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Pneumonia is a lung infection. It is usually caused by a virus or bacteria. These germs make the air sacs in the lungs fill with fluid (phlegm or mucous) (Picture 1). This makes it hard to breathe and causes your child to cough.

“Walking” pneumonia is a non-medical word that describes a mild case of bacterial pneumonia. Often the child is not sick enough to stay home. He or she can still walk around with little difficulty.

Pneumonia is spread by infected people who carry the germs in fluid droplets in their throats, noses or mouths. The infected person coughs the germs into the air. Your child breathes in the germs or comes in direct contact with the infected person’s saliva or mucous by touching something. It is possible to catch pneumonia from someone who does not know he is sick. Pneumonia cannot be “caught” by walking outside without a coat.

Pneumonia occurs most often during the cold months when children spend most of their time indoors in close contact with other people. Children under the age of 2 are at highest risk for pneumonia. Almost everyone fully recovers with proper medical care.

Signs and Symptoms

Fast, difficult breathing Severe, shaking chills Muscle aches
Cough Chest pains Loss of appetite
Fever Tiredness, weakness Nausea or vomiting

Pneumonia caused by a virus is often less severe than when caused by bacteria. The symptoms usually start out like the flu. They slowly get worse over a few days.Fluid can fill the air sacs in the lung

Pneumonia caused by bacteria can come on suddenly with a high fever, fast breathing and coughing.

Both types of pneumonia can cause the child’s cough to last for weeks after the fever has stopped.


The health provider can usually diagnose pneumonia based on the time of year and the child’s symptoms by watching the child’s breathing and by listening to the lungs. To check for bacterial pneumonia, a chest X-ray, blood and other tests may be done.

Treatment of Pneumonia

Pneumonia caused by bacteria is treated with an antibiotic. Symptoms should improve within 12 to 36 hours after starting the medicine.

It is important to take the full course of antibiotic as prescribed. Stopping the medicine early may cause the infection to come back. It may also make the medicine not work as well for your child in the future.

Pneumonia caused by a virus cannot be treated with antibiotics. Viral pneumonia usually goes away on its own.

Things That You Can Do to Help Your Child at Home Are

  • Control the fever with the proper medicine and right strength for the age of your child. Fevers lower than 101° F do not need to be treated unless the child is uncomfortable (see Helping Hand HH-I-105).
  • Give your child plenty of fluids to prevent dehydration.
  • See that your child gets lots of rest.
  • Do not give over-the-counter (OTC) cough medicines or other OTC medicines without asking the health provider first. The child needs to cough and bring up the phlegm. Coughing is the body’s way of clearing the infection from the lungs.
  • Avoid exposing your child to tobacco smoke or other irritants in the air.

Preventing Pneumonia

Teach your child good hand washing habits

  • Keep vaccinations up-to-date. All children, starting at 2 months, should begin a series of vaccines that prevents the bacterial type of pneumonia.
  • All children 6 months of age or older should get a flu vaccine yearly even if they have an egg allergy.
  • Teach children to cover their noses and mouths with facial tissue or a sleeve of their shirt when sneezing or Throw away tissues after use.
  • Teach and practice good hand washing (Picture 2).
  • Wash surfaces that are touched often (like toys, tables and doorknobs) with soap and water or wipe them down with a disinfectant.
  • Keep the home smoke free.

If your child has a weakened immune system or is at high risk because of a chronic condition of the lungs, heart, or kidneys, ask the child’s health provider if other vaccines are needed.

When to Call the Doctor

You should call your child’s doctor if your child:

  • Has trouble breathing or is breathing much faster than usual
  • Has a bluish or gray color to the fingernails or lips
  • Is older than 6 months and has a fever over 102°F
  • Is younger than 6 months and has a temperature over 100.4°F.
  • Has a fever for more than a few days after taking antibiotics

When your child should stay home and return to school or childcare

A Child Should Stay Home from School or Childcare If He

  • Has a fever over 100 °F.
  • Feels too ill or does not have the energy to take part in school or childcare activities.

A Child Can Return to School When He

  • Is fever-free for 24 hours
  • Has the energy to return to his regular routine
  • Eats and drinks well

It might take weeks for your child to get all his energy back. Some days will be better than others. Allow your child to resume activities gradually.

Pneumonia (PDF)

HH-I-299 2/09 Revised 12/16 Copyright 2009 Nationwide Children’s Hospital