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Pneumonia (Child)

Pneumonia: Infection of the lungs caused by viruses or by bacteria | KKH

Pneumonia (Child) - What it is

Signs and symptoms of pneumonia may include:
  • Fever with or without chills
  • Cough - initially dry, but may progress to phlegmy
  • Difficulty in breathing or rapid breathing
  • Chest pain when coughing or breathing
  • Nausea, vomiting (usually after coughing), or diarrhoea
  • Fatigue
  • In addition to the above, newborns or infants may have lower than normal body temperature, appear restless, without energy, or have difficulty feeding.


Pneumonia (Child) - Symptoms

Consult your doctor if your child:

  • Has difficulty breathing or has rapid breathing
  • Complains of chest pain
  • Is lethargic, drowsy or irritable
  • Has persistent high fever beyond two to three days after starting antibiotics
  • Has poor feeding and/is not retaining the oral antibiotics due to vomiting

Hospitalisation
Your child may be hospitalised if he/she is:
  • Younger than three months
  • Having difficulty breathing
  • Having low oxygen levels
  • Showing signs of dehydration, e.g. dry tongue/lips, less urine, dry skin
  • Vomiting or not feeding well
  • Excessively lethargic or sleepy

Pneumonia (Child) - How to prevent?

Prevention
Get vaccinated.
  1. Pneumococcal conjugate vaccine can prevent serious infection by some strains of pneumococcus, including pneumonia. Pneumococcal conjugate vaccine is recommended as part of the National Childhood Immunisation Schedule. Have your child vaccinated if he/she has not completed three doses of the vaccine. 
  2. Influenza vaccine can prevent influenza pneumonia and other complications of influenza. Children above six months old can be given the vaccine. Pregnant women should be vaccinated to protect themselves and their unborn child up till the child is six months old. Children with certain high risk medical conditions may also benefit from yearly influenza vaccination.
  3. Maintain good hygiene. Keep your child’s and your hands clean through regular hand-washing, or use an alcohol-based hand sanitiser, to protect your child against respiratory infections that may lead to pneumonia.
  4. Avoid smoke exposure. Smoking and inhaling second-hand smoke damages your child’s natural ability to fight against respiratory infections.
  5. Improve your immune system. Ensure your child has a healthy diet, gets enough sleep and exercises regularly.

Pneumonia (Child) - Causes and Risk Factors

Pneumonia (Child) - Diagnosis

Pneumonia (Child) - Treatments

Expected course of medication and treatment

Antibiotics are only prescribed for children who have bacterial pneumonia or viral pneumonia with suspected concurrent bacterial infection. With the start of a course of appropriate antibiotics for bacterial pneumonia, the fever usually starts improving within two to three days.

The cough may take a longer duration, up to two weeks or more, to resolve. Medications to suppress cough (cough suppressants) are not routinely indicated for treating children with pneumonia. Because coughing helps loosen and move phlegm from the lungs, it’s a good idea not to stop the cough completely. Children may not be able to cough out phlegm but they usually cough and swallow the phlegm into the stomach and pass it out in the faeces. 

Medications to loosen mucus (mucolytic) may sometimes be prescribed to help loosen and clear thick secretions from the air passages in some children. This may increase coughing initially to expel the mucus. Such medications are not recommended for children under the age of two as the child’s ability to cough up the phlegm may be limited, which may lead to obstruction of breathing tubes by retained phlegm. Some mucolytics can also induce vomiting.

Discharge instructions for home management Get plenty of rest. Do not return to school until your child stops having fever and stops coughing excessively. It is better not to jump back into the full routine until your child has fully recovered.

Stay hydrated. Drink plenty of fluids, especially water, which may help loosen mucus in your child’s lungs. Coughing spasms are often caused by sticky secretions in the back of the throat. If antibiotics are prescribed, complete the entire course of antibiotics, even if your child feels well. If the antibiotics are stopped too soon, your child’s lungs may continue to harbor bacteria that can multiply and cause the pneumonia to recur or develop complications of pneumonia.

Following discharge, while continuing medications at home, if your child develops persistent high fever, difficulty in breathing, chest pain and/or poor feeding, you should consult your doctor.

Follow-up appointment

Your child may be given a follow-up appointment for review by a doctor at the specialist clinic, polyclinic or general practitioner. Keep the appointment as advised by your doctor.

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Pneumonia (Child) - Other Information

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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