Pneumonia is a lung infection that can lead to serious complications in children. The illness may present differently in children than it does in adults.

Pneumonia is an infection of the lungs caused by bacteria, viruses, or fungi. It is marked by inflammation in the air sacs of one or both lungs. The sacs, also called alveoli, fill with fluid or pus and may lead to fever, cough, or trouble breathing.

While these symptoms are classic in adults, children may present with different symptoms or seemingly unrelated symptoms.

Here’s what pneumonia looks like in kids, what causes it, and how it can be treated.

You can read more about the stages of pneumonia here.

Not all children experience the typical symptoms of pneumonia, like fever, cough with phlegm, and trouble breathing. Instead, it’s very common for kids with pneumonia to have a stomach ache as their primary symptom.

Babies and toddlers with pneumonia may experience:

Another way to recognize pneumonia in a child is by observing their breathing. Children with pneumonia may exhibit something called intercostal retractions. During retractions, the skin between their ribs pulls in with each breath or their nostrils may flare.

Your child may also breathe faster than usual and make groaning sounds while breathing.

Seek immediate medical care

Seek medical care if your child shows symptoms that concern you.

Babies 6 months old and younger may need hospital treatment for pneumonia.

Warning signs that your older child needs immediate medical help include:

  • rapid breathing (more than 20 breaths per minute for kids, 40 for toddlers, or 50 for babies)
  • having seizures
  • becoming lethargic or unresponsive

The most common type of pneumonia in children, particularly in kids ages 5 years old and younger, is viral pneumonia. The viruses that lead to infection may include respiratory syncytial virus (RSV) and other cold or flu viruses.

Bacterial pneumonia is caused by different strains of bacteria, including pneumococcal bacteria, Haemophilus influenzae bacteria, streptococcal bacteria, or intestinal bacteria.

Pneumonia caused by bacteria is more more common in older kids and adolescents, kids who have underlying health issues, and very young infants who have been exposed to certain bacteria during birth.

What is walking pneumonia?

Walking pneumonia may be caused by viruses or by a bacteria called Mycoplasma pneumonia.

This type of pneumonia is typically mild, may not cause serious symptoms that slow a child down (hence the term “walking”), and generally does not lead to hospitalization.

To diagnose pneumonia, your child’s doctor will perform a physical exam and review the symptoms they have been experiencing.

Other tests may include:

Treatment for pneumonia in children depends on the underlying cause. Viral pneumonia often resolves on its own without medical treatment. Bacterial pneumonia, on the other hand, may require prescription antibiotics to effectively clear.

Young infants or children with severe pneumonia may need hospitalization. Treatment at the hospital involves oxygen therapy, intravenous antibiotics to address infection, and intravenous fluids to prevent dehydration. Once a child’s oxygen levels improve, they may be discharged to continue treatment at home.

There are several ways you can help prevent pneumonia in your child.

One main way to prevent pneumonia is to stay up-to-date on vaccines. Getting these vaccines can help protect your child from infections that can lead to pneumonia.

Vaccines that may help prevent pneumonia include:

  • Pneumococcal vaccination: The Centers for Disease Control and Prevention (CDC) recommends pneumococcal vaccination for children younger than 5 years, adults 65 years or older, and children and adults at increased risk for pneumococcal pneumonia, the most common, severe type of pneumococcal disease. Ask your child’s healthcare professional about this series of vaccinations.
  • Seasonal influenza: The CDC recommends a flu vaccine for all children 6 months of age and older, and children 6 months old through 8 months of age may need two doses of flu vaccine in one flu season.
  • Respiratory syncytial virus (RSV): The CDC recommends one of two options to protect infants from severe RSV. Either an individual can get a maternal RSV vaccine (Pfizer’s Abrysvo) during pregnancy, or infants whose mothers did not get an RSV vaccine during pregnancy need to get an RSV antibody after birth.
  • COVID-19: COVID-19 and the virus that causes it are common causes of pneumonia. The CDC recommends children 6 months and older have a COVID-19 vaccination.

Other ways to help protect your child from getting pneumonia include good hygiene — washing your hands often when around your child, good indoor air quality — avoiding exposure to smoke, and helping them have adequate nutrition and sleep.

The outlook for most children with pneumonia is good. Again, viral pneumonia tends to resolve on its own without treatment. Likewise, most children do not experience any long-term lung issues.

Pneumonia can be very serious, especially in children with limited access to effective medical care. Worldwide, around 1.3 million children die each year from pneumonia and related complications.

Children who have more serious outcomes usually have pneumonia caused by bacterial infections (staphylococcal and varicella, for example) or have underlying health issues, like congenital heart disease, chronic lung conditions, or immunosuppression.

While pneumonia is common in children, especially those under 6 years old, it does not typically lead to serious complications.

If your child is immunocompromised or has other chronic health issues, speak with your pediatrician about the pneumococcal vaccine.

This vaccine is routinely given to babies and toddlers, but it may also provide an added layer of protection for kids ages 5 to 18 who are at higher risk of serious infection.