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Learn to Spot Signs of Pneumonia in Babies Before It's Too Late

Being sick or having a weakened immune system may lead to pneumonia.

If you’re a parent, the word “pneumonia” triggers fear. According to the World Health Organization (WHO), this preventable illness accounts for 15% of deaths in children globally — that’s about 808,694 children under the age of 5, according to its latest 2017 report. And the Philippines is one of the top 15 countries that account for 75% of childhood pneumonia cases worldwide.

Pneumonia is an acute respiratory infection that affects the lungs’ small sacs or alveoli, which are filled with air when a healthy person takes in air. A person with pneumonia has alveoli that are filled with pus and fluid, which makes breathing difficult and painful.

The causes of pneumonia may be viruses, bacteria, or fungi. The bacteria Streptococcus pneumoniae is the most common cause of bacterial pneumonia in kids, while second on the list is Haemophilus Influenzae type b (Hib). The Respiratory syncytial virus is the most common viral pneumonia.

Pneumonia usually spreads when a person inhales tiny droplets from the cough or sneeze of an infected person or contracts it via direct contact with contaminated surfaces, an infected person’s mouth, nose, or eyes, and sometimes through the blood.

Signs and symptoms of pneumonia in babies and kids under age 5

Pneumonia in kids can strike and get worse fast. So the key to getting early treatment can identify the signs of pneumonia as soon as possible. According to, a parent resource site run by the American Academy of Pediatrics (AAP), it can start out as a viral infection and may progress into a bacterial one, which is why the flu and other viral respiratory infections can easily lead to pneumonia.

Kids with bacterial pneumonia usually become sick fairly quickly, starting with a sudden high fever and fast breathing, while symptoms may appear gradually in children with viral pneumonia. Still, if left untreated, pneumonia is life-threatening especially to infants and toddlers with weak immune systems.

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If you notice even just one of there symptoms below, alert your doctor and bring your baby to the hospital:

1. Difficulty in breathing

In infants and toddlers, this may appear as:

  • Rapid breathing — more than 50 breaths per minute (bpm) for infants 2 months to age 1 or more than 40 bpm for babies age 1 to 5
  • Flaring of the nostrils with every breath
  • Grunting or bobbing their head with every exhalation
  • Wheezing
  • Belly breathing or breathing from the lungs
  • Your child’s lower chest is indrawing or when the muscles between the ribs move in or retract during inhalation. The two videos of babies below can help show you this type of breathing (they do not have pneumonia). (Read about these babies stories and their moms’ plea for awareness here and here.)

2. Cough

Sometimes it’s a wheezing cough or just soft coughing accompanied by vomiting. Your baby’s lungs may also try to expel rusty- or green-colored mucus. In severe cases, it may be blood-tinged.

3. High fever

A temperature that is higher than 38°Celsuis in a baby who is less than 3 months old is enough reason for you to take him to the emergency room. High fever may also come with shaking or chills.

4. No wet nappies for 12 hours or more

This is a warning sign for dehydration, which means your baby is also not feeding properly or having tummy troubles such as vomiting and diarrhea.

5. Irritability and sleeping badly

Babies and toddlers may seem pale or limp and cry more than usual. Your baby may appear to have little to no energy, is drowsy or sluggish, and may sleep longer than usual. (Click here to know more about lethargy in babies.)

6. Blue-ish lips or nails

This is a result of decreased oxygen in the bloodstream, which means your baby is not breathing properly. Your baby’s skin on the face and the area under his tongue may also appear to be blueish or gray-ish.

For children who are more than 1 year old but younger than age 5, symptoms of pneumonia may also present as:

  • Stuffy nose
  • Chest pain
  • Abdominal pain as the child is coughing and has a hard time breathing
  • Loss of appetite
  • A decrease in physical activity
  • Unconsciousness, hypothermia, or convulsions in severe cases

Pneumonia is diagnosed based on these signs and symptoms. But sometimes a chest X-ray is necessary to determine which or how much the lungs have been infected. It will also help doctors decide if your baby needs to be hospitalized for better monitoring.

Viral pneumonia does not often require medication, and if it does, it is usually to help alleviate symptoms such as paracetamol for fever. The AAP strongly advises against giving cough suppressant medicine containing codeine or dextromethorphan on children.

It’s often difficult to tell whether pneumonia in babies is caused by a virus or bacteria, so doctors usually prescribe an antibiotic. Strictly follow instructions on timing and dosage. It’s also crucial to complete the full antibiotic course and do a follow-up visit to ensure your child recovers completely.

Preventing pneumonia in babies and children under age 5

Some kids are more prone to get sick with pneumonia. These include preemie babies, as well as children with heart or lung disorders (e.g., asthma) and kids with a compromised immune system. There are things you can do to lower your child’s risk of pneumonia with the help of breastfeeding, vaccination, and proper hygiene.

Breastfeeding your baby strengthens his immune system

The WHO actually recommends exclusive breastfeeding for the first six months to reduce the risk pneumonia in children. Through breast milk, a mom passes antibodies on to her baby that help put up a child’s natural defenses against diseases. It can also shorten the length of time of sickness if he ever does contract pneumonia.

Vaccines protect your child from illnesses that may lead to pneumonia

Ensuring that your child’s immunizations are up to date has a massive impact on his health. The Hib vaccine helps protect your baby from the second most common cause of pneumonia. Other vaccines such as DTaP, MMR, and the flu (for kids 6 months or older), chickenpox, and pneumococcal vaccines can all help prevent your child from contracting pneumonia. (Check the latest recommended immunization schedule from Filipino kids here).

Always practice proper hygiene

Pneumonia is spread through direct contact, so proper hand-washing before holding your baby is a good healthy habit, as well as not letting anyone kiss your baby. All things baby should be for baby only and should be washed separately as well. Teach your older child to wash his hands regularly before eating, after playing outside, and after using the bathroom. Also, try not to share glasses or utensils.

Bringing your baby to crowded places can put him at risk for contracting pneumonia. Opt for clean cooking and stop smoking as indoor air pollution and exposure to second-hand smoke increases a baby’s chances of getting the disease.

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