Pneumonia is an acute inflammatory process that affects all structural elements of the lungs. The disease is one of the ten most common causes of death in infants. Pneumonia in infants is a consequence of infection with pathogenic microflora, with most of which the immature children’s immunity cannot cope with.
In a newly born infant, many systems are in the process of formation, including the immune and respiratory systems. Immunity cannot yet cope with the massive defeat of infectious agents, and the respiratory organs are underdeveloped, prone to rapidly developing edema.
Inflammation of the lungs in an infant can be congenital or acquired. The cause of the disease is an infection that enters the child’s body in the womb, during childbirth or after birth. Various types of microorganisms can cause pneumonia:
- herpes viruses of the first and second types;
- rubella virus;
- influenza and parainfluenza viruses;
- ureaplasma ;
- enterobacter ;
- fungus of the genus Candida;
- measles virus;
- legionella ;
- Pseudomonas aeruginosa;
- haemophilus influenzae.
The risk of pneumonia is highest in the following cases:
- pregnancy has developed with pathologies, the mother has serious diseases that have prevented the normal formation of the placenta;
- during the period of bearing the child, the mother was infected with any infection;
- the child was born prematurely;
- during childbirth, injuries were received, asphyxia, meconium aspiration occurred .
Infants with immunodeficiency states, congenital malformations and developmental anomalies are more susceptible to disease.
Congenital pneumonia is called, the clinical picture of which begins to unfold in the first three days after the baby is born. The disease affects both timely born babies and premature babies. In the latter, it can be more severe and have more serious consequences, but in general, the development of pathology occurs in the same way.
The cause of congenital pneumonia is the infection of the mother or the activation of an infectious agent already present in her body during pregnancy. Most often, the causative agents of intrauterine diseases are viruses, since the child is most susceptible to their influence. Infection of the mother or activation of the virus usually occurs in the last trimester of pregnancy. If this happens earlier, then the baby has developmental abnormalities and a variety of defects. In addition, infection can occur during childbirth. Most often this occurs through the bronchogenic route or through the mother’s contaminated blood. If infection occurs during childbirth, then the first signs may appear on the second or third day of life. With intrauterine infection, symptoms begin to manifest themselves immediately after childbirth.
Acquired pneumonia in infants
Acquired forms of the disease are diagnosed if signs of pneumonia appear in a child older than three days of age. More often, such pneumonia is a consequence of viral infections, for example, ARVI. In addition, hypothermia can provoke inflammation.
Most often, infectious diseases, including pneumonia in infants, are accompanied by fever, severe cough. The first signs of a congenital form of the disease appear immediately: the baby is born with a pale or bluish skin color, screams weakly, and is unable to breathe normally. Hypoxia increases, heart rate is rapid, convulsions may be present against the background of an increase in temperature. The clinical picture is developing rapidly, treatment should be started immediately.
Acquired pneumonia, especially community-acquired pneumonia, is easier in infants up to a year and older. This is due to the fact that the child has already been at home, managed to acquire minimal immunity, and gained strength due to breastfeeding. Symptoms grow a little slower than in hospital-acquired pneumonia in newborns, but the disease is also dangerous. If the disease manifests itself, it is necessary to call an ambulance as soon as possible and deliver the child to a medical facility.
In some cases, pneumonia in infants occurs in the absence of fever and cough. Cases of such a latent course of the disease are very dangerous. Parents should be able to recognize other signs of pneumonia in infants in order to start treatment in a timely manner. If the baby does not breastfeed, he is lethargic, sleeps unusually a lot, constantly asks for a drink, this may indicate the development of pneumonia.
The diagnosis is made on the basis of the study of the clinical picture, the results of an X-ray examination, and the data of a physical examination. The doctor examines the child, listens to his lungs with a phonendoscope. If the symptoms are rapidly increasing, signs of intoxication, fever, severe cough appear, this gives reason to suspect pneumonia. When diagnosing congenital forms of the disease, it is important to collect anamnestic data about the mother’s condition, the course of pregnancy, and the presence of foci of infection in her.
General and biochemical blood tests are prescribed. In newborns, these studies are not very informative, since the blood system, like all others, is also in the process of formation. However, an increase in leukocyte mass can be detected, indicating the progression of inflammation.
If the child has congenital pneumonia, it makes sense to conduct a serological study of the mother’s blood to detect antibodies to antigens of certain infectious agents. This makes it possible to identify the pathogen and begin specific therapy for pneumonia.
Confirmation of the diagnosis is always based on the results of the radiograph. In the pictures, you can clearly see the localization, the extent of the spread of the pathological process, structural changes in the lungs.
In infants, pneumonia is treated exclusively in a hospital setting. A feature of the treatment is that it is necessary to carry out not only etiotropic therapy, but also to take measures to alleviate the symptoms. Indeed, for a baby, even the ambient temperature can play a decisive role. Newborns are placed in an incubator , where a certain temperature and humidity are maintained. For older children, for example, one year old, the regimen is also important. Be sure to continue feeding your baby with milk.
The treatment is based on antibacterial therapy. Treatment begins with broad-spectrum antibiotics. As a rule, a combination of two drugs is selected. They are administered intravenously or intramuscularly.
Evaluation of the effectiveness of therapy is carried out approximately in 36-48 hours. Doctors evaluate the severity of shortness of breath, the intensity of the manifestations of intoxication, the level of blood oxygen saturation. If there is no positive trend, other drugs are prescribed.
Along with antibiotics, probiotics are necessarily prescribed, since a violation of the ratio of microflora in the gastrointestinal tract can lead to serious digestive disorders, which, in turn, will provoke dehydration of the body.
For detoxification , saline is administered by infusion . The baby must be given oxygen support, if necessary, transferred to mechanical ventilation. At the end of the acute period, physiotherapy may be prescribed.
It is impossible to treat pneumonia in infants at home due to the high risk of the disease, there can be no talk of any folk remedies. However, a nursing mother transfers useful substances to the baby with milk, and she can take herbal infusions, decoctions, medicinal teas. A decoction of linden blossom, tea from raspberry leaves, buckthorn berries help well.
For the purpose of prevention, it is necessary to conduct pregnancy correctly, undergo regular examinations, and prevent infection with infections during the period of bearing a child.
It is best to give birth naturally and breastfeed your baby. In this case, he will be additionally protected from pathogenic microorganisms by the mother’s antibodies transmitted to him in milk. Good organization of childbirth, a properly equipped delivery room and trained staff are also important.
A newborn child should be protected from contact with infections, undergo compulsory vaccination against pneumococci. This vaccination, according to the National Calendar, is given at two months.
Due to insufficiently developed immunity, the infection can quickly spread throughout the body of an infant. Complications develop rapidly and can have serious consequences. All complications of pneumonia are divided into pulmonary and extrapulmonary. The first are:
- atelectasis ( collapse of part of the lung);
- acute pleurisy;
Such complications can develop on the second day if treatment is not started on time.
The infection can spread rapidly through the blood or lymph flow, provoking extrapulmonary complications:
- hemorrhagic syndrome;
- transition of pneumonia to a chronic course.
Also, the baby as a residual can be tormented by a cough. The delayed consequences of pneumonia may include the development of anemia or rickets. Even after discharge from the hospital, parents need to closely monitor the condition of the baby.
Pneumonia is a dangerous disease, it is necessary to observe measures for the prevention of pneumonia, to be able to recognize the signs of the disease in a timely manner. The sooner adequate treatment is started, the less the likelihood of severe complications and consequences of pathology.