Repeated pneumonia in an infant. Pneumonia in infants. Prevention of pneumonia in newborns

Pneumonia, or pneumonia, is a lesion of the lung tissue primarily of infectious origin. How does pneumonia occur in newborns and what consequences can this disease have?

Causes and risk factors

Pneumonia in newborns occurs when infected with pathogenic microorganisms in utero, during the passage of the birth canal or in the first days of life. Depending on the type of infection, there are several ways of developing the disease:

• Transplacental (through the placenta from the mother's blood): herpes simplex virus, rubella, cytomegalovirus, listeria, treponema pallidum, mycobacterium tuberculosis.
• Perinatal (during childbirth or after cesarean section): chlamydia, mycoplasma, E. coli, streptococci, Haemophilus influenzae, anaerobes.
• Postnatal (after birth): respiratory viruses, Staphylococcus aureus and Staphylococcus epidermidis, bacteria of the intestinal group, fungi.

Finding out the exact cause of pneumonia in a newborn is quite difficult. Microbiological studies are carried out only in a maternity hospital or a specialized children's department. If a child is treated at home, it is not always possible to identify the culprit of the problem. In this case, the doctor focuses on the symptoms of the disease and selects therapy taking into account all possible pathogens.

Important aspects:

• Viral pneumonia develops extremely rarely in children in the first months of life.
• Severe forms of the disease in a child are most often associated with infection with mixed bacterial flora.
• In infants, the causative agent of severe pneumonia that occurs without fever is usually chlamydia.
• Up to 10% of all pneumonias that occur in the first days of life are caused by Haemophilus influenzae.
• Many children develop a mixed infection, which causes blurred symptoms of the disease and difficulty in diagnosis.
• 70% of all household pneumonia in newborns are caused by streptococci.
• Fungal infection occurs mainly in children who have been on mechanical ventilation for a long time.
• Prolonged pneumonia (more than 1.5 months) occurs in weakened children with immunodeficiencies and some developmental defects. The consequences of such pneumonia can affect throughout life.

Risk factors for developing the disease:

• intrauterine infection;
• maternal illnesses during pregnancy;
• long difficult labor;
• asphyxia during childbirth;
• mechanical ventilation after birth;
• prematurity;
• malformations of the lungs and heart;
• rickets;
• immunodeficiency states;
• hypothermia.

Representatives of atypical flora: chlamydia and mycoplasma play an important role in the development of pneumonia in infants. This disease is characterized by a protracted course without a rise in temperature. In second place in terms of frequency of occurrence are bacterial pneumonia caused by anaerobes and intestinal flora. Staphylococcal lung disease outside the hospital is extremely rare. Children older than 3 months are at increased risk of contracting respiratory viruses.

Symptoms

Symptoms of pneumonia will depend on the pathogen and the time of infection. With intrauterine infection, signs of the disease appear in the first minutes of life. Most children have asphyxia during childbirth. Even if the baby takes his first breath on his own, clear symptoms of respiratory failure appear within the first hours.

Signs of pneumonia in a newborn due to intrauterine infection:

• dyspnea;
• noisy difficulty breathing;
• pale skin;
• refusal to eat;
• frequent regurgitation;
• inhibition of basic reflexes;
• weight loss.

All symptoms in a baby develop within 24 hours after birth. On days 1-2, the body temperature rises and the baby’s condition worsens. There may be signs of damage to other organs (heart, digestive tract, brain). Treatment of such a baby is carried out in the intensive care unit.

Symptoms of pneumonia in a newborn with postnatal infection appear somewhat later. An increase in body temperature is observed on days 2-3 of life. In the first days, the child's condition may be satisfactory. Along with signs of respiratory tract damage, other symptoms appear:

• diarrhea;
• conjunctivitis;
• pustular skin lesions.

These signs do not occur in all children. The severity of the manifestations of the disease will depend on the prevalence and severity of the process.

At the first sign of pneumonia in your baby, be sure to call a doctor!

Pneumonia in infants aged 1-6 months has its own distinctive features:

• rise in body temperature;
• runny nose with mucous or purulent discharge;
• nasal congestion;
• cough;
• dyspnea;
• refusal to eat;
• poor sleep;
• excitement followed by lethargy.

Dangerous symptoms of pneumonia in infants and newborns:

• increased respiration rate of more than 60 per minute in newborns and more than 50 in children 1-6 months;
• moaning or grunting breathing;
• pronounced retraction of the intercostal spaces;
• cyanosis of the nasolabial triangle;
• severe pallor;
• lethargy, confusion.

If any of these signs appear, you must call an ambulance and prepare for hospitalization in the children's department.

Complications

Pneumonia is a dangerous condition that threatens the life of a child. With untimely diagnosis and inadequate treatment, the following complications may develop:

• purulent pleurisy (damage to tissue around the lungs);
• lung abscess;
• heart damage;
• DIC syndrome;
• sepsis.

If complications develop, the child is treated in intensive care in a specialized children's department.

Treatment methods

Pneumonia in newborns requires a special approach to diagnosis and treatment. Pneumonia in children in the first days and months of life is often severe, with a high risk of complications. In premature and weakened babies, the clinical picture of the disease may be blurred, which does not allow a quick diagnosis to be made. Mixed bacterial-fungal or bacterial-viral lung damage also significantly complicates diagnosis.

Non-drug therapy

Feeding a child with severe lung damage with signs of respiratory failure is carried out parenterally or through a tube. Breastfeeding is possible if the baby is in satisfactory condition. If the newborn does not take the breast, an adapted artificial formula is selected for feeding.

Throughout the treatment, it is important to prevent the child from hypothermia and to monitor the cleanliness of the skin. The baby should be turned over regularly, monitoring the occurrence of possible rashes, as well as preventing the appearance of diaper rash.

Drug therapy

Pneumonia in newborns is a reason for prescribing antibacterial therapy. The choice of drug will depend on the causative agent of the disease, the severity of the condition and the age of the child. For the treatment of newborns, drugs from the group of protected penicillins are used in combination with III-IV generation cephalosporins or aminoglycosides. If pneumonia occurs after discharge from the maternity hospital, cephalosporins and drugs from the group of glycopeptides are mainly used for treatment.

In infants aged 1-6 months, drugs from the macrolide group are used to treat pneumonia. The active use of these drugs is explained by the frequent development of atypical (chlamydial) pneumonia. For pneumonia caused by common bacterial flora, cephalosporins are used. The course of treatment is 7-10 days.

Use antibiotics only as prescribed by a doctor and in strictly prescribed dosages!

After a course of antibiotic therapy, the effectiveness of the drugs must be monitored. To do this, a sputum culture is taken to identify pathogenic microorganisms. If the child is treated at home, the assessment of the effectiveness of therapy is based on clinical data (the condition of the baby, the severity of symptoms of the disease). The baby’s well-being improves after 2-3 days of using antibiotics.

Other treatments for pneumonia:

1. infusion therapy (infusion of solutions that normalize the functioning of the body).
2. enzyme preparations;
3. immunomodulators;
4. vitamins (during recovery).

Pneumonia of newborns is a serious pathology that requires close attention of parents and doctors. Self-medication for pneumonia in a baby in the first days and months of life is not acceptable. The consequences of untimely and inadequate treatment can be very sad. When the first signs of trouble appear in your child, you should definitely consult a doctor.

Every pregnant woman worries about the upcoming birth and the health of her baby. And these worries are completely justified - nowadays many babies are born with various diseases. According to statistics, about 10-15% of premature babies suffer from congenital pneumonia from birth. Congenital pneumonia in newborns is an inflammation of the lung tissue in children that occurs in the first month of life.

There are many reasons for the occurrence of this disease. Sometimes pneumonia can be caused by several precipitating factors. In this case, the disease poses a serious threat to the life of the newborn.

Most often, the disease is caused by pathogenic bacteria (pneumococcus, staphylococcus and streptococcus). Viruses, fungi and protozoa can also cause pneumonia.

The question itself arises: how will pathogenic microorganisms enter the child’s body if it is reliably protected from external influences by the amniotic sac and amniotic fluid.

There are two ways a child can become infected:

1. Bronchogenic – amniotic fluid containing pathogenic microorganisms enters the body through the baby’s lungs during childbirth.

The main causes of infection are:

• Features in the structure of the respiratory system of a newborn;
• Underdevelopment of neurons located in the central nervous system, especially in premature infants;
• Early discharge of amniotic fluid.

1. Hematogenous. In this case, infection occurs through blood from mother to child. Infection through the umbilical vein is much less common than bronchogenic.

In such cases, the mother herself feels unwell and, accordingly, turns to a doctor for help. The doctor will prescribe medications that will alleviate the condition of the expectant mother and baby.

Symptoms of congenital pneumonia

This disease cannot occur without any symptoms. There are many manifestations of this disease. However, you should pay attention to the fact that the first symptoms may appear at different times, depending on when the infection occurred - in the womb or during childbirth.

1. Choking is a fairly common phenomenon, occurring in approximately one in four newborns. However, with congenital pneumonia, almost everyone experiences suffocation. In this case, resuscitators are forced to carry out special resuscitation actions.
2. The cry of a healthy baby is loud. Children with pneumonia cry weakly or there is no sound at all. Breathing is also weak, irregular, and shallow. Moist rales are heard in the lungs, breathing is harsh.
3. Reduced body temperature. All newborn babies are susceptible to fluctuations in body temperature. However, in children with pneumonia the temperature can rise to 40, and in premature babies it can drop to 35 or even lower. High and low temperatures are a threat to the life of a newborn.
4. Decreased innate reflexes. Inflammation of the lungs negatively affects the well-being of even an adult, not to mention newborns. This child is very lethargic. Congenital sucking and breathing reflexes are reduced or absent altogether. In this case, it is necessary to use artificial ventilation and tube feeding.
5. The digestion process is disrupted and, as a result, body weight decreases. The newborn often spits up and suffers from bouts of vomiting. Because of this, body weight is reduced to a critical figure.
6. The functioning of the cardiovascular system is disrupted. All internal organs are dependent on each other. Improper functioning of the lungs leads to disruption of the cardiovascular system. The skin becomes pale, and in severe cases, even bluish. Swelling of the legs and irregular heart rhythm often occur. After recovery, the heart rhythm is restored.

If the infection occurred during childbirth, the signs of the disease will be different. And they do not appear immediately, but after 2-3 days. These symptoms include:

1. Skin color changes. Mom and doctors note that the mucous membranes and skin at the beginning of the disease become gray, as it progresses they become pale and then generally have a blue tint. Cyanosis is clearly manifested - blue discoloration of the skin of the nasolabial triangle.
2. Disturbances in the central nervous system. In newborns, this most often manifests itself as severe agitation or, conversely, lethargy. It is lethargy that happens much more often.
3. Loss of appetite. Appetite disappears 2-3 days after birth. When feeding, regurgitation and vomiting appear, sometimes even with diarrhea. Inexperienced doctors may mistake these symptoms for an intestinal infection and treat it as such. Treatment of pneumonia is delayed until obvious symptoms appear.
4. Breathing changes. As the disease progresses, breathing becomes difficult. If the baby is full-term, then breathing will be frequent, hoarse, with groans. And if the child was born prematurely, then the respiratory rate, on the contrary, will decrease. This situation requires constant monitoring - breathing can stop at any time.
5. An increase in body temperature appears last, sometimes to very high values.

The most important thing is to correctly diagnose the disease and prescribe treatment.

Treatment of congenital pneumonia

Treatment is carried out only in a hospital, because the child must be under constant supervision and control of doctors. If complications occur, such as respiratory and cardiac arrest, medical attention should be provided immediately.

Medications play a major role in the treatment of pneumonia. Doctors may prescribe:

• diuretics – for the treatment of edema;
• Antibiotics are prescribed without fail. These drugs are prescribed strictly individually, depending on the course of the disease and the pathogen that caused it. If the causative agent of pneumonia is not identified, then an antibiotic with a broad spectrum of action is prescribed;
• vitamins and immunomodulators are prescribed to strengthen the functioning of the immune system;
• lacto- and bifidobacteria are necessary for the treatment of dysbiosis that occurs after a course of antibiotics;
• local stimulating reflexotherapy (mustard plasters, massage) is prescribed only by a doctor. At high temperatures, these procedures are prohibited;
• alkaline inhalations - used only for full-term babies. The child may not want to lie still, but the result is worth it.

Successful treatment largely depends on the mother’s actions. There are rules for caring for a child with pneumonia:

1. Feeding. Due to weakness, the baby cannot suck effectively, and fatigue quickly sets in. Therefore, the mother should offer the breast more often, and not stick to timed feeding.
2. Swaddling. Young mothers increasingly prefer rompers and blouses to classic swaddling. In a situation with a child suffering from pneumonia, this will be the best solution, since tightly tied diapers tighten the chest and interfere with already heavy breathing.
3. Change of position. In order to avoid congestion in the lungs, you need to turn the baby from side to side 1-2 times an hour.

After undergoing treatment over the next two years, the child should be observed by a pulmonologist. After all, the most common cold can turn into pneumonia again.

Consequences of congenital pneumonia

The body and immune system of each newborn is unique. Some will quickly cope with the disease with minimal medical care, while others will require a long recovery process, which does not exclude the development of complications. Most often these are:

• intestinal toxicosis is characterized by agitation, anxiety, vomiting, diarrhea, and tachycardia. This excited state turns into apathy, even to the point of loss of consciousness. The body temperature drops to 34 degrees, the child begins to lose weight. Drinking plenty of fluids is necessary to avoid drying out of the mucous membranes;
• even after complete recovery, adhesions may remain on the tissue of the lungs and bronchi, and even scars in places with severe inflammation;
• neurotoxicosis. As a result of the impact of pathogenic microflora and toxins on the brain, disturbances in blood circulation, neurological sphere, and thermoregulation may occur;
• in some cases, pulmonary failure may develop;
• Due to destruction, cavities may form in the lungs.

Prevention of congenital pneumonia

Any disease is easier to prevent than to treat. An expectant mother can reduce the chance of her baby developing pneumonia. To do this you need:

• regularly take all tests prescribed by your doctor;
• treat foci of chronic infections;
• do not contact with infected people;
• eat more vegetables, fruits and greens;
• walk in the fresh air every day for at least 2 hours;
• Night sleep should be at least 8 hours;
• to refuse from bad habits.

Pneumonia in newborns is a life-threatening disease. You need to be extremely attentive to the appearance of various symptoms in order to diagnose and begin drug treatment in time.

Neonatal pneumonia is an inflammatory process localized in the lungs that occurs within 4 weeks of birth. Unlike childhood pneumonia, this disease has a number of features related to the process of infection, diagnosis and treatment. Considering the danger of inflammation of lung tissue, it is important to know about the nuances of this disease in newborns.

Forms

Pathogens

If the infection occurred in utero, it was caused by viruses that can penetrate the blood-brain barrier. Such provocateurs of the inflammatory process are called TORCH pathogens. In order to minimize the risk of disease in a newborn, the obstetrician usually refers the patient to a blood test to identify:

• herpesvirus;
• cytomegalovirus;
• toxoplasmosis;
• syphilis;
• listeorosis;
• togavirus.

In the late stages of pregnancy or directly during labor, the following microorganisms can enter the child’s body from the mother:

• fungi (candida);
• Trichomonas;
• ureaplasma;
• chlamydia;
• mycoplasma.

They may be present in the maternal body as a result of acute or chronic pathologies of the genitourinary, respiratory or digestive system. Sometimes they can be asymptomatic, which is why it is so important to carefully monitor your health before and during a planned pregnancy.

Causes of pneumonia in newborns

Pneumonia can be classified into 2 categories:

• intrauterine;
• neonatal.

The cause of intrauterine pneumonia is infection of the fetus from the mother's body. In addition to TORCH infection, somatic pathology can be provoked by underdevelopment of lung tissue, which occurs if a pregnant woman encounters genitourinary infections while awaiting childbirth. There is also a high probability of illness in the child if the woman has suffered an acute viral or bacterial infection, especially in late pregnancy.

Neonatal pneumonia, which develops after the baby is born, is divided into early and late.

1. The cause of early pneumonia is infection that occurs when the baby's body interacts directly in the maternity hospital with staphylococcus, Klebsiella, Pseudomonas aeruginosa or Escherichia coli. The mother's immune cells, which protect the newborn's body for up to six months, usually prevent infection, but the risk is still high, especially if the baby was born prematurely.
2. Late pneumonia develops outside the walls of the maternity hospital, at home. It occurs after discharge from the maternity ward up to 4 weeks. A pathogenic microorganism enters the child’s body, and if the immune system cannot cope with the antigen, it begins to actively develop in the lung tissue, provoking the appearance of signs of a clinical picture of pneumonia.

Features of the course of the disease in newborns

The extent to which the clinical picture of pneumonia in a newborn corresponds to the classic course of the disease depends on a number of factors, the list of which includes:

• full-term baby;
• the degree of maturity of its organs and systems;
• the presence of other pathological processes.

However, as a rule, the clinical picture has a number of features that distinguish pneumonia in a newborn from the course of the disease in an adult or older child.

1. After the inflammatory process occurs in the body, symptoms do not appear immediately, but only after several hours, sometimes several days.
2. Usually, pneumonia in an adult begins with a sharp rise in temperature, but in a newborn the immune system is not yet formed and cannot give the necessary immune response in the form of an increase in body temperature, so the first symptoms of pneumonia in children are weakness and drowsiness.
3. In most cases, children are diagnosed with a small-focal type of inflammation, which is almost impossible to recognize by listening to the chest organs with a stethoscope. Therefore, it is possible to understand that the pathological process is localized specifically in the lungs only after the appearance of the corresponding symptoms: cough, shortness of breath, rapid breathing.
4. Any catarrhal phenomena: cough, runny nose, sore throat, are absent with the viral etiology of pneumonia in newborns.

Risk factors

The following factors significantly increase pneumonia in newborns:

Symptoms of pneumonia in a newborn baby

If the infection occurred in utero, no signs of the disease appear before birth, since until the baby is born and takes its first breath, its lungs do not function. After the child is born, the clinical picture of the pathology begins to develop within a few hours.

It is important to know exactly what signs indicate intrauterine pneumonia:

• the baby is weakened, does not cry or the cry is weak;
• hypoxia leads to damage to the nervous system, so innate reflexes are weakly expressed (food, orientation, protective);
• breathing is frequent and shallow due to the fact that the body wants to compensate for the lack of oxygen in the tissues;
• the heartbeat is rapid, the sternum sinks when inhaling;
• the baby has no appetite;
• body temperature rises quickly, convulsions may occur;
• The baby's skin is pale, grayish.

If infection with the causative agent of pneumonia occurs after birth, the symptoms of the disease are practically no different from congenital:

• the child is capricious and cries a lot;
• body temperature rises;
• shortness of breath occurs.

How exactly pneumonia will develop in a baby depends on the pathogen, but usually intoxication is quite severe and is the prevailing symptom.

Severity

The severity of pneumonia is assessed by clinical signs, and the assessment criteria differ little from the classification of the severity of pneumonia in adults.

Features of pneumonia in premature babies

In premature babies, pneumonia develops much more often than in those born on time, both congenital and neonatal.

The course of the disease in premature newborns differs in a number of features:

• the clinical picture in a newborn is dominated by nonspecific signs of the disease: weakness, lethargy, disturbances in the sucking and swallowing reflex;
• inhibition of the sucking and swallowing reflex in an infant leads to a decrease in his body weight;
• During infection in premature patients, body temperature not only does not increase, but often decreases (hypothermia);
• signs of toxicosis predominate in the baby, and only after a few days signs of respiratory failure are detected;
• complications after pneumonia suffered at birth after a premature pregnancy in an infant are very common, especially bronchopulmonary dysplasia.

Diagnosis of pneumonia in newborns

Diagnosis always begins with a history taking. The doctor asks the child’s mother what chronic diseases she suffers from, what is the likelihood that the child was hypothermic or overheated, or was near people who could be a source of infection.

During the examination, the doctor performs the following actions:

• assesses the degree of paleness of the baby’s skin;
• listens to the lungs for wheezing;
• taps the lungs to detect the location of inflammation using a shortened sound.

If suspicion of pneumonia is confirmed, the child is immediately hospitalized in a hospital (infectious diseases department). There, the diagnosis of a newborn is carried out using:

• clinical blood test;
• urine analysis;
• culture of mucus from the nasopharynx to identify sensitivity to different groups of antibiotics;

Treatment

If pneumonia is suspected, the newborn should be immediately hospitalized in the infectious diseases department. It is strictly forbidden to independently diagnose and treat pathology, since inflammation localized in the infant’s respiratory system can lead to death if treated incorrectly or untimely.

Mode and nutrition

In a hospital setting, the most comfortable conditions are provided for infants: a microclimate is created that prevents either hypothermia or overheating of the child. Patient care includes the necessary hygiene procedures, as well as regular changes in the child’s position.

Nutrition of a newborn with pneumonia is an important topic, because impaired respiratory activity inhibits the baby’s sucking reflex. And until the activity of the bronchopulmonary system is completely restored during proper treatment, the baby must be fed through a tube: with breast milk or a special formula. The calorie content of the daily diet decreases, but the number of feedings per day needs to be increased.

Antibiotic therapy

Taking antibiotics is the main method of treating pneumonia in patients of any age, including newborns. The prescription of a specific medicine depends on the causative agent of the disease, the type of pneumonia (congenital, early, late).

• Until the causative agent of pneumonia is identified, broad-spectrum antibiotics are used: Cefuroxime, Amoxicillin.
• For pneumonia, cephalosporins (Cefotaxime) and macrolides (Erythromycin) have proven effective.

After 72 hours, it will be possible to evaluate the effectiveness of the drug, and if the newborn patient’s well-being has not improved, the prescription will be adjusted taking into account new diagnostic data.

For congenital and early types of pneumonia provoked by group B streptococci, Klebsiella, Listeria, Escherichia coli and Staphylococcus aureus, the following are prescribed:

• Ampicillin plus aminoglycoside (Amikacin);
• Amoxicillin and clavulanic acid (Amoxicav, Augmentin), plus an aminoglycoside (Amikacin);
• Ampicillin and sulbactam (Sultasin, Unazin), plus an aminoglycoside (Amikacin).

This treatment regimen has a high degree of effectiveness, but in case of poor recovery dynamics or if there are contraindications, Cefotaxime with Amikacin can be prescribed.

For late pneumonia in newborns, provoked by infection with Pseudomonas aeruginosa, Enterobacteriaceae and Staphylococcus aureus, the following are prescribed:

• Ceftazidime or Fortum;
• Cefoperazone or Cephobid;
• antipseudomonas penicillin (Carbenicillin, Azlocillin).

The drugs are also prescribed together with an aminoglycoside.

Only the attending physician can prescribe antibiotics. All medications for newborns are administered by injection.

Detoxification therapy

Intoxication of the body is one of the most dangerous phenomena during pneumonia in a newborn child. The purpose of detoxification is to remove from the body toxins formed as a result of the presence and reproduction of pathogenic organisms in the body.

• With moderate intoxication, newborns only need to maintain water and electrolyte balance, which is ensured by constant administration of fluid intravenously or through a nasogastric tube.
• In case of severe intoxication, the method of hemodialysis or plasmapheresis is used - purification of blood or plasma from toxins and subsequent return to the bloodstream.

Disruption of the respiratory process as a result of pneumonia entails hypoxia or oxygen starvation - an extremely dangerous phenomenon for health and life. The lack of oxygen in the body can be replenished using oxygen therapy, when pure oxygen or gas with a high level of oxygen is supplied to the respiratory tract. For newborns, only the second option is used, since pure oxygen can cause eye damage.

It helps:

• reduce pulmonary edema;
• activate the respiratory system;
• have a positive effect on the molecular characteristics of blood.

Oxygen gas is given through nasal cannulas, a mask (there is a risk of aspiration from vomit) or by placing the person in an oxygen tent. In severe cases, a device for artificial lung ventilation (ALV) is indicated.

Probiotics

Probiotics for newborns during treatment of pneumonia are necessary to restore intestinal function due to antibiotic therapy.

For treatment the following are used:

• Bifidumbacterin;
• Bifiform Baby;
• Biovestin;
• Linux;
• Narine.

The drug is added to breast milk or special formulas.

Treatment of cardiovascular failure

Cardiovascular failure often becomes a complication of severe pneumonia. Its signs can appear within a few hours after the onset of the disease, subject to severe intoxication and dehydration.

Heart failure should be treated promptly by an experienced physician. Therapy requires:

• intravenous prednisolone or hydrocortisone;
• plasma and 5% albumin intravenously.

If ineffective - dopamine drip, artificial ventilation.

Symptomatic treatment

Symptomatic treatment aimed at making the patient feel better with pneumonia includes normalizing the temperature and liquefying the sputum.

1. Antipyretic drugs should not be used until the thermometer reaches 39 degrees to allow the immune system to fight the disease. An exception is the risk of febrile seizures - in this case, an antipyretic drug is given to the newborn at a temperature of 37.5 degrees.
   Paracetamol or nimesulide are used as a means to normalize body temperature. Aspirin is strictly contraindicated.
2. The removal of bronchial secretions from the lungs is facilitated with the help of mucolytics:

• Ambrobene;
• Bromhexine.

Newborns can receive any medications for symptomatic treatment only under the strict supervision and supervision of a physician.

Treatment of the mother of the child while breastfeeding

A newborn baby cannot use traditional medicine during treatment, but his mother can do this if she feeds him breast milk. Beneficial substances will be transferred to the baby's body during breastfeeding and will likely speed up the healing process.

In this way you can use:

• 30 g linden leaves, 30 g viburnum berries, 1 liter of boiling water; drink the resulting tea 50 ml throughout the day;
• regular tea with raspberries, fresh or dried;
• Pour 60 g of wild rosemary and coltsfoot leaves into a liter of boiling water; take 50 ml of decoction twice a day.

Methods for treating a newborn by enriching mother’s breast milk with beneficial substances are known in homeopathy. But the effectiveness of this branch of medicine has not been scientifically proven.

Complications and consequences

What are the consequences of pneumonia suffered in infancy:

• The danger of pathology lies mainly in intoxication of the body. Exposure to the body of toxic products of microbial decay can cause death if the child does not receive proper medical care.
• Another dangerous complication of pneumonia is bronchopulmonary dysplasia, that is, damage to organ tissue and small bronchi. This entails impaired respiratory function and hypoxia of the entire body. Subsequently, the risk of repeated, recurrent pneumonia is very high.
• Extrapulmonary complications include cardiovascular failure, sepsis, asthenic syndrome, and delayed diuresis.

Prevention

Prevention of pneumonia in newborns is a set of measures that need to be taken even before conceiving a child. The list of preventive measures for pathology includes:

• full medical examination before a planned pregnancy;
• carrying out all necessary blood tests during pregnancy;
• if possible, choose a natural birth rather than a caesarean section;
• give preference to breastfeeding rather than using formula feeding;
• Avoid crowded places during epidemics.

A healthy lifestyle during pregnancy and proper care of the newborn significantly reduces the risk of pathology.

Forecast

The prognosis for pneumonia in newborns is favorable with timely initiation of treatment (on the first day). The prognosis for premature babies is least favorable - they have a higher mortality rate.

Conclusion

Pneumonia in a newborn is a disease caused by pathologies occurring during pregnancy or childbirth, as well as improper care of the child in the first days of his life. Pneumonia, as well as its complications, is very dangerous, so it is extremely important to take all measures to prevent it. And in case of illness, consult a doctor immediately.

Everyone knows about the danger in adulthood and childhood, but there is also a special condition associated with the neonatal period. This is congenital pneumonia, which manifests itself immediately after birth or during the first three days. Pathology can occur in both full-term babies and premature babies of different ages; naturally, the more pronounced it is, the more severe the pneumonia and the more dangerous its prognosis. It is important to recognize such a condition immediately and actively treat the baby, otherwise such a condition threatens his life and future condition.

Features of congenital pneumonia

Based on statistics on cases of congenital lung damage, the most common cases are births from mothers who had a severe and complicated pregnancy and signs of infections, including intrauterine infection of the fetus. In addition, infection of the lung tissue is also possible among premature infants or those babies who were born with aspiration of meconium or amniotic fluid (swallowing them due to the first breath being taken too early). According to statistics, congenital pneumonia occurs in such children almost twice as often as in healthy, full-term infants.

The name “congenital pneumonia” is used because infection with pathogenic pathogens and inflammation develops in the child during pregnancy or during childbirth, so external factors play an extremely insignificant role in its formation.

The main cause of such pneumonia is an infectious agent that was initially present in the female body and became active during pregnancy, or its activity became significant for infection during childbirth.

In this regard, all congenital pneumonia of infants is divided according to the time of their formation into two large groups:

• antenatal infection, that is, the pulmonary system suffers and becomes inflamed even before birth, in utero.
• intrapartum infection, pathogenic objects penetrate the infant’s lung tissue during labor, which is usually protracted or complicated.

Each episode of pneumonia has its own typical pathogen, which can be microbial or of origin, and it is important to accurately and quickly identify it so that treatment measures are correct and as effective as possible.

Causes of congenital pneumonia in newborns

The most common causes of congenital pneumonia are viral infections, since children in utero and immediately after birth are most vulnerable to their influence. For infectious inflammation of the lung tissue to develop, the virus must enter the third trimester. If it is activated earlier, it threatens congenital malformations, termination of pregnancy or intrauterine fetal death .

The most common causative agents of pneumonia in this group of children are considered to be. This is a group of the most detected pathogens capable of provoking defects, intrauterine infections, including damage to lung tissue. These are pathogens such as, and. It is also possible that there is an influence of other pathogens, which have their own characteristics in the structure and formation of the infectious process, and characteristics of treatment.

Features of TORCH complex infections

If speak about toxoplasmosis , it is provoked by a special pathogen, toxoplasma (a group of protozoa). The infection is transmitted through domestic animals, mainly cats, which often act as asymptomatic carriers. It is also possible that Toxoplasma enters the body through poorly cooked meat. If infection occurs for the first time during pregnancy, especially in its last weeks, the pathogen can cause damage to the fetal lung tissue and congenital pneumonia.

If a woman becomes infected with toxoplamosis before pregnancy, she already has antibodies to the pathogen, and in this case, this infection is not dangerous to herself or her baby.

The clinical picture of the most acute toxoplasmosis in a woman is nonspecific, so it is often mistaken for a cold or fatigue.

Development rubella It is also dangerous if the mother does not have antibodies to it (if the woman did not have this disease before pregnancy). This is an acute viral infection, transmitted by airborne droplets, which poses a potential threat to the fetus from early gestation due to the high risk of congenital malformations. The virus can lead to the formation of pneumonia in the fetus if infection occurs in the last weeks of pregnancy.

Defeat cytomegalovirus infection also dangerous. This is an airborne viral infection that can also enter a woman’s body through sexual and contact contact. About 60% of the adult population is infected with this virus, but clinical infection manifests itself only in isolated cases. If the expectant mother is infected, the virus is capable of penetrating the placenta, inducing inflammatory processes in many tissues and organs of the fetus - the brain, liver tissue or lungs.

Formation herpes possible at any stage of pregnancy, this is a particle with an affinity for nerve cells, but it may well affect the skin and internal organs, including lung tissue with the development of pneumonia. There are two types of herpes that are dangerous for women - the first and second types (labial and genital). The first type is transmitted primarily through airborne droplets or through kissing, close contact, or sharing utensils. The second is predominantly transmitted through sexual contact (of any type).

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Herpes of the first type can most often form antenatal pneumonia (intrauterine infection), and the second type most often affects during childbirth (intranatal). This is due to the fact that during childbirth the fetus passes through the infected genitals of the mother, on the surface of which there may be a herpes virus.

The group of TORCH infections is the most dangerous in terms of provoking such pneumonia, especially when it comes to the last stages of gestation or childbirth. But these are not the only causes of pneumonia in infants.

Features of intrauterine pneumonia of other etiologies

The influence of many other pathogens, either microbial in nature, related to fungi or protozoa, is also possible. Congenital pneumonia can often be caused by infection, or, a possible role, or. They mainly affect just before childbirth, in the last weeks or during the birth of the baby. Trichomoniasis and ureaplasmosis belong to the group of sexually transmitted infections; they very rarely can cause the development of pneumonia in completely healthy and full-term children. Typically, the infection, along with candidiasis, occurs in premature infants or those with congenital immunodeficiency.

Infection with chlamydia or mycoplasma, as intracellular pathogens, is typical for children immediately after birth and in the first hours after birth. But this requires a combination of special circumstances.

Generally speaking, for congenital pneumonia, the role of both viruses and microbes, protozoa, is great, but usually for such a problem the presence of additional factors is also necessary. In healthy full-term infants, such lesions are not typical.

The mechanism of pneumonia in each specific case depends not only on the cause affecting the baby, but also on many additional factors.

Special conditions for provoking congenital pneumonia

To form pneumonia, any infectious agent must penetrate the placental barrier in utero, have a certain affinity for the lung tissue, and penetrate through the bloodstream into the fetal lung area. Before birth, a baby’s lung tissue has specific characteristics; the alveoli are in a collapsed state and can become a breeding ground for viruses or microbes. An inflammatory process is formed, which only after birth, against the background of the onset of pulmonary respiration, manifests itself as symptoms of pulmonary insufficiency, incomplete opening of all areas, and the formation of silent zones. Typically, the inflammatory process against the background of pulmonary respiration is activated, and additional manifestations are formed.

There are a number of factors that can make an infant more likely to develop an infection. These include:

• A difficult pregnancy and maternal illness, which led to defects in the structure of the placenta and its protective role
• infectious lesions of the mother herself, especially those related to the TORCH complex group. They increase the risk of infection of the placenta and penetration of pathogens through it into the fetal tissue.
• state of prematurity, weakening of immune defense against this background.
• the course of labor and complications in it, a long anhydrous period, protracted labor and various interventions by doctors for the purpose of obstetric care.

How does congenital pneumonia manifest?

For congenital pneumonia, symptoms typically appear immediately after birth or during the first three days. If symptoms occur during the first days, we are talking about infection during childbirth, if immediately, during pregnancy.

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When pneumonia caused by certain viruses of the TORCH group develops, manifestations from other systems and organs often develop against the background of respiratory symptoms. It is important for doctors to take this into account when diagnosing lung lesions and approaching the treatment of pneumonia and all other manifestations.

It is also important to determine whether the infection is viral or microbial in nature; symptoms and treatment approaches vary greatly.

The first signs appear after birth; the baby’s general condition can be very serious due to respiratory disorders developing immediately after the first breath. Babies may be born with bluish or gray, pale skin on the body and face, and a possible rash in the form of red dots and hemorrhages due to intoxication. The baby's cry will be weak, reflexes will be suppressed due to the lack of oxygen that nourishes the nervous system during the infectious process. As a result, Apgar scores will be low, and the children are immediately taken to the NICU by neonatologists.

In some situations, they need intubation and artificial ventilation, oxygen therapy to saturate the organs with oxygen and normalize metabolic processes. This is especially important against the background of severe respiratory failure.

The main symptoms of pneumonia are breathing disorders with shortness of breath, retraction of the spaces between the ribs and areas under the sternum and above the collarbones, with active participation in breathing from the abdomen. Against the background of shortness of breath, there is increased breathing and heart rate, exceeding the norm by 20-30% or more. This indicates problems with the lungs and requires immediate examination.

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For children, the staged pattern that develops with pneumonia in adults is not typical; it is important to know that inflammation spreads quickly, and infection, for example, with the influenza virus, pneumocystis, or, leads to necrosis of the lung tissue.

Congenital pneumonias differ in the form of the pathogen into microbial, viral, fungal and caused by atypical flora, and can also be divided into specific, nonspecific, complicated. This is important for making a diagnosis and selecting the correct treatment.

Clinic of specific TORCH pneumonia and bacterial

If pneumonia is provoked by pathogens from the group of TORCH infections, a generalized infection may also be present against the background of pulmonary symptoms. Doctors know about this, simultaneously with the treatment of pneumonia, examining the child with an eye on possible damage to other systems and organs.

Yes, when cytomegaly Damage to the tissues of the brain and liver also develops, which aggravates the overall course of the pathology. When exposed to the fetus, the virus leads to serious brain damage with the formation of ischemic zones and cystic formations, enlargement of the liver with the development of severe jaundice, increased bilirubin with the formation of encephalopathy. Therefore, pneumonia will be only one of the symptoms of a viral infection.

Pneumonia with congenital rubella will be accompanied by rashes throughout the body and lesions in all other parts of the respiratory tract.

Microbial pneumonia in newborns also has special properties, since the nature of the inflammation is purulent. They often develop in the first three days, with a sharp deterioration in the child’s condition, progressing literally by the hour. Against the background of severe shortness of breath, symptoms of intoxication are formed - a sharp fever, or in case of prematurity, a paradoxical decrease in temperature to severe hypothermia. There is a refusal of the breast or bottle, weight loss and severe anxiety, cyanosis or severe pallor, wheezing when breathing.

Consequences of congenital pneumonia

Such processes are much more dangerous for newborns than for adults; complications depend on the types of pathogens and are both immediate and delayed. If, due to the pathogen, destruction is formed in the area of ​​​​the lung tissue, this threatens the spread of infection beyond the respiratory tissue. This threatens the breakthrough of the infectious agent into the vessels and the formation of sepsis with bacteremia (microbes in the blood) and the formation of secondary purulent foci in tissues and organs.

If we talk about other immediate complications, these include the formation of bleeding due to hemorrhagic syndrome or, circulatory disorders and tissue hypoxia, and the development of cardiovascular failure against the background of respiratory failure. If we talk about purely pulmonary complications, these include the formation of lesions of the pleura (acute) and (air in the chest), as well as (collapse areas).

Delayed complications include brain damage with varying degrees of intellectual impairment, chronic infection, impaired growth and development, and defects of organs and tissues.

Methods for diagnosing congenital pneumonia

Difficulties always arise regarding the rapid diagnosis of congenital pneumonia. This is due to the fact that respiratory failure at this age is typical not only for pneumonia, but also for many other conditions. If pneumonia is suspected, it is also important to accurately identify its causative agent, since treatment tactics for protozoa, viruses and microbes vary, as does the range of drugs selected.

The data obtained from the mother or her exchange card is important - how the pregnancy, childbirth proceeded and whether there were any complications, whether there were signs of infections in the third trimester, whether she was tested for the TORCH group of infections, what were the results.

The peculiarity of congenital pneumonia, especially when it comes to premature babies, is unclear objective data, difficulties in listening to wheezing and noise, similar data, both against the background of pneumonia and respiratory distress syndrome. In this case, data from laboratory tests and instrumental diagnostics are very important.

Through instrumental examinations, it is possible to accurately determine lung damage and clarify where it is localized. Particularly important for the newborn, with it, the types of typical signs of the inflammatory process are a decrease in the airiness of the lungs with an increase in the pattern of blood vessels at the beginning of pneumonia, and then the manifestation of inflammatory infiltrative changes with a tendency for them to merge. If the baby is premature, x-rays cannot provide accurate information about whether it is pneumonia or hyaline membrane disease. The changes are very similar in both pathologies, so tests are necessary.

Features of baby tests for suspected pneumonia

When diagnosing pneumonia in newborns, a number of tests are performed, but they have their own characteristics due to the physiological characteristics associated with birth. Thus, a baby typically has an increase in leukocytes and erythrocytes to fully ensure tissue respiration, and by the 5th day a physiological crossover in the level of leukocytes and lymphocytes occurs.

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These data can confuse the doctor and mask the features of inflammation. It is important to note changes in the dynamics daily, then an increase in leukocytes will be noticeable, and there may be a lack of physiological crossover.

Based on the level of leukocytes and lymphocytes, the nature of pneumonia is determined - viral or microbial, but mixed infection with the simultaneous influence of viral-microbial association is also possible.

If there is no effect from the treatment of the baby, the mother is examined, which reveals the presence of a specific pathogen. This is due to the fact that the mother will be the main source of infection for the fetus and newborn, and the child’s antibodies to the infection have not yet formed and cannot be determined.

Mothers carry out serological diagnostics, determining antibodies to certain infections with the level of immunoglobulins of class G and M. The level of antibodies to the most likely types of infections is assessed, and with an increase in the level of class G antibodies, this pathogen is not dangerous in terms of pneumonia, since this is evidence of an old infection or the presence immunity. And here the presence of class M may indicate an acute process, and this pathogen probably caused pneumonia.

Vaginal smears may be indicated for sexually transmitted infections, especially with bacterial pneumonia of a child; they can be used to determine the sensitivity of pathogens to antibiotics.

How to treat congenital pneumonia in a child?

It is necessary to treat the child immediately after diagnosis, and complex treatment regimens are used, taking into account both the type of pathogen and the characteristics of its development, in parallel with methods of caring for the baby and routine measures.

Children with pneumonia are placed in incubators to create an optimal temperature and humidity regime for them - this is 32-34 degrees with 80-90% humidity; it is also important to carry out oxygen therapy, often right in the incubator conditions.

If there is such a possibility, children are fed with mother's breast milk or donor milk, it is important to slightly reduce the total calorie intake, but increase the frequency of feedings.

Oxygen therapy is required; it is selected taking into account the child’s capabilities and condition. This is important in order to correct metabolic disorders and support the functioning of the cardiovascular system. In an incubator, this can be a direct supply or the use of a mask; if the baby is weak and premature, it is possible to correct the respiratory act by connecting an oxygen supply apparatus (with constant positive pressure), and, if necessary, transfer the baby to a ventilator. Against the backdrop of all these measures, medicinal influence is already carried out.

It is important to accurately establish the nature of the pathogen; only therapy is selected for it:

During therapy with powerful antibiotics, the intestinal microflora suffers, and it is important to correct it, especially when the intestines have not yet been populated by microbes. Reception in the form of compositions with lactobacilli and bifidoflora is indicated. The drugs are selected in such a way that they are not exposed to antibiotics and take root in the intestines.

As the condition improves, vitamin therapy and physical therapy are indicated, a transition to breastfeeding and care for the baby by the mother herself, which improves the prognosis for his recovery.

What is the prognosis for babies?

If pneumonia is recognized at the very beginning and its causative agents are accurately identified, active treatment is started, full care of the baby is organized and all measures are taken, the chances of recovery are high. But often congenital pneumonia occurs in utero, is combined with multiple lesions of tissues and organs, the nervous system, and can lead to problems. Often, severe course and atypical pathogens can lead to residual effects and disability.

Alena Paretskaya, pediatrician, medical columnist

You are a fairly active person who cares and thinks about your respiratory system and health in general, continue to play sports, lead a healthy lifestyle, and your body will delight you throughout your life, and no bronchitis will bother you. But do not forget to undergo examinations on time, maintain your immunity, this is very important, do not overcool, avoid severe physical and strong emotional overload.