Can a baby have pneumonia without a fever


How can pneumonia be prevented?


Breastfeeding your baby protects them from getting pneumonia by boosting their infection-fighting (immune) system. Breastfeeding beyond 4 months of age offers the best protection.

Smoke-free environment

Make sure your child’s environment is smoke-free. This will help reduce the chance of your child getting pneumonia. If you want to give up smoking:

  • call the Quitline on 0800 778 778 for free
  • check out the website Quitline
  • ask your health professional


Immunisation helps to prevent some serious causes of pneumonia, in particular immunisation against the following diseases:

  • pneumococcal disease
  • whooping cough (pertussis)
  • Hib (Haemophilus influenzae type b)
  • influenza vaccine

Treatment for long-lasting conditions

Make sure your child keeps up with their treatment for any long-lasting (chronic) conditions such as asthma.

A warm house

Keeping the house warm and well-insulated will also decrease your child’s risk of developing pneumonia.

Clean hands

Make sure everyone in your family washes their hands regularly and thoroughly, and dries them well including (but not only) before preparing food and eating.

Balanced diet and healthy weight

Make sure your child has a healthy balanced diet and maintains a healthy weight. Being underweight or overweight can increase your child’s risk of getting pneumonia.

Patient Education

Pneumonia (Child)

Pneumonia is an infection deep within the lungs. It may be caused by a virus or bacteria.

Symptoms of pneumonia in a child may include:

  • Cough

  • Fever

  • Vomiting

  • Rapid breathing

  • Fussy behavior

  • Poor appetite

Pneumonia caused by bacteria is usually treated with an antibiotic. Your child should start to get better within 2 days on antibiotic medicine. The pneumonia will go away in 2 weeks. Pneumonia caused by a virus won’t respond to antibiotics. It may last up to 4 weeks.

Home care

Follow these guidelines when caring for your child at home.


Fever makes your child lose more water than normal from his or her body. For babies younger than 1 year:

  • Continue regular breast or formula feedings.

  • Between feedings give oral rehydration solution as told to by your child’s healthcare provider. The solution is available at groceries and drugstores without a prescription.

For children older than 1 year:

  • Give plenty of fluids like water, juice, sodas without caffeine, ginger ale, lemonade, fruit drinks, or popsicles.


It’s OK if your child doesn’t want to eat solid foods for a few days. Make sure that he or she drinks lots of fluid.


Keep children with fever at home resting or playing quietly. Encourage frequent naps. Your child may go back to day care or school when the fever is gone and he or she is eating well and feeling better.


Periods of sleeplessness and irritability are common. A congested child will sleep best with his or her head and upper body raised up. Or you can raise the head of the bed frame on a 6-inch block.


Coughing is a normal part of this illness. A cool mist humidifier at the bedside may be helpful. Over-the-counter cough and cold medicines have not been proved to be any more helpful than a placebo (sweet syrup with no medicine in it). But these medicines can cause serious side effects, especially in children under 2 years of age. Don’t give over-the-counter cough and cold medicines to children younger than 6 years unless the healthcare provider has specifically told you to do so.

Don’t smoke around your child or allow others to smoke. Cigarette smoke can make the cough worse.

Nasal congestion

Suction the nose of infants with a rubber bulb syringe. You may put 2 to 3 drops of saltwater (saline) nose drops in each nostril before suctioning. This will help remove secretions. Saline nose drops are available without a prescription.


Use acetaminophen for fever, fussiness, or discomfort, unless another medicine was prescribed. You may use ibuprofen instead of acetaminophen in babies older than 6 months. If your child has chronic liver or kidney disease, talk with your child’s provider before using these medicines. Also talk with the provider if your child has had a stomach ulcer or gastrointestinal bleeding. Don’t give aspirin to anyone younger than 18 years of age who is ill with a fever. It may cause severe liver damage.

If an antibiotic was prescribed, keep giving this medicine as directed until it is used up. Do this even if your child feels better. Don’t give your child more or less of the antibiotic than was prescribed.

Follow-up care

Follow up with your child’s healthcare provider in the next 2 days, or as advised, if your child is not getting better.

If your child had an X-ray, a radiologist will review it. You will be told of any new findings that may affect your child’s care.

When to seek medical advice

Unless advised otherwise by your child’s health care provider, call the provider right away if:

  • Your child is of any age and has repeated fevers above 104°F (40°C).

  • Your child is younger than 2 years of age and a fever of 100.4°F (38°C) continues for more than 1 day.

  • Your child is 2 years old or older and a fever of 100.4°F (38°C) continues for more than 3 days.

Also call your child’s provider right away if any of these occur:

  • Fast breathing. For birth to 2 months old, more than 60 breaths per minute. For 2 months to 12 months old, more than 50 breaths per minute. For 1 to 5 years old, more than 40 breaths per minute. Older than 5 years, more than 20 breaths per minute.

  • Wheezing or trouble breathing

  • Earache, sinus pain, stiff or painful neck, headache, or repeated diarrhea or vomiting

  • Unusual fussiness, drowsiness, or confusion

  • New rash

  • No tears when crying, “sunken” eyes or dry mouth, no wet diapers for 8 hours in babies or less urine than normal in older children

  • Pale or blue skin

  • Grunts

My child has a bad cough and fever. Could it be pneumonia?

Possibly, since cough and fever are two of pneumonia’s main symptoms. Other symptoms can include weakness, vomiting, diarrhea, loss of appetite, headache, muscle pain, and trouble breathing. Pneumonia can strike anytime, but it usually shows up in winter and spring, often after a cold or other upper respiratory infection.

If you think your child may have pneumonia, see a doctor right away. Some cases are mild, but it can also be serious.

Are there different kinds of pneumonia?

Yes. Pneumonia is a general term for infection of the lungs, and it can be caused by many different organisms.

Babies and young children may get pneumonia from respiratory syncytial virus (RSV), for example, and infants may get it from group B streptococcus (GBS) acquired at birth, during delivery. An older baby or child might develop pneumonia as the result of other bacterial or viral infections.

Doctors group pneumonia into two categories: bacterial and viral.

Children with bacterial pneumonia usually have sudden symptoms – high fever, rapid breathing, and coughing. They don’t want to eat and seem very ill.

They may have trouble breathing (look for flaring nostrils or chest sinking in as they breathe), a faster pulse, and bluish lips or nails. They may seem weak, vomit, or have diarrhea. Less common symptoms include abdominal pain and a stiff neck.

Streptococcus pneumoniae is the usual cause, but other bacteria (such as Staphylococcus aureus or Mycoplasma pneumoniae) Can cause pneumonia, too.

Viral pneumonia typically starts out like a cold, but symptoms slowly and steadily get worse. Children may have a fever of 101.5 degrees Fahrenheit or more, with a worsening cough, wheezing, and rapid breathing. Weakness, vomiting, or diarrhea can also be a symptom.

Viral pneumonia is usually less severe than bacterial and can’t progress into it – but it can make kids more susceptible to the bacterial form of the illness. Viruses behind pneumonia include respiratory syncytial virus (RSV), parainfluenza virus, adenovirus, and the flu virus.

How is pneumonia diagnosed?

During an office exam, the doctor watches how the child breathes and listens to her lungs with a stethoscope. He listens for diminished breathing sounds or other abnormal noise. Because some of the air sacs in the lungs are filled with fluid in a child with pneumonia, she’ll be breathing rapidly to take in more oxygen.

If the doctor thinks your child has pneumonia, he may order a chest X-ray, blood work, or a test of the fluid from your child’s nose. To make sure your child is getting enough oxygen, he may use a pulse oximeter, a simple device that clips on to a finger to measure oxygen saturation.

What’s the treatment?

For bacterial pneumonia, doctors prescribe antibiotics. Viral pneumonia doesn’t respond to antibiotics, so treatment may be limited to rest and fluids. In fact, getting enough fluids is vital to fight the dehydration from rapid breathing and fever that’s often a side effect of pneumonia.

If your child has bacterial pneumonia, you may want to try running a cool mist humidifier. If she’s feverish and uncomfortable, you may want to give her the proper dose of acetaminophen or (if she’s 6 months or older) ibuprofen.

If your child needs to be treated for bacterial pneumonia in the hospital, she may be given fluids and antibiotics through an IV. The nurses may suction her nose regularly and keep an eye on her blood oxygen levels with an oximeter. She may also be fitted with a nasal oxygen tube or mask to make breathing easier.

Most uncomplicated pneumonia gets better within a week, although the cough can last for weeks.

What can I do to keep my child from getting pneumonia?

To boost your child’s chance of staying pneumonia-free:

Keep vaccinations up to date. The Hib, DTaP, MMR, flu (for children at least 6 months old), chicken pox, and pneumococcal vaccines can all help prevent pneumonia. Ask the doctor for advice if your child has missed any shots. See our complete article on recommended vaccinations.

Practice good personal hygiene. Wash your hands and your child’s hands often to prevent the spread of germs. Don’t let your child share cups or utensils. Regularly wash all the places germy body parts might touch, like the phone, toys, doorknobs, and the refrigerator door handle.

Make yours a smoke-free home. If you or your partner smokes, do it outside and ask guests to do the same. Better yet, ask your doctor about finding a program to help you quit. Studies have shown that children who live around cigarette smoke, even for short periods, get sick more often and are more susceptible to pneumonia, upper respiratory infections, asthma, and ear infections.

Pneumonia in Children

The main types of pneumonia are:

  • Bacterial pneumonia. This is caused by various bacteria. The streptococcus pneumoniae is the most common bacterium that causes bacterial pneumonia.
    Many other bacteria may cause bacterial pneumonia including:

    • Group B streptococcus

    • Staphylococcus aureus

    • Group A streptococcus

    Bacterial pneumonia may have a quick onset and the following symptoms may occur:

    • Productive cough

    • Pain in the chest

    • Vomiting or diarrhea

    • Decrease in appetite

    • Fatigue

    • Fever

  • Viral pneumonia. This is caused by various viruses, including the following:

    • Respiratory syncytial virus, or RSV (most commonly seen in children under age 5)

    • Parainfluenza virus

    • Influenza virus

    • Adenovirus

    Early symptoms of viral pneumonia are the same as those of bacterial pneumonia. However, with viral pneumonia, the respiratory involvement happens slowly. Wheezing may occur and the cough may worsen.

    Viral pneumonias may make a child susceptible to bacterial pneumonia.

  • Mycoplasma pneumonia. This presents somewhat different symptoms and physical signs than other types of pneumonia. They generally cause a mild, widespread pneumonia that affects all age groups but more commonly in older children.

    Symptoms usually do not start with a cold, and may include the following:

    • Fever and cough are the first to develop

    • Cough that is persistent and may last three to four weeks

    • A severe cough that may produce some mucus

    Other less common pneumonias may be caused by the inhaling of food, liquid, gases or dust, or by fungi.

Walking Pneumonia in Children

Pneumonia is a serious and potentially life-threatening lung infection. A germ called Mycoplasma pneumoniae is often responsible for a milder type of pneumonia called “walking pneumonia.” People with this illness may feel unusually tired and run down, but they may not realize they have pneumonia and continue about their business.

Facts about Mycoplasma pneumoniae

About 2 million Mycoplasma pneumoniae infections occur each year in the U.S.

Mycoplasma pneumoniae bacteria can also cause bronchitis and a number of upper respiratory tract infections.

Mycoplasma pneumoniae is quite contagious. It can spread between people through bodily fluids, including phlegm that is coughed up. It can also spread through airborne droplets from sneezing, coughing, or talking. It is most easily spread among people who are in close contact with one another. This includes those living within households, military barracks, camps, and college dorms. Mycoplasma pneumoniae infections can spread through whole communities as well.

Mycoplasma pneumoniae is extremely common in school-aged children. It’s the most common cause of pneumonia in this age group. But these infections are rare in children younger than 5 years old.

Although Mycoplasma pneumoniae infections can occur at any time of year, they are most common in the fall and winter.

Mycoplasma pneumoniae infections can cause a number of symptoms:

  • Fever, which can be high, but is usually low grade

  • Fatigue

  • Headache

  • Skin rash

  • General feeling of sickness

  • Cough, particularly one that progresses from a dry cough to a productive cough

  • Ear infections

  • Croup

  • Sinus infection

  • Sore throat

Children who have reactive airway disease may have wheezing as a result of the infection.

Symptoms may appear anywhere from 2 to 3 weeks after exposure to the bacteria and may last from a week to a month.

Diagnosis and treatment

Special diagnostic tests are being developed to for Mycoplasma pneumoniae bacteria. But they’re not yet widely available to the general public. Doctors can diagnose the infection based on symptoms and a chest X-ray. Blood work can identify antibodies to the bacteria.

Often, mild respiratory infections, such as upper respiratory infections and bronchitis, clear up on their own and don’t require treatment with antibiotics. But when symptoms are more severe and pneumonia or ear infections develop, antibiotics such as doxycycline, erythromycin, azithromycin (most common), or clarithromycin may be prescribed.

No vaccine is available to prevent a Mycoplasma pneumoniae infection. Practicing good hygiene can help. This includes teaching kids to cover their nose and mouth when they cough or sneeze and to frequently wash hands. These measures can help prevent other infections, too.

What else you need to know

Mycoplasma pneumoniae infections are rarely serious. They respond well to antibiotic treatment, and they typically clear up even without treatment. Deaths are most common in older adults or in people with other health conditions, including sickle cell disease.

People who have already had a Mycoplasma pneumoniae infection do develop some immunity. But this usually doesn’t last for a lifetime. A second infection from the bacteria is possible, but the illness is likely to be a milder version.

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