What is pneumonia?

Pneumonia is an infection in the lungs. It may also be called a lower respiratory tract infection. Most cases of pneumonia are caused by viruses in children age 3 and younger. In older children and teenagers, most cases of pneumonia are caused by bacterial infections. A child could start out by having a viral pneumonia which then becomes complicated by a bacterial pneumonia.

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In the lung with pneumonia, the affected part of the lung will appear white in a chest X-ray. The white shadow is caused by fluid in the lung's air sacs.

Signs and symptoms of pneumonia

Pneumonia symptoms can vary greatly in children. Common signs and symptoms of pneumonia include:

  • high and/or persistent fever 
  • cough
  • fast breathing 
  • trouble breathing 
  • crackly noises in the lung 
  • loss of appetite 
  • vomiting due to the cough or from swallowing mucus 
  • feeling unwell 
  • abdominal (belly) pain or chest pain 

What your doctor can do for pneumonia

Your doctor will listen to your child’s lungs with the stethoscope and observe your child’s breathing. If your doctor suspects pneumonia, your child may have a chest X-ray to see what your child’s lungs look like. Viral pneumonia does not need antibiotic treatment. If your doctor suspects a bacterial infection as a cause of the pneumonia, then your doctor will prescribe antibiotics. Your child’s doctor will look at many factors before deciding the best treatment.

Taking care of your chil​d at home

Finish all ant​ibiotics

If your child was given antibiotics, they must finish all the pills or liquid , even if they are feeling better. This is important to prevent the infection from coming back and to decrease the chance of antibiotic resistance.

Monitor and treat ​the fever

To treat the fever or achy muscles, use acetaminophen (Tylenol or Tempra) or ibuprofen (Advil or Motrin). You can give these medicines even if you child is also on antibiotics. They do not interact. DO NOT give your child ASA​ (acetylsalicylic acid or Aspirin).

Keep your child fed and hydrated.

Make sure your child drinks plenty of fluids to stay hydrated. Your child may not want to eat much at first. Once the infection begins to clear and your child starts to feel better, they will want to eat more.

Avoid smok​y places

Keep your child away from smoke and other lung irritants.

Cough symptoms

Your child’s cough may get worse before it gets better. As the pneumonia goes away, your child will cough to get rid of the mucus. The cough may continue for two to three weeks.

Hospital admiss​ion if needed

Most children can be cared for at home. Very sick children may need to go to the hospital. They may need oxygen and other medicines. They may need antibiotics given intravenously (into a vein) at first, and then by mouth as they get better.

When to see a do​ctor

See your child’s regular doc​tor if:

  • Your child’s cough lasts for more than three to four days and is not improving
  • Your child has a fever for more than two to three days
  • Your child's fever lasts more than three days after starting antibiotics.

T​​ake your child to the nearest Emergency Department, or call 911 if your child:

  • has difficulty breathing
  • becomes very pale or blue in the lips
  • vomits antibiotic doses or will not take fluid
  • appears more sick

Key poi​nts

  • Pneumonia is an infection deep in the lungs. It can be caused by viruses or bacteria.
  • If your child is given antibiotics, be sure to finish all of them, even if your child is feeling better.
  • Keep your child comfortable and give them lots of fluids.​
Elly Berger, BA, MD, FRCPC, FAAP, MHPE​