Community-Acquired Pneumonia, Infant

Pneumonia is a lung infection that causes inflammation and the buildup of mucus and fluids in the lungs. Community-acquired pneumonia is pneumonia that develops in people who are not, and have not recently been, in a hospital or other health care facility.

Usually, pneumonia in babies develops as a result of an illness that is caused by a virus, such as the common cold and the flu (influenza). It can also be caused by a bacteria. While the common cold and influenza can spread from person to person (are contagious), pneumonia itself is not considered contagious.

What are the causes?

• Viruses.
• Bacteria.

What increases the risk?

• Your baby has other lung problems.
• Your baby has a weakened body defense system (immune system).
• Your baby is being treated for cancer.
• Your baby is in close contact with children who are sick, especially during the fall and winter seasons.
• Your baby has not received a vaccine for a preventable pathogen.

Babies born to mothers who have untreated chlamydia are also at higher risk for developing pneumonia after birth. Chlamydia is an infection that a person can get through sex with another person (sexually transmitted infection or STI).

What are the signs or symptoms?

• A dry cough or a wet (productive) cough.
• Breathing problems, such as:
  • Fast breathing.
  • Making high-pitched whistling sounds when breathing, most often when breathing out (wheezing).
  • Nostrils opening wide during breathing (nasal flaring).
• Fever.
• Trouble nursing or taking a bottle.
• Being less active and sleeping more than usual.
• Irritability.

How is this diagnosed?

• A physical exam.
• Your baby's medical history.

• Imaging studies, such as X-rays.
• Lab tests on blood and urine.

How is this treated?

• Pneumonia that is caused by a virus may go away without treatment. In severe cases, your baby may be given a medicine to kill the virus (antiviral medicine).
• Pneumonia that is caused by bacteria will be treated with an antibiotic medicine.
• Your baby may need to be treated in the hospital. If your baby has trouble breathing, they may also need:
  • Oxygen, if tests show that oxygen is low.
  • Medicines to treat infection, fever, runny nose, or cough.
  • IV fluids.

Follow these instructions at home:

Medicines

• Give your baby over-the-counter and prescription medicines only as told by your baby's health care provider.
• Do not give your baby cough medicine or cold medicine unless your baby's health care provider says so. Cough medicine can prevent the body from removing mucus from the lungs.
• If your baby was prescribed an antibiotic medicine, give it as told by your baby's health care provider. Do not stop giving the antibiotic even if your baby starts to feel better.
• Do not give your baby aspirin because of the association with Reye's syndrome.

Eating and drinking

• Breastfeed or bottle-feed your baby often and in small amounts. Slowly increase the amount. Do not give your baby extra water.
• Have your baby drink enough fluid to keep their urine pale yellow. Ask the health care provider how much your baby should drink each day.

General instructions

• Ask your baby's health care provider how you should help clear mucus. This may include using:
  • A vaporizer or humidifier. These machines add moisture to the air, which can loosen mucus.
  • A suction bulb or other tool to remove mucus from the nose.
  • Salt–water (saline) drops to loosen thick mucus in the nose.
  • A moist, soft cloth to clean the nose.
• Wash your hands with soap and water for at least 20 seconds before and after handling your baby. If soap and water are not available, use hand sanitizer. Ask other people in your household to wash their hands often, too.
• Keep your baby away from secondhand smoke. If you smoke, make sure you smoke outside only and change clothes afterward.
• Make sure your baby's surroundings help to promote rest.
• Keep all follow-up visits.

How is this prevented?

• Keep your baby's vaccines up to date.
• Make sure that you and everyone who provides care for your baby has received vaccines for influenza and whooping cough (pertussis).
• If your baby is younger than 6 months, feed them only with breast milk, if possible. Continue this practice until your baby is at least 6 months old. Breast milk can help your baby fight infections.
• Avoid exposure to tobacco smoke.

Contact a health care provider if:

• Your baby has trouble feeding.
• Your baby passes less stool or urine than usual.
• Your baby does not sleep or sleeps too much.
• Your baby is very fussy.
• Your baby has a fever.

Get help right away if:

• Your baby has signs of trouble breathing, such as:
  • Fast breathing.
  • A grunting sound when breathing out.
  • Ribs that appear to stick out when they breathe.
  • Wheezing.
  • Nasal flaring.
  • Lips, nails, or face turning blue.
  • Short pauses in breathing during or after coughing.
• Your baby coughs up blood.
• Your baby vomits often.
• Your baby has symptoms that suddenly get worse.
• Your baby is younger than 3 months and has a temperature of 100.4°F (38°C) or higher.
• Your baby is 3 months to 3 years old and has a temperature of 102.2°F (39°C) or higher.

These symptoms may be an emergency. Do not wait to see if the symptoms will go away. Get help right away. Call 911.

Summary

• Community-acquired pneumonia is pneumonia that develops in people who are not, and have not recently been, in a hospital or other health care facility.
• Usually, pneumonia in babies develops as a result of an illness that is caused by a virus or bacteria.
• Treatment for this condition depends on the cause and how severe the symptoms are.
• Contact a health care provider if your baby has trouble feeding, passes less stool or urine than usual, has trouble sleeping, is very fussy, or has a fever.