Pneumonia in Children

What are the signs and symptoms of pneumonia in kids?

Symptoms of pneumonia in infants and children vary depending on the age of the child and what's causing the pneumonia. Kids with bacterial pneumonia usually get sick quickly and have a high fever, cough, rapid breathing and maybe even chest pain with breathing. Viral pneumonia symptoms tend to appear more slowly and may be less severe, though you can see fever and cough from viruses too. Wheezing is more common in viral pneumonia.

The length of time between when your child is exposed to the germ that causes illness and when they feel sick from pneumonia (called the incubation time) varies. If a child develops pneumonia from a cold caused by RSV, symptoms will start in 4 to 6 days. With the flu virus, symptoms can start after just 18 to 72 hours.

Pneumonia caused by bacterial infections develops after several days of cold symptoms. Kids may seem to get sicker after 3 or 4 days of symptoms and develop a worse cough or trouble breathing. Antibiotics can help with bacterial infections, fevers and chest pain, but some symptoms (like cough) can still last weeks after the infection even with appropriate antibiotics. Because there are no medications to treat viral infections, symptoms from viral pneumonia may last longer. You can help with medicines to control fever or pain as their immune systems fight off the infection.

Call your child’s doctor if you notice any of these pneumonia symptoms:

• Cough
• Fever
• Rapid breathing (in some cases, this is the only symptom)
• Breathing with grunting or wheezing sounds
• Labored breathing that causes nasal flaring and makes the rib muscles draw in (muscles under the ribcage or between ribs suck inward with each breath)
• Chest pain
• Abdominal pain or vomiting
• Loss of appetite in older kids or poor feeding in infants, which may lead to dehydration

Seek immediate help if your child:

• Is having trouble breathing or is breathing abnormally fast
• Has a bluish or gray color to the fingernails or lips
• Has a fever of 102ºF (38.9ºC), or above 100.4ºF (38ºC) in infants under 6 months

Learn how to spot the differences between pneumonia symptoms and symptoms of other respiratory infections.

What tests do we use to diagnose pneumonia?

Your child's doctor may order a chest X-ray to diagnose pneumonia. The doctor also might order blood tests or tests for viruses in nasal secretions.

How do we treat pneumonia children?

In most cases, children with bacterial pneumonia receive oral antibiotics at home. If your child’s doctor prescribes antibiotics, make sure your child takes all the medicine as directed. Not taking antibiotics according to the directions can make the infection worse or spread it to other members of your family.

We can treat pneumonia due to flu virus with antiviral medications to target the flu. These medications are only helpful if you start them within the first 2 or 3 days of symptoms.

For other viruses that cause pneumonia, there are no medications. In these cases, supportive measures such as keeping your child hydrated, controlling fever, and treating wheezing or oxygen need help fight off the infection. For wheezing, your child’s doctor might recommend using a nebulizer or inhaler.

One way to know if your child’s lungs are getting enough oxygen is to check their lips and fingernails. They should have a pinkish hue — not bluish or gray.

If you child has a cough, ask your child’s doctor if any over-the-counter medicines might help. Cough suppressants may not help with cough caused by pneumonia. And non-prescription cough and cold medications are generally not recommended for kids under 6 years old.

You should check your child's temperature at least twice a day (morning and evening) while they are sick. In older infants and children, call the doctor if the fever goes above 102ºF (38.9ºC). For babies younger than 6 months, call if a fever is above 100.4ºF (38ºC).  

We may recommend a hospital stay if your child:

• Needs supplemental oxygen
• Has a lung infection that may have spread into their bloodstream
• Has any chronic illnesses that weaken their immune system
• Is vomiting so much that they cannot keep down oral medications
• Is dehydrated

Can pneumonia be prevented?

Vaccines can help prevent some types of pneumonia by preventing the infections that lead to it. Children’s Hospital Colorado, along with the American Academy of Pediatrics, recommend that infants and children receive routine immunizations against Streptococcus pneumoniae and Haemophilus influenza type B, two of the most common bacterial causes of pneumonia. Children should receive the vaccine for pertussis (whooping cough) starting when they are 2 months old.

Yearly influenza (flu) and COVID shots can also reduce your child’s risk of pneumonia due to those infections . Children with chronic respiratory diseases may also receive an additional immunization against Streptococcus pneumoniae for more protection against pneumonia.

Why choose Children’s Colorado for pneumonia treatment?

Our Breathing Institute provides comprehensive care for children with breathing problems relating to pneumonia and our medical experts are very experienced in diagnosing and treating children with pneumonia. We work with your child's primary care physician and other specialists your child may need to bring your family the very best care possible.

Children’s Colorado offers the latest in diagnostic testing for both infants and older children with pneumonia. Our experienced staff of pediatric specialists includes physicians, nurses, dietitians, social workers and respiratory therapists so we can treat every symptom. This collaborative approach helps us provide the highest quality care and gets your child back on the road to recovery as soon as possible.

• Healthy Children provides in-depth information for parents about pneumonia from the American Academy of Pediatrics.
• Medline Plus offers easy-to-understand information about causes and treatments for kids with pneumonia.