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What is pneumonia?

Pneumonia is an infection in one or both lungs. Pneumonia can be caused by bacteria, viruses, fungi, or parasites. Viruses are usually the cause of pneumonia in children. Children with viral pneumonia can also develop bacterial pneumonia. Often, pneumonia begins after an infection of the upper respiratory tract (nose and throat). This causes fluid to collect in the lungs, making it hard to breathe. Pneumonia can also develop if foreign material, such as food or stomach acid, is inhaled into the lungs.

What may increase my child's risk for pneumonia?

• Premature birth

• Breathing secondhand smoke

• Asthma or certain genetic disorders, such as sickle-cell anemia

• Heart defects, such as ventricular septal defect (VSD), atrial septal defect (ASD), or patent ductus arteriosus (PDA)

• Poor nutrition

• A weak immune system

• Spending time in a crowded place, such as a child care center

What are the signs and symptoms of pneumonia?

The signs and symptoms depend on your child's age and the cause of his or her pneumonia. The signs and symptoms of bacterial pneumonia usually begin more quickly than they do with viral pneumonia. Your child may have any of the following:

• Fever or chills

• Cough

• Shortness of breath or trouble breathing

• Chest pain when your child coughs or breathes deeply

• Abdominal pain near your child's ribs

• Poor appetite

• Crying more than usual, or more irritable or fussy than normal

• Pale or bluish lips, fingernails, or toenails

How do I know if my child is having trouble breathing?

• Your child's nostrils open wider when he or she breathes in

• Your child's skin between his or her ribs and around his or her neck pulls in with each breath

• Your child is wheezing, which means you hear a high-pitched noise when he or she breathes out

• Your child is breathing fast:

• More than 60 breaths in 1 minute for newborn babies up to 2 months old

• More than 50 breaths in 1 minute for a baby 2 months to 12 months old

• More than 40 breaths in 1 minute for a child older than 1 to 5 years

• More than 20 breaths in 1 minute for a child older than 5 years

How is pneumonia diagnosed?

Your child's healthcare provider will examine your child and listen to his or her lungs. Tell the provider if your child has other health conditions. Your child may also need any of the following:

• A chest x-ray may show signs of infection in your child's lungs

• Blood tests may show signs of an infection or the bacteria causing your child's pneumonia

• A mucus sample is collected and tested for the germ that is causing your child's illness. It can help your child's healthcare provider choose the best medicine to treat the infection

• Pulse oximetry measures the amount of oxygen in your child's blood

How is pneumonia treated?

If your child's pneumonia is severe, the healthcare provider may want your child to stay in the hospital for treatment. Trouble breathing, dehydration, high fever, and the need for oxygen are reasons to stay in the hospital.

• Antibioticsmay be given if your child has bacterial pneumonia

• NSAIDs, such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider

• Acetaminophendecreases pain and fever. It is available without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Read the labels of all other medicines your child uses to see if they also contain acetaminophen, or ask your child's doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly

• Your child may need extra oxygen if his blood oxygen level is lower than it should be. Your child may get oxygen through a mask placed over his nose and mouth or through small tubes placed in his nostrils. Ask your child's healthcare provider before you take off the mask or oxygen tubing

How can I manage my child's symptoms?

• Let your child rest and sleep as much as possible. Your child may be more tired than usual. Rest and sleep help your child's body heal

• Give your child liquids as directed. Liquids help your child to loosen mucus and keeps him or her from becoming dehydrated. Ask how much liquid your child should drink each day and which liquids are best for him or her. Your child's healthcare provider may recommend water, apple juice, gelatin, broth, and popsicles

• Use a cool mist humidifier to increase air moisture in your home. This may make it easier for your child to breathe and help decrease his cough

How can pneumonia be prevented?

• Do not let anyone smoke around your child. Smoke can make your child's coughing or breathing worse

• Get your child vaccinated. Vaccines protect against viruses or bacteria that cause infections such as the flu, pertussis, and pneumonia

• Prevent the spread of germs. Wash your hands and your child's hands often with soap to prevent the spread of germs. Do not let your child share food, drinks, or utensils with others

• Keep your child away from others who are sick with symptoms of a respiratory infection. These include a sore throat or cough

When should I seek immediate care?

• Your child is younger than 3 months and has a fever

• Your child is struggling to breathe or is wheezing

• Your child's lips or nails are bluish or gray

• Your child's skin between the ribs and around the neck pulls in with each breath

• Your child has any of the following signs of dehydration:

• Crying without tears

• Dizziness

• Dry mouth or cracked lip

• More irritable or fussy than normal

• Sleepier than usual

• Urinating less than usual or not at all

• Sunken soft spot on the top of the head if your child is younger than 1 year

When should I contact my child's healthcare provider?

• Your child has a fever of 102°F (38.9°C), or above 100.4°F (38°C) if your child is younger than 6 months

• Your child cannot stop coughing

• Your child is vomiting

• You have questions or concerns about your child's condition or care

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

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