pneumonia in children

Overview

Pneumonia is an infection in the lungs that causes the tiny air sacs (where your body takes in oxygen) to fill with fluid, so it is harder to breathe. In children, it can be mild or serious, but with the right care most children recover well.

Yes, pneumonia is one of the most common infections in children worldwide. In countries with good healthcare, it is generally less common and less dangerous in healthy children.

Pneumonia can affect any child, but it is more likely in babies under 2, children with weak immune systems, or children with health conditions like asthma or congenital heart disease.

Symptoms

Common symptoms

• Cough
• Fever
• Fast breathing or difficulty breathing
• Chest pain, especially when coughing or breathing deep
• Feeling very tired or weak
• Poor appetite or not drinking well

Symptoms in children

• Breathing faster than usual, or making a grunting sound
• Nostrils flaring open with each breath
• The chest pulling in with each breath (between the ribs)
• Poor feeding or refusing to drink
• Being very irritable or sleepy
• Blueish lips or face (this is an emergency)

Symptoms in older adults

• Confusion or feeling dizzy without much fever
• A milder cough than children
• Feeling weak and less steady
• Losing appetite or drinking very little

Causes

Main causes

• Viruses – such as those that cause colds and flu, and respiratory syncytial virus (RSV)
• Bacteria – such as Streptococcus pneumoniae
• Less often, fungi or other germs can cause pneumonia, especially in children with weakened immune systems

Risk factors

• Being born prematurely
• Being under 2 years old
• Chronic lung disease (like asthma or bronchopulmonary dysplasia)
• Congenital heart disease
• Weak immune system (from illness or medication)
• Exposure to tobacco smoke
• Poor nutrition or not being vaccinated

When to see a doctor

See a doctor urgently if:

• If your child has trouble breathing, is breathing very fast, or has chest pain
• If your child is not drinking fluids and shows signs of dehydration
• If your child becomes very sleepy, confused, or hard to wake
• If fever stays high and does not get better with medication or rest

Book a routine appointment if:

• If your child has a cough that lasts more than 3 weeks
• If your child has repeated episodes of pneumonia or frequent chest infections
• If you are unsure about your child's symptoms and want to check them

Diagnosis

The doctor will ask about your child's symptoms, listen to their chest with a stethoscope, and check how much oxygen their body is getting with a small clip on a finger. Based on this, they may decide whether more tests are needed.

Tests that may be done

• Pulse oximetry – a small sensor on the finger or toe to measure oxygen levels
• Chest X-ray – to see how the lungs look and where the infection is
• Blood tests – to check for signs of infection or bacteria
• A sample of phlegm (spit) – sometimes looked at to find the cause

What to expect at your appointment

A doctor will explain what they are doing and why. If your child has a mild case, they may be sent home with advice on fluids, rest and warning signs. If the infection is more serious, the doctor may suggest that your child stay in the hospital for a while for closer monitoring.

Treatment

Treatment depends on the cause. Viral pneumonia usually needs only rest, fluids and time for the immune system to fight it off. Bacterial pneumonia is treated with antibiotics prescribed by a doctor. Some children with serious symptoms may need hospital care for oxygen, fluids and monitoring.

Self-care at home

• Give your child plenty of clear fluids to keep them well hydrated
• Encourage rest and sleep
• Keep the room at a comfortable temperature and avoid smoke or strong fumes
• Support your child by using a cool-mist humidifier (if you have one) to make breathing easier
• Keep your child away from tobacco smoke and other people who smoke

Medical treatments

If a doctor decides that bacteria are causing the pneumonia, they will prescribe an antibiotic. It is important to give the medicine exactly as directed and finish the full course, even if your child feels better. In more severe cases, children may need hospital care where they can receive oxygen, fluids through a drip, and breathing support if needed. The healthcare team will tailor the treatment to your child's needs.

When is surgery considered?

Surgery is not usually needed for pneumonia. In rare and complicated cases, such as a lung abscess or fluid around the lungs that does not heal, a specialist may consider a small procedure to drain it.

Living with this condition

While your child recovers, keep things calm and restful. Offer small amounts to drink often, and watch for warning signs like fast breathing or a blue tinge. Keep in close contact with your doctor, especially if your child's symptoms change.

Lifestyle tips

• Keep a smoke-free home
• Make sure your child gets enough sleep and quiet time
• Encourage regular handwashing with soap and water
• Keep vaccinations up to date
• Avoid crowded indoor places when there is a lot of flu or RSV around

Diet and exercise

Offer small, light meals and lots of fluids like water, warm soup or diluted juice. Once the fever goes and energy returns, let your child gradually get back to normal activity and play. Don't push them – they will naturally rest when they need to.

Mental health and emotional wellbeing

Being sick can be stressful and scary for a child. They may feel anxious, restless or clingy. Reassure them with calm words and routines. If you worry about your child's emotions or your own stress, talk to your doctor or a local family support service – you do not have to cope alone.

Prevention

Many cases of pneumonia can be prevented with vaccines, good hygiene, a smoke-free environment, and good nutrition. While not every infection can be avoided, these steps lower the risk a lot.

Vaccines

Vaccinations against flu, pneumococcal disease, and other common childhood infections can help protect your child from pneumonia. Talk to your healthcare provider about the recommended immunisation schedule for your region.

Screening programmes

There is no routine screening test for pneumonia in healthy children. The best way to catch problems early is to notice symptoms and see a doctor if you are concerned.

Complications

If left untreated

• The infection can spread to the bloodstream or throughout the body
• Fluid can build up around the lungs (pleural effusion), making breathing even harder
• A pocket of pus may form in the lungs (lung abscess)
• Breathing can become dangerously difficult, especially in babies or children with other health conditions

Long-term outlook

With early medical care and the right treatment, most children recover fully from pneumonia within a few weeks. Some may have a lingering cough, but it usually fades. Even children who need hospital care often respond well and go on to lead healthy lives. You are not alone – doctors and nurses are there to help you and your child get through it.

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