Your baby is refusing feeds and sleeping more: Could these be signs of pneumonia?

What if a baby with pneumonia does not cough at all? Or what if a child who suddenly becomes less playful, refuses food or seems unusually tired is showing early signs of a lung infection? Pneumonia is commonly associated with cough, fever and breathing difficulties, but its symptoms are not always obvious. Depending on a child's age, the infection can present itself differently, making it important for parents to recognise changes that may otherwise go unnoticed.

How does pneumonia present in babies?

In babies, particularly newborns and infants, pneumonia can be difficult to identify because they cannot communicate what they are experiencing. Instead of familiar respiratory symptoms, parents may notice poor feeding, unusual irritability, excessive sleepiness or reduced activity.

Some babies may develop a fever, while others, especially newborns, may have an unusually low body temperature. Rapid breathing, grunting sounds, flaring nostrils or the skin pulling inward between the ribs while breathing can indicate respiratory distress requiring medical attention.

Can pneumonia look different in older children?

Older children, on the other hand, may display symptoms that are easier to recognise but can still be misleading. Along with cough and fever, they may complain of chest pain, headaches, body aches or even stomach pain.

Some children experience vomiting, loss of appetite and general weakness. Interestingly, abdominal pain can sometimes accompany pneumonia, particularly when the infection affects the lower parts of the lungs. This can lead parents to mistake the condition for a digestive problem rather than a respiratory infection.

When should parents seek medical attention?

Not every cough or fever indicates pneumonia, but parents should pay attention to how long symptoms last and whether they are improving.

If there is persistent high grade fever, cough continues to worsen, or the child does not show signs of improvement after a few days, a paediatric consultation is important. Seek immediate medical attention if child develops: rapid or laboured breathing, chest indrawing or difficulty breathing, grunting while breathing, bluish discoloration of lips/ tongue, inability to breast feed, drink or eat, extreme drowsiness, reduced responses or difficulty walking, and pauses in breathing. dehydration or difficulty feeding. These are warning signs that require immediate medical attention.

Who are at higher risk?

Children below five years, particularly infants, premature babies and those with underlying health conditions, may be more vulnerable to severe respiratory infections.

Can pneumonia be prevented?

Keeping vaccinations up to date, including pneumococcal, Haemophilus influenzae type b (Hib) and influenza vaccines, can help protect against infections that may lead to pneumonia.

Parents should also avoid self-medicating children with antibiotics or cough syrups. Pneumonia requires proper medical evaluation, and treatment depends on its cause and severity.

Pneumonia does not always announce itself through a persistent cough or high fever. Sometimes, it begins with a baby refusing a feed or an older child losing interest in play or poor food intake. Paying attention to these seemingly minor changes, seeking timely medical advice and recognising warning signs can make a significant difference to a child's recovery.

(The author is a paediatrician, Milann Fertility and Birthing Hospital, Bengaluru)

The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.