Baby has pneumonia: how to react?

Pneumonia is no longer as dangerous as it was for our grandparents and is now much more treatable! However, it is very important to treat the condition as soon as symptoms appear and to monitor their progress carefully. Pneumonia is one of the most deadly infections worldwide. According to the World Health Organization (WHO), this respiratory disease was responsible for 15% of infant deaths in 2018.

The term pneumonitis is sometimes mistakenly used as a synonym for pneumonia. Pneumonitis is actually the broader term for an infection of the lungs , whereas pneumonia is a lung infection caused by a microbe, either a virus or bacteria. Less commonly, pneumonia can be caused by a fungus or parasite.

Children are mainly affected by bacterial pneumonias, mainly caused by pneumococcus. They often start after a simple cold. Viral pneumonias are mainly due to the syncytial virus or the flu virus, the influenza virus. Note that the latter is one of the most dangerous pneumonias. Indeed, it can lead to a bacterial superinfection in the respiratory tract, sometimes fatal. The complications of pneumonia mainly concern babies who are already weakened, suffering from a heart problem for example.

There is a form of pneumonia linked to chickenpox but which is only developed by adults:  varicella pneumonia . This disease particularly affects pregnant women with symptoms such as fever, joint and muscle pain, malaise, headaches, etc. Infection of the fetus can occur through the placenta before the vesicles appear in the mother. This may trigger a spontaneous abortion (especially during the first trimester), malformations (limbs, eyes, etc.) or even brain damage. If the pregnant woman develops pneumonia at the end of pregnancy, there is a risk of congenital chickenpox for the fetus , potentially linked to organ damage, neurological after-effects or even death.

About a hundred children suffer from interstitial pneumonia in France. The symptoms are:

The origin of interstitial lung disease is often genetic, sometimes environmental . It is difficult to diagnose since it can either affect only the lungs or involve several organs at the same time.

In case of interstitial pneumonia, it is the thin liquid layer covering the alveoli of the lungs that is affected. Normally, the latter acts as a shield by protecting the lungs against bacteria and viruses . In case of pneumonia, therefore, the proteins that make up this barrier are deficient and the lungs are weakened.

As for the very thin tissue that surrounds and supports the alveoli, the interstitium, it thickens and complicates the passage of  oxygen from the alveoli to the blood . This is why children with pneumonia have respiratory problems.  There is no treatment to cure the lungs but oxygen intake and anti-inflammatory drugs , such as corticosteroids, can relieve young patients.

If your child has or has had interstitial pneumonia or not, be particularly vigilant for classic infections . Bronchitis or  colds  can damage their already weakened lungs. Interstitial pneumonias are more or less serious depending on the patient, because the protein that is deficient in the thin membrane can also sometimes be deficient in other organs.

Within pneumonias, viral forms of pneumonia are particularly contagious . Causing sneezing and coughing , they promote the spread of the virus via drops of saliva and mucus. It is not the pneumonias themselves that are contagious but the viruses, or bacteria, that caused them. As for the parasite sometimes encountered, it is mainly the microscopic fungus  Pneumocystis jirovec.  Whatever the pathogen, it causes problems in the pulmonary alveoli. . These abnormally fill up with liquid and can no longer properly ensure the gas exchanges of respiration. Logical consequence: baby has difficulty breathing!

In order to prevent the spread of viruses and bacteria, it is recommended to wash your hands well , to limit hugs, or, for example, not to use the same cutlery and glasses without washing them in between. In addition, it is advisable to have your child vaccinated against pneumococcus, generally before the age of one, and high-risk childhood diseases ( flu , measles, whooping cough , chickenpox, etc.). 

Make an appointment with your pediatrician or primary care physician as soon as you notice symptoms. In addition to difficulty breathing (rapid breathing and/or wheezing), other symptoms can help you recognize pneumonia:

Viral forms can cause a variety of additional symptoms, depending on the virus involved. For example, babies may have:

Diagnosis  of pneumonia in young children  begins with a physical examination. Your doctor will take into account all the symptoms and will listen carefully  to the baby's breathing . Bacterial forms are characterized by what is called "  crepitant rales  ", a very particular sound produced during breathing.

It is also common to have a chest X-ray of a baby. In the case of a viral or parasitic infection, both lungs of the child will show opacities on the X-ray, whereas this will only be the case for one lobe that is opaque in the case of a bacterial form. A blood test and biological examinations will then provide details on the nature of the virus, bacteria or parasite in question.

Treatment for baby pneumonia depends on its cause but in all cases requires a lot of rest . Antibiotics are generally reserved for bacterial or parasitic forms. Antivirals specific to the virus responsible can be used for viral forms. In all cases, it is also important to  fight baby's fever  using paracetamol, for example, which will be prescribed by your doctor or pediatrician. A little  respiratory physiotherapy  can also help the child breathe better during his illness.  Pneumonia  normally disappears in 10-12 days on average. It is also important to always make sure that baby remains well hydrated.

A chest X-ray is normally performed to ensure that the baby has healed properly. Note that babies at risk (immunocompromised or with a heart problem) and infants under 3 months are often hospitalized during treatment. The medical team can thus keep an eye on their progress and act urgently if necessary.

If this is not the case, do not hesitate to return to your caregiver if the fever persists for several days, if breathing difficulties worsen, or if other signs of infection appear (stiff neck, red and swollen joints, vomiting , etc.). Let's also monitor the potential developments of pneumonia, in particular the risk of bronchial dilation.

Although treatments are very effective these days, it is still better to protect your baby as much as possible against this disease!  The pneumococcal vaccine is then necessary.  It can be done before the age of one. And let's not forget simple hygiene rules, such as washing your hands or sneezing into the crook of your arm, to reduce the risk of transmission.