Pneumonia in Babies & Toddlers
Content reviewed against published AAP, WHO, CDC guidelines
Last reviewed:
Pneumonia is an infection of the lungs that causes inflammation and fluid buildup in the air sacs. In babies, it is most often caused by viruses (RSV, influenza, adenovirus) but can also be bacterial. It can range from mild to serious, especially in infants under 6 months.
Key takeaways
- Pneumonia is an infection of the lungs that causes inflammation and fluid buildup in the air sacs.
- Duration: Viral: 1-3 weeks. Bacterial: improvement within 48 hours of antibiotics, full recovery in 2-4 weeks.
- Go to ER if: Severe difficulty breathing with retractions or grunting
- A vaccine or immunization is available
Symptoms
How It Presents by Age
0-3 months
May present with poor feeding, lethargy, grunting, and temperature instability. Cough may be minimal. Always requires urgent evaluation.
Risk level: High
3-12 months
Fever, cough, fast breathing, and difficulty feeding. May present after a worsening cold.
Risk level: Moderate to high
1-3 years
Fever, cough, fast breathing. May complain of tummy pain (referred from lower lungs). Often follows a viral upper respiratory infection.
Risk level: Moderate
Treatment
Viral pneumonia
Supportive care — fluids, rest, fever management. Antibiotics are NOT needed.
Bacterial pneumonia
Oral antibiotics (usually amoxicillin) for mild-moderate cases. IV antibiotics for severe or hospitalized cases.
Oxygen therapy
For babies with low oxygen levels (below 92%).
Hydration
Small frequent feeds or IV fluids if unable to feed.
Home Care
- Keep baby well-hydrated with frequent small feeds
- Use a cool-mist humidifier
- Manage fever with acetaminophen or ibuprofen (6+ months)
- Rest and limited activity
- Saline drops for nasal congestion
- Complete the full course of antibiotics if prescribed
When to Worry
Go to the ER if:
- Severe difficulty breathing with retractions or grunting
- Blue lips or face
- Baby under 3 months with fever
- Unable to keep fluids down
- Very lethargic or difficult to rouse
Call your doctor if:
- Persistent fever above 102°F (39°C)
- Cough worsening instead of improving after 3-5 days
- Child refusing to drink
- Not improving with prescribed antibiotics after 48 hours
Keep an eye on:
- Breathing rate over 50/min (under 1 year) or over 40/min (1-3 years)
- Not improving after 48 hours of antibiotics
- Fever returning after initially improving
- Increasing lethargy
Prevention
- Pneumococcal vaccine (PCV15 or PCV20)
- Influenza vaccine annually
- Handwashing
- Breastfeeding
- Avoiding cigarette smoke exposure
- Keeping up with all recommended vaccines
Contagion & Incubation
Incubation
1-3 days for viral; variable for bacterial
Contagious for
Varies by cause; viral pneumonia contagious for first few days of symptoms
Duration
Viral: 1-3 weeks. Bacterial: improvement within 48 hours of antibiotics, full recovery in 2-4 weeks.
Frequently asked questions
How long does pneumonia last?
How does pneumonia spread?
When should I take my baby to the ER?
Can pneumonia be prevented?
When can my child return to daycare?
Sources
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Illnesses
Bottom line
Pneumonia is a viral illness that typically resolves on its own. Seek emergency care if severe difficulty breathing with retractions or grunting.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.