Pneumonia in children: What you should know

When children get pneumonia, they may have a fever, chills, and a cough with phlegm. But they don't always have these typical symptoms. Many children with pneumonia mainly have a tummy ache. The first signs of pneumonia in babies often include not wanting to drink, listlessness, or vomiting. Sometimes they only have a high fever and a very fast pulse.

Children who have pneumonia often breathe faster than normal. If they experience shortness of breath while they have pneumonia, their labored breathing may sound like groaning. When breathing, the skin between their ribs is visibly drawn in and/or their nostrils move a lot. You should see a doctor immediately if these symptoms occur.

Pneumonia in children is mainly caused by bacteria or viruses. Viral pneumonia usually develops from cold viruses or the common flu viruses. Bacterial pneumonia in children is often caused by pneumococcal bacteria, like in adults too. Infections with the Hemophilus influenzae bacteria are also typical in children. In young babies, pneumonia may be caused by certain streptococcal and intestinal (bowel) bacteria too.

Pneumonia in children is classified as “severe” or “not severe.” In both cases, children breathe quickly – babies more than 50 times per minute, toddlers more than 40 times per minute, and older children more than 20 times per minute. Other warning signs of severe pneumonia in children include sleepiness, not wanting to eat or drink, or having seizures. Severe pneumonia is generally treated in the hospital. Hospital treatment is also needed if the child has breathing difficulties, becomes unconscious or is less than six months old.

Like adults, children with bacterial pneumonia are often given antibiotics. It is important that the drug is effective against the bacteria that most commonly cause pneumonia in children. Antibiotics can be taken as tablets or syrup. Particularly if the infection is severe, a drip (infusion) may be used, or a combination of two different antibiotics can be given. Extra fluid is often given through a drip because sick children tend not to drink enough and may become dehydrated. Antibiotics are not needed if the pneumonia symptoms are mild or if the pneumonia is caused by a virus.

Two vaccinations can be given to prevent children from developing pneumonia caused by two bacteria:

• the pneumococcal vaccination
• the vaccination against Hemophilus influenzae.

Children are given a total of three injections at the ages of 2 months, 4 months and around 12 months. In premature babies, an additional pneumococcal injection is recommended at the age of 3 months. Depending on the vaccine, a fourth Hemophilus injection can be given at the age of 3 months. These vaccines can easily be given during the child's standard pediatric check-up appointments ("U-Untersuchungen" in Germany).

If you haven't had your child vaccinated, you should get the vaccinations done as soon as possible. Catch-up vaccinations against Hemophilus can be given until the age of five years, and those against pneumococci can be given until the age of two years.

Vaccinations against the childhood diseases measles, whooping cough and chickenpox are also recommended. Pneumonia can develop as a complication of those diseases. An overview of all the vaccinations recommended for children, teenagers and adults in Germany can be found on infektionsschutz.de – a website of the German Federal Institute of Public Health (BIÖG), formerly known as the Federal Centre for Health Education (BZgA).