At a glance
- Pneumonia often follows a cold and can be caused by viruses or bacteria.
- Key signs: cough, fever, and fast, labored breathing with skin pulling in around the ribs.
- Call 911 for blue or gray lips, a severe struggle to breathe, or a child who is hard to wake.
- Doctors usually diagnose it from symptoms and an exam; a chest X-ray is only sometimes needed.
- If an antibiotic is prescribed, give the full course even after your child feels better.
- Skip cough medicines with codeine or dextromethorphan; coughing helps clear the lungs.
- Children under 5 are at highest risk; pneumococcal, flu and other vaccines lower it.
Signs of pneumonia in children
Pneumonia usually starts after a cold or another virus, when infection spreads down into the lungs.
Children often have fever with chills or sweats, a cough, a poor appetite and little energy. Babies and toddlers may look pale and limp and cry more than usual.
- Breathing is fast and looks like hard work, with skin sucking in between the ribs or under the breastbone.
- The nostrils may flare with each breath, and some children wheeze.
- Chest pain with coughing or deep breaths is common, and some children have nausea, vomiting or diarrhea.
Viral or bacterial pneumonia?
- Flu, RSV, COVID-19 and other cold viruses
- Rest and fever care; antibiotics do not help
- Better in a few days; cough may last weeks
- Pneumococcus or Mycoplasma, sometimes after a virus
- Treated with a full course of antibiotics
- Mycoplasma (walking pneumonia) is often milder
Warning signs: when to get help
- Call 911 or your local emergency number for blue, gray or pale lips or nail beds, a severe struggle to breathe, or a child who is limp or very hard to wake.
- See a doctor right away for fast or labored breathing, ribs pulling in, or flaring nostrils.
- A baby under 3 months with 100.4°F (38°C) or higher needs a doctor right away.
- Call the doctor if fever lasts more than a few days on antibiotics, or goes away and then comes back.
- Call if your child grows sleepier or drinks much less than usual.
- Call about new problems elsewhere, such as a stiff neck, red swollen joints, bone pain or vomiting.
Pneumonia: when to get help
- Call 911 nowBlue, gray or pale lips, severe struggle to breathe, limp or very hard to wake.
- Get seen nowFast or labored breathing, ribs pulling in, flaring nostrils, or a baby under 3 months with 100.4°F (38°C).
- Call todayFever after a few days of antibiotics or fever that returns, more sleepy, drinking much less.
- Care at homeBreathing easier, drinking, more energy: finish the medicine; the cough can take weeks to go.
How doctors diagnose and treat pneumonia
The doctor looks at how your child is breathing and listens to the chest. A chest X-ray is sometimes used to confirm pneumonia or see how much lung is involved.
- Viral pneumonia needs no specific medicine beyond rest and fever control.
- Because the two types are hard to tell apart, the doctor may prescribe an antibiotic anyway.
- Give every dose at the prescribed amount until the course is done; stopping early can let the infection return.
- Walking pneumonia, often from Mycoplasma bacteria, can be mild enough that a child keeps going about the day.
- In children under 5, Mycoplasma may look like a cold, with a runny nose, sore throat, wheeze, vomiting or diarrhea.
Recovery at home
- Let your child rest and offer small, frequent drinks.
- Ease fever or chest pain with acetaminophen or ibuprofen at the right dose for age and weight; never give aspirin.
- Coughing clears mucus from the lungs, so do not give cough syrups with codeine or dextromethorphan.
- Keep your child away from cigarette smoke.
- Most children feel better within a few days, but the cough can last several weeks.
Pneumonia recovery: what to expect
- Day of the visitExam, sometimes an X-ray; start any prescribed medicine.
- First few daysFever eases and energy returns; keep giving every dose.
- If fever lingersFever beyond a few days of antibiotics, or fever that returns: call the doctor.
- Several weeksA cough can linger while your child is otherwise well.
Who is at risk and how to prevent pneumonia
- Children under 5 are at higher risk, and the younger the child, the higher the risk.
- Long-term heart, lung or liver disease, diabetes or a weak immune system also raise the risk.
- The pneumococcal vaccine is given to all babies at 2, 4 and 6 months, with a dose at 12 to 15 months.
- Vaccines against flu, COVID-19, RSV, whooping cough, Hib, measles and chickenpox also lower the risk.
- Wash hands, cover coughs and sneezes, keep away from sick people and keep asthma well controlled.
Common questions
Is pneumonia contagious?
The germs behind it pass from person to person through coughs and sneezes. Hand washing and covering coughs help protect the rest of the family.
What is walking pneumonia in kids?
A milder lung infection, usually from Mycoplasma bacteria, in which children may not seem sick enough to stay in bed. It can drag on for weeks.
How long does a cough last after pneumonia?
Often a few weeks, even once fever and tiredness are gone. Breathing that gets harder or a fever that returns needs a call.
Does my child need a chest X-ray for pneumonia?
Not always. Many children are diagnosed by their symptoms and an exam alone.
Why give antibiotics if pneumonia might be viral?
The viral and bacterial kinds can look the same, so the doctor may treat to be safe. Once started, finish all of it.
Sources
- AAP — Pneumonia in Children: Causes, Symptoms, Treatment & Prevention
- CDC — About Pneumonia
- CDC — Risk Factors for Pneumonia
- CDC — Pneumonia Prevention and Control
- CDC — About Mycoplasma pneumoniae Infection
Written for Pedemy in our own words from the sources above; checked October 2026. For education only, not medical advice. Pedemy is independent and not affiliated with or endorsed by the organizations cited.