Pneumonia in Children
The term "pneumonia" means "infection of the lung." While pneumonia was extremely dangerous in past generations, today, most children can recover easily with proper medical attention.
What Causes Pneumonia?
Viruses, like the flu or RSV (respiratory syncytial virus), cause most cases of pneumonia. Children with viral pneumonia often develop symptoms gradually, which tend to be mild. Most cases of pneumonia follow a viral upper respiratory tract infection, such as the common cold.
Less often, bacteria can cause pneumonia. When this happens, children typically become sick more quickly, often with a sudden high fever, cough, and sometimes rapid breathing. Types of bacterial pneumonia include pneumococcal pneumonia, mycoplasma pneumonia (walking pneumonia), and pertussis (whooping cough).
Certain children, such as those whose immune systems or lungs are weakened by other conditions like cystic fibrosis, asthma, or cancer, are more likely to develop pneumonia. Children with other abnormalities in their airways or lungs may also have a higher risk.
Since most forms of pneumonia are linked to viral infections that spread from person to person, they are most common during the fall, winter, and early spring, when children spend more time indoors in close contact with others. The chance that a child will develop pneumonia is not affected by how they are dressed or by cold air temperatures.
Signs & Symptoms of Pneumonia in Children
Like many infections, pneumonia usually causes a fever, which in turn may lead to sweating, chills, flushed skin, and general discomfort. The child may also lose their appetite and seem less energetic than usual. Babies and toddlers may appear pale and limp and may cry more than usual.
Since pneumonia can cause breathing difficulties, you may notice other, more specific symptoms, including:
- Cough
- Rapid, labored breathing
- Retraction (drawing in of the skin) around the ribs and breastbone
- Flaring (widening) of the nostrils
- Chest pain, especially with coughing or deep breathing
- Wheezing
- Bluish tint to the lips or nails, caused by decreased oxygen in the bloodstream
- Although pneumonia is usually diagnosed based on signs, symptoms, and examination, a chest X-ray may sometimes be needed to confirm the diagnosis and assess the extent of lung involvement.
Pneumonia Treatment
When pneumonia is caused by a virus, there is typically no specific treatment other than rest and standard fever control measures. Cough suppressants containing codeine or dextromethorphan should not be used, as coughing helps clear the excessive secretions caused by the infection. Encourage the child to drink clear fluids, use nasal saline, and, in some cases, take guaifenesin (to loosen mucus).
Viral pneumonia usually improves after a few days, although the cough may linger for several weeks. If a child’s cold does not improve or worsens after 7–10 days, the pediatrician may prescribe an antibiotic, as it can be challenging to distinguish between viral and bacterial pneumonia. All antibiotics should be taken for the full prescribed course and at the recommended dosage. While it may be tempting to stop them early, this can allow some bacteria to survive and lead to a recurrence of the infection.
Follow up with the doctor if your child shows any of the following warning signs that the infection is worsening or spreading:
- Fever lasting more than 3–4 days despite antibiotic use
- Fever that goes away and then returns after a few days
- Breathing difficulties
- Increased lethargy and sleepiness
- Evidence of an infection elsewhere in the body, such as red, swollen joints; bone pain; neck stiffness; vomiting; or other new symptoms
Is Pneumonia Contagious?
Generally, like ear and sinus infections, pneumonia itself is not contagious, but the respiratory viruses and bacteria that cause it are. These germs can spread through coughs and sneezes if they are present in someone’s mouth or nose.
Germs can also spread through shared drinking glasses, eating utensils, and contact with used tissues or handkerchiefs. If someone in your household has a respiratory or throat infection, keep their drinking glasses and eating utensils separate from others, and wash your hands frequently, especially if you’re handling used tissues or dirty handkerchiefs.
Additionally, children under one year old are at higher risk if they are exposed to secondhand tobacco smoke, especially if their mother smokes.
Can Pneumonia Be Prevented?
Some types of pneumonia can be prevented with vaccines. Children typically receive routine vaccinations against Haemophilus influenzae, pneumococcus, and whooping cough beginning at two months of age.
Influenza (flu) is a highly contagious viral infection and one of the most severe illnesses of the winter season. Influenza spreads easily from person to person, typically when an infected person coughs or sneezes. Influenza is a common cause of pneumonia, especially among young children, the elderly, pregnant women, and people with certain chronic health conditions or those living in nursing homes. While most flu cases do not lead to pneumonia, those that do tend to be more severe.
The flu vaccine and an updated COVID-19 vaccine are recommended for all adults and children aged six months and older. These vaccines are especially important for children with chronic illnesses such as heart or lung disorders or asthma. Since flu strains change each year, getting a flu vaccination each season is necessary to stay protected against the most current strains.
When possible, keep children away from anyone showing respiratory infection symptoms (such as a runny nose, sore throat, or cough). During the COVID-19 pandemic, masks were shown to be very effective in preventing the spread of viruses and bacteria that cause pneumonia.
