protect you. (Antibodies that provide protection develop in the body about 2 weeks after vaccination.)
  • You may be exposed to a flu virus that is not included in the seasonal flu vaccine. There are many different flu viruses that circulate every year. A flu vaccine is made to protect against the three or four flu viruses that research suggests will be most common.
  • Unfortunately, some people can become infected with a flu virus a flu vaccine is designed to protect against, despite getting vaccinated. Protection provided by flu vaccination can vary widely, based in part on health and age factors of the person getting vaccinated. In general, a flu vaccine works best among healthy younger adults and older children. Some older people and people with certain chronic illnesses may develop less immunity after vaccination. Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection.

What protection does a flu vaccine provide if I do get sick with flu?

Some people who get vaccinated may still get sick. However, flu vaccination has been shown in some studies to reduce severity of illness in people who get vaccinated but still get sick. A 2017 study showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized adults with flu. Another study in 2018 showed that a vaccinated adult who was hospitalized with flu was 59 percent less likely to be admitted to the ICU than someone who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated.

Vaccine Benefits

What are the benefits of flu vaccination?

There are many reasons to get an influenza (flu) vaccine each year. Because of the on-going COVID-19 pandemic, getting a flu vaccine during 2020-2021 will be more important than ever. Flu vaccines will not prevent COVID-19, but they will reduce the burden of flu illnesses, hospitalizations and deaths on the health care system and conserve scarce medical resources for the care of people with COVID-19.

Below is a summary of the benefits of flu vaccination and selected scientific studies that support these benefits.

  • Flu vaccine prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2019-2020, flu vaccination prevented an estimated 7.5 million influenza illnesses, 3.7 million influenza-associated medical visits, 105,000 influenza-associated hospitalizations, and 6,300 influenza-associated deaths.
  • During seasons when the flu vaccine viruses are similar to circulating flu viruses, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40 percent to 60 percent.
  • Flu vaccination can reduce the risk of flu-associated hospitalization for children, working age adults, and older adults.
  • A 2018 study showed that from 2012 to 2015, flu vaccination among adults reduced the risk of being admitted to an intensive care unit (ICU) with flu by 82 percent.
  • Flu vaccination is an important preventive tool for people with chronic health conditions.
  • Flu vaccination has been associated with lower rates of some cardiac events among people with heart disease, especially among those who had had a cardiac event in the past year.
  • Flu vaccination can reduce worsening and hospitalization for flu-related chronic lung disease, such as in persons with chronic obstructive pulmonary disease (COPD).
  • Vaccination reduces the risk of flu-associated acute respiratory infection in pregnant women by about one-half.
  • A 2018 study that included influenza seasons from 2010-2016 showed that getting a flu shot reduced a pregnant woman’s risk of being hospitalized with flu by an average of 40 percent.
  • A number of studies have shown that in addition to helping to protect pregnant women, a flu vaccine given during pregnancy helps protect the baby from flu for several months after birth, when he or she is not old enough to be vaccinated.
  • Flu vaccine can be lifesaving in children.
  • A 2017 study was the first of its kind to show that flu vaccination can significantly reduce a child’s risk of dying from flu.
  • Flu vaccination has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick.
  • A 2017 study showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized flu patients.
  • A 2018 study showed that among adults hospitalized with flu, vaccinated patients were 59 percent less likely to be admitted to the ICU than those who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated.
  • *References for the studies listed above can be found at Publications on Influenza Vaccine Benefits. Also, see the A Strong Defense Against Flu: Get Vaccinated! fact sheet.

Vaccine Side Effects (What to Expect)

Can a flu vaccine give me flu?

No, a flu vaccine cannot cause flu illness. Flu vaccines that are administered with a needle (flu shots) are currently made in two ways: the vaccine is made either with a) flu vaccine viruses that have been killed (inactivated) and are therefore not infectious, or b) with proteins from a flu vaccine virus instead of flu vaccine viruses (which is the case for recombinant influenza vaccine). Nasal spray vaccine is made with attenuated (weakened) live flu viruses, and also cannot cause flu illness. The weakened viruses are cold-adapted, which means they are designed to only cause infection at the cooler temperatures found within the nose. The viruses cannot infect the lungs or other areas where warmer temperatures exist.

What side effects can occur after getting a flu vaccine?

While a flu vaccine cannot give you flu illness, there are different side effects that may be associated with getting a flu shot or a nasal spray flu vaccine. These side effects are mild and short-lasting, especially when compared to symptoms of bad case of flu.

A flu shot: The viruses in a flu shot are killed (inactivated), so you cannot get flu from a flu shot. Some minor side effects that may occur are:

  • Soreness, redness, and/or swelling where the shot was given
  • Headache (low grade)
  • Fever
  • Muscle aches
  • Nausea
  • Fatigue

The nasal spray: The viruses in the nasal spray vaccine are weakened and do not cause severe symptoms often associated with influenza illness. In children, side effects from the nasal spray may include:

  • Runny nose
  • Wheezing
  • Headache
  • Vomiting
  • Muscle aches
  • Fever (low grade)

In adults, side effects from the nasal spray vaccine may include:

  • Runny nose
  • Headache
  • Sore throat
  • Cough

If these problems occur, they begin soon after vaccination and usually are mild and short-lived. A flu shot, like other injections, can occasionally cause fainting. Tell your provider if you feel dizzy or have vision changes or ringing in the ears. As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death. People who think that they have been injured by a flu vaccine can file a claim for compensation from the National Vaccine Injury Compensation Program (VICP).

Where can I find information about vaccine supply?

Information about vaccine supply is available on CDC’s Vaccine Supply & Distribution.Edit”Key Facts About Seasonal Flu Vaccine”

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Flu

Influenza Vaccine Safety Questions & Answers

Are flu vaccines safe?

Flu vaccines have a good safety record. Hundreds of millions of Americans have safely received flu vaccines over the past 50 years, and there has been extensive research supporting the safety of flu vaccines.

A flu vaccine is the first and best way to reduce your chances of getting the flu and spreading it to others. CDC recommends that everyone 6 months of age and older receive a flu vaccine every year.

Can I get the flu from the flu vaccine?

No, the flu vaccine cannot cause flu. The vaccines either contain inactivated virus, meaning the viruses are no longer infectious, or a particle designed to look like a flu virus to your immune system. While the nasal spray flu vaccine does contain a live virus, the viruses are changed so that they cannot give you the flu.

Do flu vaccines cause any side effects?

Like any medical product, vaccines can cause side effects. Side effects of the flu vaccine are generally mild and go away on their own within a few days.

Common side effects from the flu shot include:

  • Soreness, redness, and/or swelling from the shot
  • Headache
  • Fever
  • Nausea
  • Muscle aches

The flu shot, like other injections, can occasionally cause fainting.

Some studies have found a possible small association of injectable flu vaccine with Guillain-Barré syndrome (GBS). Overall, these studies estimated the risk for GBS after vaccination as fewer than 1 or 2 cases of GBS per one million people vaccinated. Other studies have not found any association. GBS also, rarely, occurs after flu illness. Even though GBS following flu illness is rare, GBS is more common following flu illness than following flu vaccination. GBS has not been associated with the nasal spray vaccine.

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Are there signs or symptoms that should cause concern after getting a flu vaccine?

With any vaccine, look for any unusual conditions, such as a high fever, behavior changes, or signs of a severe allergic reaction after vaccination.

Signs of a severe allergic reaction can include:

  • Difficulty breathing
  • Hoarseness or wheezing
  • Swelling around the eyes or lips
  • Hives
  • Paleness
  • Weakness
  • A fast heart beat or dizziness

Life threatening allergic reactions to the flu shot are rare. These signs would most likely happen within a few minutes to a few hours after the vaccine is given.

What should I do if I think I am having a severe reaction to a flu vaccine?

If you think it is a severe allergic reaction or other emergency that can’t wait, call 9-1-1 and get to the nearest hospital. Otherwise, call your doctor.

Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.

What should I do if I think I have been injured by the flu vaccine?

If you believe you have been injured by a flu vaccine you may be eligible to receive compensation from the federal government for your injuries if certain criteria are met. To learn more visit the National Vaccine Injury Compensation Program websiteexternal icon or call 1-800-338-2382.

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Are there some people who should not receive a flu vaccine?

CDC recommends everyone 6 months of age and older should receive an annual flu vaccination with rare exceptions. Individuals who can’t get the flu shot include:

  • Children younger than 6 months, since they are too young to get a flu shot.
  • Individuals with severe, life-threatening allergies to flu vaccine or any ingredient(s) in the vaccine.

Individuals should talk with their doctor before getting the flu shot if they:

There are multiple flu vaccines available, and not all flu vaccines can be given to people of all ages. Talk to your doctor if you have any questions regarding which flu vaccine options are best for you and your family. See Vaccination: Who Should Do It, Who Should Not and Who Should Take Precautions) for more information.

Should pregnant women receive a flu vaccine?

Yes, pregnant women should get a flu shot to protect themselves and their developing babies. To learn more about flu vaccine safety during pregnancy, visit Flu Vaccine Safety and Pregnancy.

How is the safety of flu vaccines monitored?

CDC and the Food and Drug Administration (FDA) closely monitor the safety of vaccines approved for use in the United States. CDC uses two primary systems to monitor the safety of flu vaccines:

  1. Vaccine Adverse Event Reporting System (VAERS): an early warning system that helps CDC and FDA monitor problems following vaccination. Anyone can report possible vaccine side effects to VAERS. Generally, VAERS reports cannot determine if an adverse event was caused by a vaccine, but these reports can help determine if further investigations are needed.
  2. Vaccine Safety Datalink (VSD): A collaboration between CDC and nine health care organizations which allows ongoing monitoring and proactive searches of vaccine-related data.

People with egg allergies can receive any licensed, recommended age-appropriate influenza vaccine (IIV4, RIV4, or LAIV4) that is otherwise appropriate. People who have a history of severe egg allergy (those who have had any symptom other than hives after exposure to egg) should be vaccinated in a medical setting, supervised by a health care provider who is able to recognize and manage severe allergic reactions. Two completely egg-free (ovalbumin-free) flu vaccine options are available: quadrivalent recombinant vaccine and quadrivalent cell-based vaccine.

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