Pneumonia
This advice has been written for safety netting advice after your child has been assessed by a healthcare professional.
Pneumonia is infection of one or both of the lungs and can be caused by viruses and bacteria. Usually only part of the lung is affected. It can affect people of any age, but is more common and can be more serious in young children.
Symptoms
Symptoms of pneumonia can come on over 24-48 hours or more slowly over several days. A child with pneumonia is usually very tired and looks unwell.
Common symptoms include:
Fever
Breathing faster than usual
Using extra effort when breathing
Being too breathless to feed (young children)
Cough
Chest pain when breathing or coughing
These symptoms usually pass within 4-7 days.
Causes
Pneumonia is caused by bacteria and viruses, of which there are many types. These viruses are catching (contagious) meaning they can spread easily between people. Viruses are more common in the winter and young children are particularly at risk of catching them. Having your child immunised, including the flu vaccine, reduces the risk of them getting pneumonia.
If your child has any of the following:
- Breathing very fast or breathing that stops or pauses
- Makes a grunting noise every time they breathe out
- A harsh noise as they breathe in (stridor) present all of the time (even when they are not upset)
- Becomes pale, blue, mottled and / or unusually cold to touch
- Difficult to wake up, very sleepy or confused
- Weak, high-pitched, continuous cry or can’t be settled
- Has a fit (seizure)
- Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red or amber features)
- Has a rash that does not go away with pressure (the glass test)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
- Working hard to breathe, drawing in of the muscles below the ribs
- A harsh noise as they breathe in (stridor) only when upset
- Dry skin, lips or tongue
- Not had a wee or wet nappy in last 8 hours
- Poor feeding in babies (less than half of their usual amount)
- Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
- Is 3-6 months old with temperature 39oC or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
- Temperature of 38oC or above for more than 5 days or shivering with fever (rigors)
- Temperature less than 36°C in those over 3 months
- Getting worse and I am still worried
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS Wales 111 - dial 111
If none of the above features are present
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS Wales 111 – dial 111
Treatment
Mild pneumonia often gets better by itself without antibiotic treatment. If your child's fever lasts for more than 2 days and they are breathing more quickly than usual, they may need treatment with oral antibiotics, usually Amoxicillin.
Treatment with intravenous antibiotics (given into a vein) is usually only needed for severe cases or those that have not responded to antibiotics given by mouth. Your child may also need extra help with their breathing, such as being given oxygen.
Children who need intravenous antibiotics are usually admitted to hospital. Some children may be able to be at home for part, or all of, the intravenous antibiotic course. These children would come into hospital once a day for someone to look at them and for their antibiotics to be given.
The decision on when to change from intravenous to oral antibiotics (tablets or liquid) will be made by the medical team caring for your child. this will depend on how quickly your child responds to treatment (improvement in fever, breathing difficulty and sometimes their blood tests) and whether your child has other health conditions. Antibiotics are usually given for a total of 5 to 7 days. You can give regular pain relief (Paracetamol or Ibuprofen) until any discomfort has improved.
Complications:
Most children recover without any complications. Complications of pneumonia are rare, but can be serious, including:
Empyema - a collection of pus (infection) in the space that surrounds the lung
Septicaemia - overwhelming infection that can affect the whole body, including vital organs
If you are concerned that your child's condition is getting worse, you should contact your discharging ward.
Things to look out for include:
Worsening of fever
Fast heart beat
Breathing rate getting quicker and your child finding it harder to breath
Blue lips
Changes in behaviour, such as confusion or disorientation
Call 999 for an ambulance if you have serious concerns for your child.
Prevention
It is difficult to prevent pneumonia, however good standards of hygiene can help prevent germs from spreading.
Washing hands regularly and thoroughly
Ensure that prescribed courses of antibiotics are completed, even if they are feeling better. If the course is stopped part way through, this can lead to the bacteria becoming resistant to the antibiotic and therefore not being eradicated
It can take a couple of weeks for a child to fully recover. During this time the immune system will be clearing up the pneumonia. Coughing up the mucus on the chest is part of that process; hence the cough can last for 1-2 weeks or even longer. If you are worried that the cough is getting worse again, or not getting better after 4 weeks, you should take your child to see their GP. Most children make a full recovery from pneumonia with no lasting effects. Some children may be followed up by the doctors at the hospital with an x-ray.
For wear and tear, minor trips and everything in between.
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
For wear and tear, minor trips and everything in between.
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Wales Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Wales Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 Wales if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 Wales if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
