Pneumonia in children: What you should know

Photo of a child washing their hands
PantherMedia / Peter Müller

Pneumonia can sometimes be hard to detect in children because they don't always have a cough, a fever or shortness of breath. What's more, the germs that are involved may be different from the ones that cause in adults. Because of this, two vaccinations are recommended for children: one for Haemophilus and one for pneumococci.

Pneumonia is more common in children than in adults. One reason for this is that their is not yet fully developed. Also, germs like or viruses are passed quickly from child to child, especially between the ages of three and six years. That is why infections are generally very common in children.

Pneumonia is more common in babies and toddlers than it is in older children and teenagers. Every year, develops in 35 out of 10,000 children under the age of six, but in only 15 out of 10,000 older children.

The generally doesn't lead to complications in children. But can be life-threatening if a baby develops directly after birth or a child is weakened due to another disease or malnutrition. Globally, is one of the most common causes of death in children, especially in poorer regions of the world.

How can I tell if my child has pneumonia?

When children get , they may have a fever, chills, or a cough with phlegm. But they don't always have these typical symptoms. Many children with mainly have a tummy ache. The first signs of 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 often breathe faster than normal. If they experience shortness of breath while they have , 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.

What are the typical causes in children?

Pneumonia in children is mainly caused by bacteria or viruses. Viral is usually caused by cold viruses or common flu viruses. Bacterial is often caused by pneumococcal , like in adults too. Haemophilus influenzae infections are also typical in children. Certain streptococcal and intestinal sometimes lead to in babies.

When is pneumonia considered to be severe?

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 include sleepiness, not wanting to eat or drink, or having seizures. Severe 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.

What do you need to know about treatment with antibiotics?

Like adults, children with bacterial are often given antibiotics. It's important that the drug is effective against the germs that most commonly cause in children. Antibiotics can be taken as tablets or syrup. Particularly if the is severe, a drip (infusion) may be used, or a combination of two different 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 is caused by a .

Which vaccinations are advisable for children?

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

  • the pneumococcal and
  • the 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.

Deutsche Gesellschaft für Pädiatrische Infektiologie (DGPI), Gesellschaft für Pädiatrische Pneumologie (GPP). S2k-Leitlinie „Management der ambulant erworbenen Pneumonie bei Kindern und Jugendlichen (pädiatrische ambulant erworbene Pneumonie, pCAP)“. AWMF-Registernr.: 048-013. March 2017.

Eppinger M, Müller M. Pädiatrie für Studium und Praxis. Breisach: Medizinische Verlags- und Informationsdienste; 2016.

Prina E, Ranzani OT, Torres A. Community-acquired pneumonia. Lancet 2015; 386(9998): 1097-1108.

Robert Koch-Institut (RKI). Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut – 2017/2018. August 14, 2017. (Epidemiologisches Bulletin; Volume 34).

Weltgesundheitsorganisation (WHO). Pneumonia. September 2016.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on May 18, 2021
Next planned update: 2024

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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