A 6-week-old admitted with influenza is not allowed to eat by mouth. Which explanation best supports this?

• A. We are giving your child intravenous fluids, so there is no need for anything by mouth.
• B. The shorter and narrower airway of infants increases their chances of aspiration so your child should not have anything to eat now.
• C. Eating burns calories, but we want to conserve the child's energy.
• D. Your child has nasal congestion; if we feed the child by mouth, the distress will likely increase.

Answer: (B)

Infants have a shorter, narrower airway and immature swallowing coordination, which means they are less able to protect their airway while swallowing. When a young infant has influenza, coughing and fatigue can further impair airway protection, making aspiration of fluids or secretions into the lungs more likely. Withholding anything by mouth minimizes the risk of inhaling material and developing pneumonia or respiratory compromise, while intravenous fluids help maintain hydration. The other ideas don’t address the main risk of aspiration or airway protection in a very young infant.