SPRINGFIELD, Ohio - Wendy McGeean said she feels fairly confident she would know if her 11-month-old daughter, Valerie, was experiencing complications from the flu.

"I would watch to see if she isn't eating, or drinking or urinating, or if there's shortness of breath," the Community Mercy Health Partners nurse said as she and her blonde-haired daughter waited in the lobby of the Rocking Horse Center. "Those are things I would be cautious about."

As it becomes likely the national shortage of flu vaccines will leave many children without a first line of defense against influenza, Dr. James Duffee, director of the Rocking Horse Center, said parents can know if their child's flu is normal or has become something more severe.

Dehydration, increased work to breathe or an altered mental state are the three main danger signs of complications of the flu, Duffee said.

He said some parents assume a high fever means a serious situation, but that is not accurate, he said.

"Fever is not a good danger sign," he said. "Fever does no harm. A 105-degree fever is not uncommon in small children."

A parent can suspect dehydration if a child has not urinated at least two times in a 24-hour period, Duffee said. Hydration is measured by output, not input, and a high fever can cause dehydration.

If a child can point to a specific painful spot when they breathe, it could be a sign of pneumonia, Duffee said. For children who cannot verbalize where they hurt, parents should watch for labored breathing. If the child's ribs pull in when he breathes or his nostrils flair, he may be having complications.

Any child who shows those symptoms should be taken to the emergency room immediately or the parents should call 911.

"These are things that can't wait until the next day," Duffee said.

Fast breathing, though, is not a sign of complications as breath rate increases with a high fever. Fast breathing is only a concern if a child is taking more than 60 breaths a minute while sleeping, which could also be a warning sign.

A fever could become dangerous if a parent wraps the child in blankets while feverish or over-medicates the child.

"The more effective ways to bring down a fever is to unclothe them; place them in a lukewarm bath," he said.

A parent may use a pain reliever to reduce a fever to where a child can function. Bringing a fever down to 101 or 102 degrees is reasonable with the flu. A child's fever often peaks in the evenings, so Duffee recommends parents call their doctor before their child gets sick to find out the dosage recommendation if and when their child gets the flu.

"After-hour calls should be limited to emergencies only," Duffee said. "The parents should really find out beforehand."

The length of an illness is not an indication of its severity - the flu could last for two weeks - but if, after two weeks, a child is ill, it is a good idea to call the doctor, Duffee said.

Many children are considered high risk for developing complications from the flu. Children who are 6 to 23 months old and children with underlying health conditions are eligible for the flu vaccine.

McGeean said she had some questions about the vaccine but is considering the shot for 11-month-old Valerie.

"I'm going to ask the doctor about it," she said. "If I feel strongly enough about her getting it, I probably will, because she's in daycare and she's always catching something."