Pneumonia

Symptoms

• Upper respiratory tract infection lasting for more than 2 or 3 days
• Worsening symptoms and a high fever (between 40^°C and 40.6^°C)—even if there was little or no fever the first few days (38.3°C to 38.5°C)
• Severe cough, chills, and fast, laboured breathing
• Possible chest pains
• Fatigue
• Possible abdominal pain (when the pneumonia is in the lower part of the lung)

If you think your child has pneumonia, consult your doctor.

• Unusually fast breathing
• Bluish lips or fingernails

What is pneumonia?

Pneumonia is a lung infection usually caused by a virus or bacteria. Less commonly, pneumonia can be caused by fungi, such as mould. This usually happens in children with weakened immune systems. Most cases of pneumonia are viral.

Sometimes, an upper respiratory infection (like a cold) can spread to the lungs and turn into pneumonia. The symptoms can vary: They usually appear when the child has a cold, flu, sore throat, or ear infection for 2 or 3 days. The infection reaches the lungs when the child, for whatever reason, has a weakened immune system.

Pneumonia can be treated. The important thing is to act quickly, especially for very young children, in order to prevent more serious infections like pleurisy or bacteremia.

Children who have asthma, cystic fibrosis, swallowing difficulties, or an immune deficiency are more likely to have recurring cases of pneumonia.

How to treat pneumonia

Although most cases of pneumonia can be treated at home, it’s important to see a doctor to determine the type of infection and get the right treatment.

If your child is prescribed antibiotics, make sure they take them for the full length of time recommended by the doctor, even if they start feeling better after a few days. Stopping antibiotics too early can cause the pneumonia to come back and may contribute to antibiotic resistance.

More serious cases sometimes require hospitalization, especially for children under 2 years old. In those cases, the child might need oxygen or antibiotics given through an IV.

Care and practical advice

• Encourage quiet activities. Your child doesn’t need to stay in bed all day, but they do need to rest.
• If your child doesn’t have much of an appetite, offer small amounts of nutritious food 5 or 6 times a day. Don’t force them to eat if they’re not hungry.
• If they have a fever, make sure they drink often (water, juice, broth, etc.).
• Take their temperature at least twice a day, once in the morning and once at night. If the fever lasts more than 2 or 3 days despite antibiotics, see a doctor.
• To relieve your child’s pain and fever, give them acetaminophen (e.g., Tylenol^®, Tempra^®) or ibuprofen (e.g., Advil^®, Motrin^®), following the instructions and with the recommended dose based on their weight. Do not give ibuprofen to a baby under 6 months, and never give acetylsalicylic acid (ASA),such as Aspirin^®, to a child or teenager.
• Keep the room temperature around 20°C.
• Do not give over-the-counter cough medicine (syrups or other products) to children under 6 unless specifically recommended by a doctor. These medications are not recommended for older children either, since they can cause side effects and are generally not effective. Even if they were to stop the cough, they could lead to a buildup of secretions in the bronchi and lungs, making breathing problems worse. Coughing is a protective reflex that helps clear secretions.

Prevention

The best way to prevent pneumonia is to protect your child from upper respiratory infections and to treat any infections promptly when they appear. Breastfeeding during the first few months of life also helps protect babies from upper respiratory tract infections and pneumonia.

The following measures can help lower the risk of getting pneumonia:

• Wash your hands with soap after being in contact with someone who’s sick or touching objects they’ve handled. If your child is young, wash their hands frequently. Show your child how to wash their hands as early as possible, especially after they cough, sneeze, or blow their nose.
• Teach your child to cough or sneeze into a tissue or into the crook of their elbow instead of into their hand if they don’t have one.
• Clear your child’s nose with a saline solution. For more details, see our article on cleaning and blowing a stuffy nose.
• Clean faucets, door handles, and toys thoroughly, preferably with an alcohol-based cleaning product. For more information, read our fact sheet on cleaning and disinfecting toys.
• Make sure your child gets all the recommended vaccines on schedule. The Canadian Paediatric Society also recommends that all children over 6 months of age get the influenza vaccine every year, especially those at higher risk of flu-related complications.
• Avoid smoking around your child. Young children exposed to second-hand smoke are at greater risk of developing pneumonia.

Scientific review: Dr. Anne-Claude Bernard-Bonnin, pediatrician Research and copywriting:The Naître et grandir team Updated: November 2021

Photo: Bsip/PINON