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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. Most children are able to get better at home with treatment from their healthcare provider, but pneumonia can be very serious and can require a stay in the hospital. Untreated pneumonia can lead to serious illness, It's important for a child with pneumonia to get treatment.

Several routine childhood shots (vaccines) protect against common causes of pneumonia. Ask your healthcare provider whether your child should have a flu shot or a vaccine against pneumococcal pneumonia. Not all types of pneumonia can be prevented with a vaccine.

How to say it

noo-MOHN-yah

What are the symptoms of pneumonia?

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 are different for everyone. They often include:

  • Fever and chills

  • Cough (either dry or producing thick mucus)

  • Wheezing, trouble breathing, or fast breathing

  • Chest pain especially with coughing or breathing or belly pain

  • 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. Antibiotics will be prescribed if the cause of the infection is bacterial. Your child should start to feel better within 24 to 48 hours after starting this medicine. It's very important that the child finish all of the antibiotics as instructed, even if they feel 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.

  • Wheezing. Sometimes pneumonia can cause wheezing, even in children who don't have asthma. If this happens, your child's healthcare provider may prescribe nebulizer treatments. This medicine will help your child breathe better. Use the nebulizer as instructed.

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 them feel more comfortable and get better faster:

  • Keep the child quiet and be sure they get 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 as instructed by your child's healthcare provider. 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 advises 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. Scrub your hands for at least 20 seconds.

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

  • Limit contact between a sick child and other people.

  • 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 the healthcare provider

Call your child's healthcare provider right away any time you see signs of distress in your otherwise healthy child. This includes:

  • Harsh cough or cough that continues

  • Headache that continues or severe headache

  • Fever (see Fever and children below)

  • Symptoms don't get better within the advised time period or symptoms get worse

  • Your child has vomiting that continues or can't take the prescribed medicines

Call 911

Call 911 if your child has:

  • Trouble breathing or is unable to speak

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

  • A seizure

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

Online Medical Reviewer: Amy Finke RN BSN
Online Medical Reviewer: Jessica Gotwals BSN MPH
Online Medical Reviewer: Liora C Adler MD
Date Last Reviewed: 5/1/2022
© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.