Childhood Pneumonia

Pneumonia is an infection of the lung tissue itself. The tiny air sacs at the end of the airways fill with fluid and inflammatory cells, so the surface where oxygen crosses into the blood is reduced. Your child compensates by breathing faster and harder, and that effort is what makes the illness visible from across the room.

The cause varies with age. In infants and pre-school children, viruses are responsible for most cases. Bacteria become relatively more common in older children, and they tend to produce a sharper illness with a higher fever. In practice the two overlap, and a bacterial infection sometimes follows a viral one a few days in.

Some things make pneumonia more likely and more severe: being under one year old, being born premature, undernutrition, incomplete immunisation, an existing heart or lung condition, and exposure to indoor smoke from cooking fuel or cigarettes. Crowded housing and a lack of exclusive breastfeeding in the early months add to the risk, and reducing smoke exposure at home is one of the few things within a family's control.

The most informative sign is one anyone can check. Your doctor counts your child's breaths over a full minute while the chest is settled, and compares the number against what is expected for your child's age. A rate above that threshold in a child with fever and cough is what defines the illness in most guidelines used in India.

The examination then looks at the effort of breathing: whether the skin draws in below the ribs or between them with each breath, whether the nostrils flare, whether there is a grunt at the end of each breath in an infant, and whether the head is nodding. Oxygen saturation is measured with a probe on the finger or toe. Your doctor listens over each part of the chest for crackles and for areas where air entry is reduced, and checks whether one side is moving less than the other.

How your child is feeding and drinking is part of the assessment, since a child too breathless to feed is a child who needs admission. A chest X-ray is not needed in every case; it is taken when the diagnosis is uncertain, when your child is severely unwell, or when the illness is not improving on treatment.

With the right treatment, the fever usually breaks within forty-eight to seventy-two hours, and that is the point at which your doctor judges whether the treatment is working. A review at forty-eight hours is standard, and your child should be seen sooner if the breathing gets worse.

The cough is the slow part. It commonly lasts two to four weeks after everything else has settled, and it does not by itself mean the infection is still active. Appetite and energy take one to two weeks to come back, and small frequent feeds work better than pressing for full meals.

A child treated at home can return to school once the fever has been gone for twenty-four hours and the breathing and appetite are normal, which is usually around a week. A child who needed admission stays until the oxygen level holds without support and feeding is reliable, often three to five days, with a further two weeks at home before full activity.