When a child with the flu can’t walk – Benign Acute Childhood Myositis

When a child with the flu can't walk: Benign Acute Childhood Myositis. From #Naturopathic Pediatrics

When a child with the flu can’t walk – Benign Acute Childhood Myositis

We are familiar with the common flu symptoms: fever, chills, fatigue, malaise, sore throat, and runny nose. We’re also not surprised when the flu is paired with diarrhea and dizziness. But when our children can’t walk after having the flu, that’s more concerning.

When flu symptoms become more severe, this suggests the immune system needs more support, and was likely jeopardized to begin with. Treating the flu with fever suppressors and pain relievers does not support the immune system. In fact, fever reducers suppress the immune system by preventing the cytokine action. This can prolong the infection and interfere with the healing process.

When a child with the flu can’t walk

The condition is called Benign Acute Childhood Myositis, BACM. Benign is a medical term for “not harmful,” acute means it has been occurring recently and for a limited amount of time, “Myo” refers to muscle and “itis” means inflammation. Symptoms of muscle inflammation include tenderness, weakness, and pain. The severity of symptoms depends upon the origin of the myositis. More details can be found in this article.

  1. Idiopathic inflammatory myopathies: typically painless muscle weakness at the onset, and gradually worsens over time (weeks, months, or years). The progression may affect muscles all over the body, often in the neck, shoulders and hips, called polymyositis. In some cases, dermatomyositis can develop, where symptoms are seen on the skin such as rashes, scaly patches, or discoloration of the eyelids.
  2. Infectious myositis: muscle aches and weakness are accompanied by flu symptoms of high fever, fatigue, chills, cough, sore throat, and runny nose. If these symptoms are paired with diarrhea, this could suggest parasitic infection.
  3. Benign acute myositis or viral myositis: sudden trouble walking or complaints of leg pain that prevent them from walking. Pain is often localized to the calf muscles.
  4. Other types of myositis include myositis ossificans and drug-induced myositis, but they are not seen in conjunction with flu symptoms.

Does my child have myositis?

If an investigation is performed, you can expect screening blood work such as a CBC with differential, which is the basic red and white blood cell analysis. The white blood cell count gives a general overview of ratios that suggest whether bacterial or viral infection is present. Other testing may include a urine myoglobin test, which looks for indications of muscle destruction. An article published by The College of Family Physicians of Canada in 2017 noted that “no clear management guidelines exist,” and that our clinical management allows for “rapid diagnosis, without further investigation.”

A conventional medical approach to myositis

Because this is believed to be a benign condition, conventional medical doctors will often recommend rest and analgesics – Tylenol or Motrin. It is considered self-limiting, which means it will run its course and disappear on its own.

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A naturopathic approach to myositis

While it’s true that myositis may be self-limiting, this shouldn’t prevent us from investigating further. The context around the symptoms are suggestive of the condition of the immune system as a whole. An individual who is frequently ill and often develops more severe varieties of symptoms in conjunction with common viral infections has a compromised immune system. A thorough medical history including analysis of their environmental exposures, dietary habits, sleep patterns, and mood fluctuations can point to other body systems that are compromised and may be influencing their immunological resilience.

We must also carefully evaluate their medications, particularly antibiotic use. One course of antibiotics can trigger a significant shift in the gut ecology that does not present with measurable effects until years later.

Most naturopathic doctors recommend avoiding Tylenol and Ibuprofen, as it simply suppresses symptoms and can have potentially serious side-effects.  See this article for more information: Just say NO to Tylenol (Acetaminophen linked to autism?)


The goal of naturopathic treatment for the flu is to provide antiviral support (elderberry), immune-system support (vitamin D, mushrooms), antioxidants to reduce inflammation (elderberry, leafy greens), and hydration (bone broth, electrolytes) to keep the child comfortable and allow the fever to break on its own.  Naturopathic treatment also eliminates “obstacles to cure” – in this case mucus-causing foods (bananas, citrus, dairy products) that can worsen symptoms.

Below are common recommendations, but you should always consult with your child’s provider before starting any supplements.

Elderberry syrup:

Elderberry has been used as medicine for centuries. Elderberry is safe for children and can be used preventatively during the cold and flu season. I prefer Gaia Herbs.

Preventative dosing recommendations:

  • 2 tsp once daily children 4+
  • 1 tsp once daily children 2+
  • Age 1-2: 2ml daily
  • 6+ mos: 1 ml daily
  • Under 6 mos: 5 drops daily

Vitamin D

Vitamin D 1,25(OH)2D acts as an immune system modulator, preventing excessive expression of inflammatory cytokines. True, our body absorbs vitamin D from the sun, but then needs to convert it to the active form before it can perform these important duties. Often times, our body is not efficient at converting, and we become deficient, even during summer months when we have frequent sun exposure. Supplementing with vitamin D helps to  stimulates the expression of potent anti-microbial properties.

Vitamin D should be administered in a liposomal base in conjunction with K2, which aids absorption. I prefer Orthomolecular.

Dosing recommendations:

  • If vitamin D blood levels are below 80, I recommend my patients supplement with 10,000IU daily for 30 days.
  • Adult maintenance dose is typically 4,000-6,000 IU daily
  • Children maintenance dose is typically 400-1,000 IU daily

Nutrition as cure – the best kind

  • Dark leafy greens: contain vitamins A and C, antioxidants, fiber and more
  • Mushrooms: reishi is especially good for the immune system
  • Bone Broth
  • Hydration with natural electrolytes. Coconut water is a wonderful source.
  • Avoid dairy, banana and citrus, as they can contribute to mucus production
Lindsay Hollister, ND

Lindsay Hollister is a Naturopathic Doctor specializing in chronic pediatric conditions in the areas of mental, digestive, and skin health. After years of struggling to find practitioners who met the needs of her own children, she left her job and relocated her family to San Diego, where she earned her doctorate at Bastyr University. She has since returned to her hometown of Colorado Springs, Colorado, where she used her business background to open a practice of her own. She now works closely with parents of struggling children to bridge the gaps in their healthcare, and plans to one day open a clinic where various medical specialties work in unison under one roof.


  • Avatar
    Karolina Zieminska
    March 9, 2023 at 12:26 pm

    My 8 year old had it 3 times, at the age of 5 and recently twice in 3 months. Third time during covid infection, that wasn’t very severe (so far). I wonder what is the trigger and why my child gets it. Is there something underlying?

    • Avatar
      April 11, 2024 at 5:53 am

      Hi Karolina,

      My daughter has had this a handful of times now (she’s 4.5). First time experiencing when infected with covid. Have you found any further information or medical advice for your child?

  • Avatar
    Mila Knez-Marj
    November 6, 2022 at 7:21 pm

    My one twin son has this at age 4 now age 8 it’s happened again. I was wondering Will he grow out of this ?

    His twin brother has never had this issue. My twins were two months premature and are absolutely healthy – I’m just wondering why he gets it but really hoping he grows out of it
    Thank you

  • Avatar
    Heather Allenby
    September 19, 2021 at 5:59 pm

    Is this something my son will grow out of? He has had 3 episodes and hospitalized all 3. Nobody seems to have any idea why it’s happening. We’ve been to Metabolics l, Endocrinologist and now next is neurology. They are going to request a muscle biopsy

    • Avatar
      Karolina Zieminska
      March 9, 2023 at 12:27 pm

      Hi, did they eventually find the trigger?

  • Avatar
    Kim Phillips
    February 23, 2020 at 8:22 pm

    At what point is this a symptom of sepsis and how do you tell the difference?

    • Avatar
      Lindsay Hollister
      February 25, 2020 at 2:05 pm

      Great Question! This article states: “Daily physical examination and urine dipstick are sufficient to confirm the diagnosis of benign acute childhood myositis (BACM) during the acute phase, to promptly detect severe complications” {}. The emphasis on differentiation between BACM and sepsis is focused on the inability to walk, and whether it’s due to pain (BACM) or muscle weakness (which could point to sepsis). Sources say it’s safe to diagnose BACM clinically based on symptomatology, so recognizing the signs of sepsis is very important, as you pointed out. These symptoms are common with sepsis but less common with flu: rapid heart rate, shortness of breath, cold hands and feet, clammy and pale skin, confusion, disorientation. Because we know there are no absolutes in medicine, we should always refer if in doubt. Did this answer your question? Does anyone else have thoughts to add?

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