Caused by viruses, bacteria, parasites and fungi, pneumonia is an infection in the lungs, which can affect either one or both of them. In the case of children, the most common cause of pneumonia is viruses. However, viral pneumonia can also develop bacterial pneumonia. Pneumonia, generally begins with an infection in the nose or throat (upper respiratory track), resulting in fluid collection in the lungs. Pneumonia can also occur in case any foreign material is mistakenly inhaled into the lungs – common culprits are food or acid from the stomach.
Pneumonia is the leading infectious cause of death in children worldwide, accounting for 15% of all deaths in children below 5 years of age. According to UNICEF, pediatric pneumonia is responsible for the death of 3 million children globally each year. However, the majority of these deaths occur in children with underlying conditions, such as congenital heart disease, chronic lung disease of prematurity and immune-suppression. The majority of these deaths occur in developing countries; however, pediatric pneumonia is a significant cause of death in industrialized nations too.
What are the factors that increase the risk of pneumonia in my child?
Pneumonia spreads in a number of ways including person to person contact through the saliva or mucus from the infected person and through air-borne droplets from a sneeze or a cough. Inhalation of the bacteria or virus, commonly found in the child’s nose and throat, can lead to pneumonia. Pneumonia can also infect the child through the blood, especially during or immediately after birth. Some of the common risk factors are listed below:
- Premature birth;
- 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 daycare center;
- Breathing secondhand smoke.
What are the signs and symptoms that indicate pneumonia in my child?
The signs and symptoms depend on the type of pneumonia and the age of the child. The most common symptom of pneumonia in infants is the cough, along with retractions, tachypnea and hypoxemia. Often these may be accompanied by fever, congestion, irritability and suppressed appetite. While adolescents experience similar symptoms, they may show other constitutional symptoms such as pleuritic chest pain, abdominal pain, headaches, vomiting, diarrhea, otalgia / otitis and pharyngitis. Most children will show either or all of the following symptoms:
- Difficulty in breathing;
- Abdominal pain near the ribs;
- Poor appetite;
- Excessive crying, or more irritable or fussy than normal;
- Pale or bluish lips, fingernails, or toenails.
What are the signs of breathing problems in my child?
While it is fairly easy to pick up signs of discomfort in the child, the following symptoms indicate that your child is facing difficulties in breathing.
- Increased pulling of the breathing muscles below and between the ribs and above the collarbone;
- Flaring (widening) of the nostrils;
- Pain in the chest, particularly with coughing or deep breathing;
- Your child is breathing fast:
- More than 60 breaths in one minute for newborn babies up to 2 months old
- More than 50 breaths in one minute for a baby 2 months to 12 months old
- More than 40 breaths in one minute for a child older than 1 year
How will they diagnose if my child has pneumonia?
The first thing that your child’s doctor will observe is the respiratory efforts of the child during his physical examination. In case there are respiratory symptoms present, he would then undertake an assessment of the oxygen saturation by pulse oximetry. Following this, other diagnostic tests may include:
- Auscultation by stethoscope;
- Complete blood cell count (CBC);
- Chest radiography;
How will my child be treated for pneumonia?
In most cases, your child will be treated either at the doctor’s office or at your home. However, sometimes if the case is severe or if your child is younger than 2 months, the doctor will want to admit your child to the hospital for treatment. The first line of treatment normally is to provide immediate respiratory support in case of breathing problems.
In case of pneumonia caused by a virus, generally there is no specific treatment other than rest and the usual treatment to control fever. Viral pneumonia usually improves after a few days, although the cough may linger for several weeks. Ordinarily, no medication is necessary. However, because it is often difficult to tell whether the pneumonia is caused by a virus or by bacteria, the doctor will prescribe an antibiotic, which has to be taken for the full prescribed course and at the recommended specific dosage. You may be tempted to discontinue them early, but you should not do so. Your child will feel better after just a few days and it may tempt you to discontinue with the antibiotic. However, you should never do that as some bacteria may remain resulting in the infection returning again.
How can I prevent my child from getting pneumonia?
The first and most important step in prevention is immunization against Hib, pneumococcus, measles and whooping cough (pertussis). The key to improving your child’s natural defense is adequate nutrition, starting with breastfeeding for the first six months. Some of the other measures are listed below:
- Do not let anyone smoke around your child.
- Keep your child away from people with sore throat or cough.
- Wash your hands and your child’s hands with soap before feeding or eating.
- Encourage good hygiene around the house.
- Do not let your child share food, drinks, or utensils with others as far as possible.
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