Short answer
Most coughs and colds in children are mild, but a cough with fast breathing, or the lower chest sucking in with each breath, can mean pneumonia. WHO counts fast breathing as 50 or more breaths a minute from 2 to 12 months, and 40 or more from 1 to 5 years. A child who cannot drink, vomits everything, is very sleepy or has a fit needs hospital care immediately.
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- Dhruva Hospitals, Kadapa
How to count breathing
Count your child’s breaths for one full minute while they are calm or asleep, watching the chest or tummy rise. Compare with the WHO cut-offs:
| Age | Fast breathing is |
|---|---|
| Under 2 months | 60 breaths a minute or more |
| 2 to 12 months | 50 breaths a minute or more |
| 1 to 5 years | 40 breaths a minute or more |
Other signs of pneumonia
- The lower chest sucks in when the child breathes in (chest indrawing)
- Fever, cough and tiredness
- Wheezing, or grunting in babies
- Poor feeding or loss of appetite
Danger signs: go to hospital immediately
- The child cannot drink or breastfeed
- The child vomits everything
- A fit (convulsion)
- Unusual sleepiness, or the child is hard to wake
- Blue or grey lips, or severe difficulty breathing
Call +91 90368 52311. Children with severe pneumonia may need oxygen and treatment in hospital.
Treatment
Pneumonia caused by bacteria is treated with antibiotics; WHO recommends amoxicillin as the first choice for most children. Give the full course exactly as prescribed, even when your child seems better. Severe pneumonia is treated in hospital, sometimes with oxygen.
Do not give leftover antibiotics or medicines prescribed for someone else.
Prevention
- Vaccines: PCV, pentavalent (which includes Hib) and measles-rubella all help protect against pneumonia.
- Breast milk only for the first 6 months.
- Hand washing with soap.
- Keeping children away from smoke from cooking fires, mosquito coils and cigarettes.
At Dhruva Hospitals
Our paediatric ward cares for children who need admission, with paediatric ICU and ventilator support for critically ill children and a 24-hour paediatric emergency team.
Common questions
Does every cough need antibiotics?
No. Most coughs and colds are caused by viruses and get better on their own. Antibiotics are for bacterial infections such as bacterial pneumonia, and the doctor decides after examining your child.
How long does recovery take?
Recovery can take 2 to 4 weeks, and cough and tiredness are often the last to settle. Return to the doctor if breathing gets faster, your child stops drinking, or there is no improvement on treatment.
Read next
Sources
This article is general information, not a diagnosis or treatment plan. In an emergency, call +91 90368 52311.