Everything About Pneumonia In Children To Watch Out For

How do I know if my child has pneumonia? How serious is pneumonia in a child? How does a child get pneumonia? Learn about pneumonia in children here.

Persistent coughing, fever and breathing difficulties in children are symptoms that raise alarm bells for parents, and these may actually point to signs of pneumonia in children.

Young children are more susceptible to contracting pneumonia and this can be a potentially life-threatening illness if left untreated.

Hence, it is crucial for parents to be aware of the simple ways it can be prevented and to look out for signs of pneumonia in children to avoid any complications it can bring.

What Is Pneumonia

Pneumonia is an infection in the lungs, specifically in one or both air sacs. The sacs may become filled with pus which causes the different symptoms.  fever, laboured breathing and chills.

Signs of Pneumonia in Children

In a nutshell, the telltale signs of pneumonia in children are fever, laboured breathing and chills.

• Difficulty breathing
• A low fever (37.8  to 38.5 C)
• A general feeling of discomfort
• Flu- or cold-like symptoms such as sore throat, chills, headache
• Coughing that is dry and frequent
• Rapid breathing with wheezing sounds
• Stomach pain
• Chest pain
• Shaking and chills
• Vomiting
• Mucus tinged with blood or has a green or rust colour
• Poor feeding (in infants) and decreased appetite (in older kids)

Signs of pneumonia in children vary depending on what part of the lungs are infected. A middle or top infection may cause laboured breathing; an infection on the lower part may cause vomiting, nausea or an upset stomach.

Causes of Pneumonia

When it comes to pneumonia in children, several factors can kick it into gear. Here's a list to break it down:

1. Bacteria: Pneumonia can be caused by bacteria like streptococcus and mycoplasma (which leads to "walking pneumonia").

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2. Viruses: The notorious culprits include influenza and respiratory syncytial virus (RSV).

3. Fungus: While less common, pneumonia can also be triggered by fungi.

4. Parasites: Though rare, parasites can be behind some pneumonia cases.

5. Compromised Immune Systems: For kids with weakened immune systems, organisms like pneumocystis jiroveci may lead to pneumonia. This is particularly seen in individuals with HIV, which may prompt a doctor to recommend an HIV test.

Understanding the different causes of pneumonia helps healthcare providers determine the most appropriate treatment for children facing this respiratory challenge.

How Does a Child Get Pneumonia

A child may develop pneumonia by:

• Breathing pneumonia-infected air or certain bacteria*
• Having a viral upper respiratory infection such as the cold or flu*
• Experiencing complications with other diseases such as chicken pox or measles
• Breathing gastric juices from the stomach and large amounts of food into the lungs; or vomiting into the lungs. This usually occurs in a seizure or stroke

*Note: The nose, even one of a healthy person's, usually houses pneumonia-causing viruses or bacteria. When these spread to the lungs, pneumonia can develop. This occurs more during or after episodes of a cold or chronic diseases like chronic obstructive pulmonary disease.

Pneumonia can either be community-associated pneumonia (spread at school or work, for example) or healthcare-associated pneumonia (spread through hospitals). Treatment options for both vary; for this article, we focus on treatments for community-associated pneumonia since kids will most likely get the disease from school instead of a healthcare facility.

Risk Factors

Who are most likely to develop pneumonia? Your child is at risk if they have:

• Weakened immune system. Those with HIV or AIDS who are receiving chemotherapy, long-term steroids and those who have recently undergone an organ transplant
• Chronic illnesses such heart disease, asthma, chronic obstructive pulmonary disease
• Age. Pneumonia can be more severe for infants, young children and those 65 year and above. These groups are the ones with compromised immune systems or existing health issues
• Hospitalisation. Those who are in the intensive care unit, especially if on a ventilator

Complications

How serious is pneumonia in a child?

When untreated or diagnosed, pneumonia can lead to the following health issues:

• Difficulty breathing. Severe cases of pneumonia may lead to insufficient intake of oxygen. In which case, hospitalisation is required where the child may be given a ventilator to assist with breathing
• Lung abscess is when pus is present in the lung cavity. This is removed either through antibiotics; or draining or surgery using a long tube or needle
• Having bacteremia, which is when bacteria is present in the bloodstream. Bacteria in the blood can spread to the lungs, and in some cases can cause organ failure
• Pleural effusion is when fluid accumulates around the lungs. This must be drained immediately to avoid further infection

When to Call the Doctor

One of the signs of pneumonia to monitor in children is fever. Log the child's temperature every morning and evening. If the fever goes above 38.9 C (for infants six months and older, and children) or 38 C (young infants) then call a doctor.

Tests and Diagnosis

Pneumonia can be diagnosed through a physical examination performed by a doctor, who will listen to a child's breathing and a crackling sound (one of the definite signs of pneumonia in children).

Other tests to confirm pneumonia are chest X-ray; blood tests; sputum test (when a sample of lung fluid, or sputum, is analysed); and pulse oximetry (to measure the oxygen level in the blood).

Additional tests that are usually done on older patients or those who have serious health conditions are: chest CT scan and pleural fluid culture (this helps determine the type of infection).

Walking Pneumonia

Diagnosing walking pneumonia in children often starts with a trip to the paediatrician. The healthcare provider will consider the child's symptoms, like a persistent cough, low-grade fever, or difficulty breathing. They may also conduct a physical examination and use a stethoscope to listen for abnormal lung sounds.

In some cases, additional tests like a chest X-ray or blood work might be needed to confirm the diagnosis and rule out other conditions. If you suspect your child might have walking pneumonia, it's a good idea to consult a healthcare professional for proper evaluation and guidance.

Treatment for Pneumonia in Children

Medication administered to treat pneumonia depends on the bacteria or virus that causes the infection.

If the pneumonia is caused by bacteria, antibiotics are usually given to tackle the condition.

If the pneumonia is caused by a virus, antibiotics will not be provided since it would be ineffective. Viral pneumonia may be treated using anti-viral medication. In addition to antibiotics and anti-viral medication, supportive medication is usually offered to provide relief for cough, fever, chest pains and body aches, depending on the patient's symptoms.

Antibiotics must be taken on schedule, as prescribed by the doctor, to help kill the bacteria which is causing your child to be unwell. The treatment lasts from seven to 10 days.

Note that the course of antibiotics should be completed as advised by the doctor. Incomplete intake of antibiotics affects how long it takes for the child to recover, thus prolonging the child's discomfort and affecting his daily activities.

Other medicines prescribed to help ease the symptoms and signs of pneumonia in children are:

• Cough medicine to help loosen lung fluids, and relieve throat inflammation, phlegm or pain
• Anti-pyretics or fever-reducing medicines such as ibuprofen and acetaminophen. Avoid giving aspirin to kids since it may cause Reye's syndrome

In the event of mild viral pneumonia, bed rest, balanced diets and plenty of fluids may help improve the condition. Avoid exercise or activities (both indoor and outdoor) including sports or social play to minimise contact with other children too.

With regard to severe cases of pneumonia, hospitalisation may be required upon the doctor's advice. The patient may require intravenous antibiotics and be put on oxygen to cope with breathing difficulties or discomfort that the child may experience.

Vaccine Against Pneumonia

Vaccines are a crucial part of keeping our little ones healthy, and protecting against pneumonia in children is no exception. Pneumococcal vaccines, like Prevnar 13, are recommended to safeguard against this potentially serious illness.

Kids should typically get their first dose around two months of age, followed by a few more doses at various intervals up to 15 months, with booster shots later on. These vaccines are a vital defence against pneumonia, so be sure to check with your paediatrician to keep your child up to date on their immunizations!

Use of Medisave in Singapore

Up to $400 per year per Medisave account can be used for Pneumococcal vaccinations for persons with higher risk of developing influenza-related complications and severe pneumococcal disease respectively. Do find out from your doctor or specialist about the procedures on this.

Home Remedies

In mild cases when the signs of pneumonia in children are not that severe, some kids may feel well enough to go to school. However, it is highly recommended for an unwell child to stay home and rest, to facilitate the body to recover from this bout of illness.

Here are things that can be done at home:

• Offer your child plenty of fluids, including soup dishes such as bee hoon soup, mee sua soup or porridge, to hydrate the child and help purge the body of toxins.
• Use a warm compress on the chest area if your child experiences chest pains or discomfort.
• Ensure that the child sticks to the prescribed medication to ensure that the bacteria is completely eradicated.
• If your child is running a temperature, offer him a cool fever patch to help bring down the temperatures, and wiping him down with room temperature water (not iced cold water) to help provide some comfort and relief.
• Your child may be lethargic and disinterested in eating, so do be patient and offer him comfort by being there. Offer fruit or juices to help with getting your child hydrated too.

How to Prevent Pneumonia in Children

Once on antibiotics, a child with pneumonia has a smaller chance of passing on the bacteria to anyone else at home. Nevertheless, be sure that everyone at home:

• Washes hands frequently and correctly (following the 20-second rule)
• Must avoid using the same cups, plates or utensils with the sick child
• Must have up-to-date immunizations to prevent other infections
• Boost a child's immune system by allowing him to get enough sleep, adequate exercise and have a healthy diet
• Sneeze or cough into a tissue and wash your hands thereafter
• Wear a surgical mask when you are down with the common cold or cough

Pneumonia should not be taken lightly, and parents should ensure that they look out for signs of pneumonia in children especially when they have been unwell for a persistent period. If you think your child is exhibiting the symptoms mentioned above, do not hesitate to reach out to their paediatrician.

Here at theAsianparent Singapore, it's important for us to give information that is correct, significant, and timely. But this doesn't serve as an alternative for medical advice or medical treatment. theAsianparent Singapore is not responsible for those that would choose to drink medicines based on information from our website. If you have any doubts, we recommend consulting your doctor for clearer information.