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Pneumonia in Children

Pneumonia is a term that means lung infection. It can be caused by infection by germs, including bacteria, viruses, and fungi. Though most children are able to get better at home with treatment from their healthcare provider, pneumonia can be very serious and can require hospitalization. Untreated pneumonia can lead to serious illness and even death. So it is important for a child with pneumonia to get treatment.

Ask your healthcare provider whether your child should have a flu shot or a vaccination against pneumococcal pneumonia.

What are the symptoms of pneumonia?

Girl sitting up in bed, coughing.

Pneumonia is caused by an infection that spreads to the lungs. The infection often starts with symptoms of a cold or sore throat. Symptoms then get worse as pneumonia develops. Symptoms vary widely, but often include:

  • Fever, chills

  • Cough (either dry or producing thick phlegm)

  • Wheezing or fast breathing

  • Chest pain especially with coughing or breathing

  • Tiredness

  • Muscle pain

  • Headache

  • Bluish color to the lips or nails

Any child with cold or flu symptoms that don’t seem to be getting better should be checked by a healthcare provider.

How is pneumonia treated? 

  • Bacterial pneumonia. If the cause of the infection is found to be bacterial, antibiotics will be prescribed. Your child should start to feel better within 24 to 48 hours of starting this medication. It's very important that the child finish ALL of the antibiotics, even if he or she feels better.

  • Viral pneumonia. Antibiotics will not help treat viral pneumonia. Occasionally, antiviral medicines may be prescribed. In time. this infection will go away on its own. To help your child feel more comfortable, your healthcare provider may suggest medicine for the child’s symptoms.

Follow any instructions your provider gives you for treating your child’s illness. A very sick child may need to be admitted to the hospital for a short time. In the hospital, the child can be made comfortable and may be given fluids and oxygen.

Helping your child feel better

If your healthcare provider feels it is safe to treat the child at home, do the following to help him or her feel more comfortable and get better faster:

  • Keep the child quiet and be sure he or she gets plenty of rest.

  • Encourage your child to drink plenty of fluids, such as water or apple juice.

  • To keep an infant’s nose clear, use a rubber bulb suction device to remove any mucus (sticky fluid).

  • Elevate your child’s head slightly to make breathing easier.

  • Don’t allow anyone to smoke in the house.

  • Treat a fever and aches and pains with children’s acetaminophen or ibuprofen. Don't give a child aspirin. Don't give ibuprofen to infants 6 months of age or younger.

  • Don't use cough medicine unless your provider recommends it.

Preventing the spread of infection

  • Wash your hands with clean, running water and soap often, especially before and after tending to your sick child.

  • Teach your child and other family members when and how to wash their hands.

  • Limit contact between a sick child and other children.

  • Don't let anyone smoke around a sick child.

  • Talk with your child's healthcare provider about having your child vaccinated against a bacterial cause of pneumonia (pneumococcal infections). The American Academy of Pediatrics recommends that all children 2 months of age and older get this vaccine. It's called pneumococcal conjugate (PCV13). If your child has a serious health condition or a weak immune system, the provider may suggest another pneumococcal vaccine called pneumococcal polysaccharide (PPV23).

When to call your healthcare provider

Call your healthcare provider right away any time you see signs of distress in your otherwise healthy child, including:

  • Harsh or persistent cough

  • Persistent or severe headache

  • Fever (see Fever and children, below)

Call 911

Call 911 if your child has:

  • Trouble breathing or unable to speak

  • Blue, gray or purple color to lips, skin or fingernails

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For babies and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Baby under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older

Online Medical Reviewer: Daphne Pierce-Smith RN MSN CCRC
Online Medical Reviewer: Liora C Adler MD
Online Medical Reviewer: Marianne Fraser MSN RN
Date Last Reviewed: 9/1/2019
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