Pneumonia in children: What you should know

When children get pneumonia, they may have a fever, chills, or 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, and 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 is usually caused by cold viruses or common flu viruses. Bacterial pneumonia is often caused by pneumococcal bacteria, like in adults too. Haemophilus influenzae bacteria infections are also typical in children. Certain streptococcal and intestinal bacteria sometimes lead to pneumonia in babies.

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 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's important that the drug is effective against the germs 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 needn't be taken for milder infections or if the pneumonia is caused by a virus.

Two vaccinations can be given to protect children from developing pneumonia caused by the following germs:

• the pneumococcal vaccination and
• the vaccination against Haemophilus 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 three months. Depending on the vaccine, a fourth Haemophilus booster can be given at the age of three 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 Haemophilus can be given until the age of five years, and ones against pneumococci can be given until the child is two years old.

Vaccinations against the childhood diseases measles, whooping cough and chickenpox are also a good idea. 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 the Federal Centre for Health Education’s (Bundeszentrale für gesundheitliche Aufklärung, BZgA) website www.impfen-info.de.