Pneumonia In Infants: Causes, Symptoms & Remedies

Pneumonia affects one or both lungs which causes the air sacs to fill up with mucus, pus and other fluid making it hard to breathe. Babies may develop pneumonia after flu, or a cold and viruses are the most common cause of the infection. In babies with a weak immune system, severe pneumonia if left untreated can be potentially life-threatening. Continue reading to know all about the different types of pneumonia and how to care for your child, if they get one.

What Is Pneumonia?

When the lungs get infected with different types of bacteria and viruses that attack the respiratory system, it is called pneumonia. It can affect one or both the lungs and can potentially make a person very sick. The air sacs in the lungs get inflamed by the infection and fill up with pus and other fluids which make breathing difficult. The common symptom is coughing that is followed up by thick mucus (phlegm) from the lungs that could be green, brown or tinged with blood. People develop pneumonia after a cold or flu and often in the winter months.
Pneumonia can develop without warning within a day or two or over several days. It could be mistaken for just a bad cold or not and cough is one of the first and most common symptoms. Pneumonia can be treated at home and clears up in about 2 to 3 weeks. It can be severe and dangerous in babies, older adults and people with other diseases. They can become very ill and need to be hospitalised.

What Are Different Types Of Pneumonia?

Pneumonia is a general term for the infection in the lungs which can be caused by many different organisms. It is basically grouped into two categories: Bacterial and Viral pneumonia. Young children and babies more commonly get pneumonia caused by viruses such as the respiratory syncytial virus (RSV). Pneumonia in infants may be caused by pathogens such as group B streptococcus (GBS) which is usually contracted at birth during a normal delivery. Older children may develop pneumonia because of various other viral and bacterial infections of the lungs.

1. Bacterial Pneumonia:

Bacterial pneumonia is characterized by a sudden onset of symptoms such as high fever, coughing and rapid breathing. The babies also don’t eat well and seem very ill. Other symptoms include faster pulse, lips and nails turn bluish, and they may have trouble breathing (trying hard to breathe with the chest sinking in and flared nostrils). Bacterial pneumonia can be caused by organisms such as Chlamydophila pneumoniae, Mycoplasma pneumoniae and Streptococcus pneumoniae to name a few. The type of infection caused by Mycoplasma pneumoniae usually result in milder symptoms even in children and is often referred to as atypical or walking pneumonia. It is most common among school-aged children and is not severe enough to keep them in bed-rest. It most often develops in summer and spreads from person to person. The infection responds well to antibiotics, and people develop some level of immunity, although subsequent infection is possible.

2. Viral Pneumonia:

Typically, viral pneumonia starts out like a cold or flu, and the symptoms steadily get worse as the days pass. Viral pneumonia is moderate and not as sudden as the bacterial type. It attacks children between the ages of 4 or 5, and the affected children have symptoms that are typical with other viruses such as; fever, sore throat, cough, nasal congestion, loss of appetite, diarrhoea and lack of energy. The fever can be in the range of 101.5 degrees Fahrenheit, and some of the children might experience wheezing. Although less severe than bacterial pneumonia, it can make children more susceptible to bacterial types of the illness. The viruses that cause pneumonia typically include the flu virus, respiratory syncytial virus, adenovirus and parainfluenza virus.

What Causes Pneumonia?

Pneumonia can be caused by a variety of pathogens such as bacteria, virus, fungi and parasites. Most of the cases are viral and bacterial. It often begins an upper respiratory tract infection which affects the nose and throat. The symptoms show up after 2 or 3 days, and the infection slowly moves down to the lungs. This causes the lungs to fill up with white blood cells, mucus and fluid which start to gather in the air sacs of the lungs. The congestion thus caused, interferes with the smooth passage of air which makes it harder to breathe.
The symptoms give an important clue as to which organism is causing pneumonia. Children with pneumonia caused by bacteria can become ill fairly quickly with a sudden high fever and rapid breathing. Pneumonia caused by a virus will show symptoms more gradually and are less severe.

Signs & Symptoms of Pneumonia in Babies

Take your baby to the paediatrician if you see symptoms such as:

• Fever accompanied by shivering and sweating.
• A severe cough with coughing up thick phlegm that is green, yellow or bloodstained.
• Baby is generally unwell and has lost appetite

More serious symptoms of pneumonia that would need hospitalization involve:

• Rapid shallow breathing. The skin between the ribs, below the rib cage and above the collar bone seems to suck in with each breath.
• Baby has had less than half the normal amount of fluid intake over the past 24 hours.
• Wheezing (an audible coarse whistling sound with each breath).
• The lips and fingernails have turned blue.

Pneumonia can quickly develop over a day or two or take several days for its onset depending on the causative organism. In both cases, it could seem like a bad cold, and cough is one of the earliest signs.
The paediatrician conducts chest examination using a stethoscope to listen for crackling sounds and the sound of fluids. The baby’s heart rate and breathing will also be checked along with observation of other symptoms. A chest X-ray might also be done to check how much of the lungs have been affected if the baby seems particularly unwell. A blood or mucus test might also be done to determine whether it is bacterial or viral.

How To Treat Pneumonia In Babies?

If the paediatrician thinks that the pneumonia is mild, then the baby can be treated at home. Viral pneumonia usually resolves on its own over time as the baby’s immune system fights the virus. Bacterial pneumonia would be treated with antibiotics. If the baby is being treated at home, it can be difficult to tell whether the infection is bacterial or viral since there are no tests to determine the causative organism. In such cases, the doctor would prescribe a course of antibiotics just to make sure the baby is on the safe side.

Medical Treatment for Pneumonia

If the pneumonia is caused by bacteria, the child will be put on a course of antibiotics. These can be in tablet or liquid form. A significant improvement will be seen within the first 48 hours, but a cough will remain for a few more days. It’s imperative that the full course of antibiotics is finished even if the child seems better.
If the baby is struggling to breathe and its condition does not improve after 48 hours and shows signs of fever getting worse, hospitalization will be needed. Also, babies who are under 6 months are more likely to be admitted. The doctors in the hospital will make sure that the baby gets enough fluids and antibiotics by means of a drip. If there is trouble breathing, extra oxygen will be provided through a mask.
The severity of pneumonia determines how long the baby stays in the hospital. Milder cases might need a day or two in the hospital while severe cases would need five or six days in the hospital. If the baby recovers well after discharge, a follow- up treatment may not be required. If the symptoms persist, a chest X-ray will be done for further evaluation.

The signs to look out for before hospitalization are:

• Has difficulty breathing or is struggling to breathe
• The baby is dehydrated as it won’t feed or drink water
• Is too young to take antibiotics through the mouth
• Oxygen levels in the blood are very low
• Has other deficiency conditions of the heart, lungs or immune system

Home Remedies for Pneumonia

If the baby has mild pneumonia or one that is caused by a virus, treatment at home becomes possible. If the condition becomes stable after 48 hours of starting the antibiotics, the baby need not be hospitalized. There are many other treatments that can be given in parallel to help ease the baby’s discomfort. It’s important the baby gets plenty of rest throughout the day. To bring down fever, infant paracetamol or infant ibuprofen can be given on the doctor’s advice. Babies older than two months can have infant paracetamol. If they are over three months old and weigh at least 5 kilograms, they can have ibuprofen. Make sure you read the dosage correctly on the packet and if in doubt consult the doctor or the pharmacist. Also, refrain from giving the baby any over-the-counter medicines for cold and cough. They are unsuitable for children under six years due to the risk of side effects.

To take care of your baby at home:

• Try running a cool mist humidifier if the baby has bacterial pneumonia.
• Ensure they get a lot of rest.
• Even though your baby may not want to each much, it is important to keep them hydrated. Give them small amounts to drink frequently or small portions of breastfeeding whenever they can.
• Wet nappies are a sign that they are getting enough to drink, therefore regularly check for it.
• If they have tummy or chest ache, they can be given pain relief like ibuprofen or paracetamol made for infants.
• Refrain from giving them any cough medicines; they do not help with pneumonia.
• Do not smoke around the child or let it breathe in dust or smoke from outside.
• Even though a high temperature and prolonged fever are worrying, it is natural. Don’t try to wet sponge them with water to reduce the temperature.

How to Prevent Pneumonia?

• Ensure The Vaccinations Are Up To Date: The pneumococcal vaccine (PCV) is given to protect against pathogens that cause pneumonia, septicemia (blood poisoning) and meningitis. Several other vaccines are given for diseases such as diphtheria, Hib and whooping cough prevent pneumonia as well.

• Maintain a Good Personal Hygiene: Keep your hands clean when you handle the baby and if you have a maid, who takes care, make sure they practice good hygiene. Cover your mouth when you cough and wash your hands and the baby’s hands often to prevent germs. Regularly sanitize toys, feeding bottles, utensils and other things that can accumulate germs.
• Make The House a Smoke-Free Environment: If you or your partner smokes, try to stop. If not, smoke outside the house staying far enough. Research shows that babies who are exposed to cigarette smoke fall sick more often and is more susceptible to illness such as asthma, colds, ear infections and pneumonia.
• Good Nourishment: It is important to keep your baby well-nourished, so they are strong enough to fight infections. Breastfeeding them exclusively for the first 6 months is the ideal way to strengthen your baby’s developing an immune system. The breast milk contains antibodies produced by your body which helps the baby fight off infections while its immune system is still developing. As you slowly introduce them to solid foods, breast milk should remain as an important source of antibodies and nutrients until they are fully weaned.
• Extra Care: Premature babies need extra care from the start as their immune systems tend to be weaker making them prone to infections.

With up-to-date vaccination, good nourishment and hygiene, pneumonia can be prevented. Even if your child gets pneumonia, with timely treatment and care, they can recover fully.

Also read: Bronchiolitis In Babies: Causes, Signs & Treatment