Discharge Instructions for Influenza A in an Infant
An infant with influenza A can be safely discharged from the hospital when they are clearly improving, physiologically stable, can tolerate oral feeds, have a respiratory rate <50/min, and maintain an awake oxygen saturation >92% on room air. 1
Discharge Criteria
Your infant is ready to go home when ALL of the following are met:
- Clinical improvement is evident - the infant appears less ill, more alert, and is feeding better 1
- Physiologically stable - vital signs are stable without concerning trends 1
- Tolerating oral feeds - able to take adequate breast milk or formula by mouth 1
- Respiratory rate <50 breaths per minute (for infants) 1
- Oxygen saturation >92% on room air when awake 1
Home Care Instructions
Fever and Comfort Management
- Administer acetaminophen for fever control using appropriate weight-based dosing 1
- Fever, headache, body aches, and irritability are common with influenza and can be managed with antipyretics to keep your infant comfortable 1
Hydration
- Ensure adequate fluid intake through frequent breastfeeding or formula feeds 1
- Watch for signs of dehydration: decreased wet diapers, dry mouth, sunken fontanelle, lethargy 1
Monitoring at Home
- Check your infant at least every 4 hours for worsening symptoms 1
- Monitor breathing pattern, work of breathing, and overall alertness 1
- Most infants recover uneventfully within 7-10 days 2
When to Return to the Hospital Immediately
Bring your infant back to the emergency department if ANY of these occur:
- Respiratory distress: breathing rate >50/min, grunting sounds, visible chest retractions (skin pulling in between ribs), flaring nostrils 1
- Cyanosis: blue or purple color around lips or face 1
- Severe dehydration: no wet diapers for 8+ hours, sunken fontanelle, extreme lethargy 1
- Altered consciousness: difficult to wake, not responding normally, seizure activity 1
- Worsening condition: infant appears significantly more ill despite treatment 1
- Persistent high fever despite appropriate acetaminophen dosing 1
Antiviral Therapy (If Prescribed)
- Complete the full course of oseltamivir (Tamiflu) as prescribed, even if your infant appears better 1, 3
- Oseltamivir reduces illness duration by approximately 1.5 days and decreases complications in children 1
- The most common side effect is vomiting (occurs in about 6% of children) 1
Infection Control at Home
- Isolate the infant from other household members as much as possible, especially other young children and elderly family members 1
- Infants remain contagious for approximately 10 days or more after symptom onset (longer than adults) 1
- Practice hand hygiene: wash hands thoroughly before and after caring for the infant 1, 2
- Avoid sharing items: bottles, pacifiers, towels, or other personal items 1
- Influenza virus can survive on hard surfaces for 24-48 hours, so clean frequently touched surfaces regularly 1
Follow-Up Care
- Most infants do not require follow-up if they recover uneventfully 1
- Contact your pediatrician if symptoms persist beyond 7-10 days 1
- Hospital follow-up is only needed for infants who had severe disease, prolonged illness, or complications like lobar collapse on chest x-ray 1
Special Considerations for High-Risk Infants
If your infant has underlying conditions (prematurity, neurological disorders, immunosuppression, diabetes, sickle cell disease), they are at higher risk for complications and may require closer monitoring even after discharge 4. Discuss specific follow-up plans with your pediatrician before leaving the hospital 4.