Pneumonia is a common infectious disease that can strike infants of any age. The condition affects lungs, impairing breathing and eventually causing a decline in the baby’s healthy growth.
Pneumonia is thus a fatal infection with a potential to cause lasting damage. But how do babies catch pneumonia? Is there a vaccine against the disease?
Get all the answers you need about pneumonia in babies in this MomJunction article. We also tell you about ways to cure and prevent the infection.
What Is Pneumonia?
Pneumonia is an acute lung infection characterized by the inflammation of the air sacs, called alveoli, in the lungs. An alveolus is where gaseous exchange occurs: oxygen from inhaled air transfers to the blood and carbon dioxide from the blood transfers to the air. In pneumonia, the alveoli become inflamed and fill with fluid, which impairs the lung’s ability to exchange gases.
There are two types of pneumonia depending on the part of the lung affected (1).
- Lobar pneumonia: It affects a single large lobe of the lung, and has a continuous presence across one section of lung.
- Bronchial pneumonia: It is also called bronchopneumonia. This infection causes a discontinuous spread of the disease in small pockets across the lungs.
What Is Walking Pneumonia?
Walking pneumonia is a less severe form of pneumonia, usually caused by Mycoplasma bacteria and sometimes other bacteria and viruses (2). Babies with this pneumonia may seem lethargic but will go about their routine as usual, which gives it the name walking pneumonia.
The symptoms, diagnosis, and treatment for walking pneumonia and regular pneumonia are the same. Walking pneumonia, which can develop into regular pneumonia when neglected, is rare among children below the age of five years (3).
What Causes Pneumonia In Babies?
There are three primary causes of pneumonia viz. bacteria, virus, and fungi (4). The most likely pathogens to cause pneumonia from each class are mentioned next (5):
1. Bacteria causing pneumonia:
- Streptococcus pneumoniae
- Mycoplasma pneumonia
- Group A & Group B streptococcus
- Staphylococcus aureus
2. Viral pneumonia causes:
- Respiratory syncytial virus (RSV)
- Influenza
- Rhinovirus
- Parainfluenza
- Adenovirus
3. Fungal pneumonia causes:
- Pneumocystis jirovecii
- Coccidioidomycosis
- Histoplasmosis
- Cryptococcus
Viral pneumonia is the most common type affecting children, with RSV being the most common culprit causing the infection (6). Fungal pneumonia is less common and mostly affects individuals with compromised immunity.
How Do Babies Catch Pneumonia?
The following are the most common settings for a baby to catch the pneumonia-causing pathogen (7):
- Community-acquired pneumonia is the most common in babies. The baby picks the pathogen by breathing the tiny droplets of mucus or saliva expelled by an infected person sneezing, coughing, or spitting. Since it spreads from person to person, it is called community-acquired pneumonia.
- Hospital-acquired pneumonia is when an unwell baby catches the pathogen during a visit to or stay in the hospital. Hospital-acquired pneumonia tends to be the most dangerous since the body is already weak and the pathogens in hospitals tend to be more resistant to pharmaceutical drugs.
- Aspiration Pneumonia occurs when the baby inhales food, liquid, or vomit from their mouth. It causes the food item or the vomit to lodge inside the lungs and become infected. Such a form of pneumonia is likely to occur when the baby has a problem with the gag reflex and is unable to cough out lodged food and liquids.
While all babies are vulnerable to infections, some may be more susceptible to pneumonia than others.
What Are The Risk Factors Of A Baby Getting Pneumonia?
Some factors and situations exacerbate a baby’s chances of contracting a pneumonia-causing pathogen (8):
- Children less than two years old are more prone to pneumonia infections due to their developing immune system, which isn’t strong enough to fight all pathogens.
- Babies exposed to second-hand smoke and pollution can be at higher risk due to damage to the lungs. Children below the age of one year are most prone to damage to the lungs caused by smoke.
- Children who have an innately weak immune system, due to HIV-AIDS or cancer treatment are more prone to infection.
- Acute chronic lung problems like cystic fibrosis and asthma impact lung health and leave it open to infection.
- With an existing lung infection, a baby’s immune system is already burdened, which causes opportunistic pathogens to cause pneumonia.
- Certain medical conditions such as a gag-reflex or trouble coughing and diseases like measles also make the baby susceptible to catching pneumonia. Living in a crowded environment also makes a baby prone to pneumonia.
How Common Is Pneumonia In Babies?
According to UNICEF, pneumonia is “the leading infectious cause of death among children under five” (9). Pneumonia accounts for 16% of deaths among children below the age of five years, with those aged less than two at a higher risk. Almost half of the childhood pneumonia deaths occur due to air pollution, which includes indoor air pollution.
What Are The Symptoms Of Pneumonia In Babies?
A baby with pneumonia will display the following symptoms (10):
- Fever is a general symptom and perhaps one of the first to emerge when the baby contracts the pathogen.
- A persistent wet cough with mucus is another sign. If your baby had a cough before, then you can differentiate it from a pneumonia cough.
- Labored breathing or trouble with respiration are common due to fluid-filled air sacs within the lung. The fast breathing is visible through the rapid movement of the ribs, contraction of abdominal muscles, and flaring of the nostrils.
- The laborious breathing is going to cause exertion, pain in the chest, and wheezing.
- In severe cases, the baby will develop cyanosis, which is a bluish tint to the lips and nails due to low oxygen levels in the blood.
- Fatigue, decrease in appetite, general lethargy and drowsiness.
- A headache, body pain, and chills.
Pneumonia symptoms worsen as the pathogen invades the lungs more. Therefore, take your baby to the doctor soon as you suspect any signs of pneumonia.
How Is Pneumonia In Babies Diagnosed?
Here is how a doctor finds out if the baby has pneumonia:
- Assessment of symptoms: The doctor will ask you about the extent of the baby’s symptoms and past medical history, such as the presence of an underlying medical condition, and about the baby’s living conditions to know if the baby is exposed to smoke.
- Physical exam: It involves listening to the infant’s breathing using a stethoscope. The doctor may even perform a pulse oximetry test. A clip-like instrument called pulse oximeter is attached to the baby’s finger to check the levels of oxygen in the blood. An unusually low level of oxygen in the bloodstream indicates trouble in respiration and thus problems with the lungs.
- Chest X-ray: An X-ray can reveal the clogged alveoli. It can also help the doctor assess if the pneumonia is lobular (restricted to one lung lobe) or bronchopneumonia (spread in pockets across the lungs).
- Mucus or sputum test: Doctor collects a small sample of the baby’s mucus from the nose or sputum from the mouth for laboratory analysis. It determines the pathogen that could have caused pneumonia.
- Blood test: A complete blood count checks the number of white blood cells, which are heavily produced during an infection. A blood test also helps determine what pathogen is present in the bloodstream.
- Invasive testing: Sometimes the doctor may rely on more intrusive diagnostic methods for accurate diagnosis. Examples of such procedures are chest CT scan, bronchoscopy (checking airways through a camera probe), and pleural fluid culture (collecting fluid from lungs).
The use of these tests is rare and seldom used for infants. Health professionals rely on these methods when all other results are inconclusive, the pathogen has spread to multiple parts of the body, the baby is suffering from various infections, or the baby does not respond to treatment at all.
How Is Pneumonia In Babies Treated?
The treatment depends on the type of pathogen that led to pneumonia:
- Antibiotics are used if the cause of pneumonia is bacterial. The length of the antibiotic course and mode of delivery depends on the extent of the infection. In severe cases, the baby may be admitted to the hospital and given the medicines intravenously. Bacterial pneumonia gets better within three days of starting medication, but you will have to complete the entire antibiotic course to prevent a relapse of the infection.
- Adequate rest and care: There is no specific medicine or treatment for viral pneumonia. The immune system works against the virus to overpower it and usually improves in three weeks. Rest, fever control, and sufficient nourishment are vital to help the body fight the infection. In very severe cases, the doctor may prescribe an antiviral medicine, depending on the type of virus.
- Antifungal and antiparasitic medicine: If fungus and parasites are the cause of pneumonia, then the child will get a dose of antifungal and antiparasitic drugs. The medication will differ as per the type of fungus and parasite causing the illness.
- Supportive treatment: Pneumonia takes a heavy toll on the body. To help the body regain its good health and fight infections better, the baby should get supportive care in the form of regular intravenous feed. Other steps include improving oxygen levels in the blood, removal of mucus from the nose through suctioning and administering acetaminophen (paracetamol) for alleviating fever and body pain. These steps do not cure pneumonia but help the baby feel better and thus fight the infection better.
Care at home also plays an essential role in ensuring that the baby recovers faster from the pneumonia infection.
How Can Parents Care For A Baby With Pneumonia?
Here is what you can do at home when your baby has pneumonia:
- Give plenty of fluids: Babies with pneumonia will have trouble eating due to loss of appetite and lethargy. So switch to a liquid diet that is nourishing and keeps the baby hydrated. If the baby is older than six months, you can consider giving meat and vegetable broth, and fruit and vegetable purees with a thin consistency. You can continue breastfeeding, but wear a mask while breastfeeding to prevent transmitting any bacteria to the baby and also avoid contracting the pathogen from the baby.
- Use a cool-mist humidifier: Cool-mist humidifiers pump water vapor into the air and make breathing easy. The American Academy of Pediatrics recommends the use of cool-mist humidifiers for infants with cold and flu symptoms (11). Do not use a hot-mist or steam humidifier since it can increase the risk of burns.
- Install an air purifier: Babies with pneumonia can be particularly sensitive to pollution and biological matter in the air. Place an air purifier in the baby’s room to make sure the surrounding air is clean.
Prevention is always better than cure, and it is also easier when it comes to pneumonia in babies.
How To Prevent Pneumonia In Babies?
The following steps help keep pneumonia away from your baby:
- Immunization: Vaccinating your baby alone plays a significant role in reducing the risk of pneumonia. Preventive vaccines include Haemophilus influenzae type b (Hib) vaccine, DTaP vaccine, Pneumococcal pneumonia vaccine, and Influenza (flu) vaccine (12). Medical experts also recommend getting the measles vaccine, since measles increases the risk of contracting pneumonia.
Babies with HIV must get a repeated dose of antibiotics to minimize the risk of pneumonia. Each vaccine and medicine has a schedule. The chances are that the vaccines that help prevent pneumonia are already present in the infant’s immunization roster. Nevertheless, speak to your baby’s doctor about the said vaccines.
- Proper nourishment: Keeping your baby’s immune system healthy is vital for preventing pneumonia. One of the best ways to do it is by providing adequate nourishment to the baby. A balanced diet of fruits, vegetables, meat, and grains for older babies and breast milk for infants is the best food for nourishment.
Research suggests that breastfed infants have a 47% lower risk than infants who rely on formula as their primary source of nourishment (13). Breastfeeding also protects against asthma, which increases the risk of pneumonia (14). So it is good to continue breastfeeding for a while, even when your baby switches to solids.
- Maintain good hygiene: Babies often catch pathogens from infected family members. Unwell members in the family must maintain distance from the baby. If you have a cold, then wear a mask when around the baby and while breastfeeding. Wash your hands when handling the baby and their things. Also, ask the doctor to prescribe medicines that are compatible with breastfeeding.
The World Health Organization states that you can prevent pneumonia in children through “simple interventions, low-cost, low-tech medication, and care” (15). The preventive steps for pneumonia in babies are simple and require minimal effort. Babies develop stronger immunity as they grow older, which further reduces the risk of pneumonia.
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