How long does it take to treat pneumonia in newborn full-term babies? Congenital, intrauterine pneumonia in a newborn: consequences, causes. Risk of illness after caesarean section

A newborn baby does not yet have strong immunity; in the first month of life, its organs and tissues adapt to environmental conditions. Any infection that enters the baby’s body at this time can lead to serious illness and consequences, sometimes fatal. The infectious process during pneumonia, including intrauterine pneumonia, is dangerous because it affects not only the lung tissue, but can also spread throughout the body. Knowing the causes, manifestations and preventative measures of the disease, you can avoid serious complications.

What is neonatal pneumonia

Pneumonia of newborns (pneumonia) is an infectious disease of lung tissue in children in the first 28 days of life with characteristic symptoms of intoxication and changes in the respiratory system.

With inflammation of the lungs, the alveoli become filled with secretions and cease to perform their functions.

At risk are:

• premature babies (born at less than 38 weeks of pregnancy);
• children with intrauterine growth retardation (body weight less than 2500 g);
• children born by caesarean section.

In addition, a number of factors significantly increase the likelihood of a baby developing the disease, for example:

• fetal hypoxia (oxygen starvation). Occurs as a result of a lack of oxygen in the mother’s blood, placental insufficiency (lack of oxygen supply to the fetus through the blood vessels of the placenta);
• aspiration syndrome, when during the child’s inhalation, part of the amniotic fluid enters the respiratory tract;
• birth injuries;
• hypoxia during childbirth - a long anhydrous period (more than 24 hours);
• infectious diseases of the genitourinary and respiratory systems of the mother;
• malformations of the lungs (bronchopulmonary dysplasia).

It is interesting that a third of pneumonia in newborns is a secondary concomitant disease against the background of the main one. For example, congenital pneumonia can occur against the background of hemolytic disease, severe birth trauma, or sepsis. Such pneumonia often determines the severity of the underlying disease, as well as its outcome.

Types of disease

1. Congenital (or intrauterine) pneumonia. The infection infects the fetus in the mother's womb. They are divided into transplacental, when the infection reaches the baby from the mother through the placenta. Antenatal, when the fetus becomes infected through amniotic fluid. And intrapartum, when the child is infected while passing through the birth canal. The causative agent of the disease in this case penetrates from the amniotic fluid or from the infected reproductive tract of the mother (genital tract).
2. Postnatal pneumonia that occurs after the birth of a child. They are divided into hospital-acquired (nosocomial) pneumonia, when infection occurs in the maternity hospital or neonatal pathology department, and community-acquired, when the newborn catches the disease after discharge from the maternity hospital.

One of the ways a fetus can become infected from its mother is through the placenta (transplacental route of infection)

In addition, according to the type of causative agent, pneumonia is usually divided into bacterial, viral and fungal.

Causes

In full-term newborns, the main cause of pneumonia is infection.. All other factors (maternal infections, hypoxia during childbirth, birth trauma, etc.) only increase the likelihood of pneumonia, but are not its cause!

During antenatal infection, the most common pathogens are cytomegalovirus infection, herpes simplex virus and pneumocystis. The latter becomes the most common cause of the development of the disease in premature babies. With intranatal infection, the child is exposed to microorganisms inhabiting the mother’s birth canal, these are:

• chlamydia;
• mycoplasma;
• ureaplasma;
• streptococci;
• candida (fungal infection).

Streptococcal infection causes pneumonia in 35% of infants in the first month of life.

Hospital infections that provoke nosocomial pneumonia are Klebsiella, enterococci, Pseudomonas aeruginosa and Staphylococcus aureus.

In premature newborns, the main cause of pneumonia, in addition to infection, is underdevelopment of the respiratory system and immune system. It is more difficult for such children to fight infectious agents and are more susceptible to infection.

In children after delivery by cesarean section, the main cause of pneumonia is the absorption of infected amniotic fluid or mucus from the birth canal. As a result of this, atelectasis occurs (collapse of part of the lung), which contributes to the development of pneumonia.

Ways of contracting pneumonia in newborns:

• Hematogenous (with blood flow). This is the most common route of infection for intrauterine pneumonia. From foci of infection in a pregnant woman, the virus or bacteria travels through the bloodstream to the fetus. This is where intrauterine infection of the fetus occurs.
• Bronchogenic. This is the route of infection during postnatal pneumonia, when a child picks up an infection from a sick mother or relatives. Infection occurs by airborne droplets.

Symptoms of the disease

In the clinical manifestation of pneumonia in newborns, several groups of symptoms are distinguished:

• Intoxication syndrome - occurs as a result of poisoning of a child’s body with toxins of viruses or bacteria. The nervous and immune systems are primarily affected. This manifests itself in the child’s weakness, refusal to eat, drowsiness, pallor or gray skin. There may also be frequent regurgitation or episodes of short-term respiratory arrest (apnea).
• Respiratory disorders - occur as a result of damage to the lung tissue and, as a result, lack of oxygen. They manifest themselves in increased breathing, participation in the act of breathing of auxiliary muscles (retraction of the intercostal spaces, flaring of the wings of the nose). The newborn's breathing becomes groaning and noisy, and sometimes wheezing can be heard in the distance. The skin around the lips and on the limbs becomes bluish, which is a sign of oxygen starvation.
• Disorders of the cardiovascular system manifest themselves in the form of tachycardia (increased heart rate), decreased blood pressure, and edema.
• Nervous system disorders - increased excitability of the child, anxiety, regurgitation, decreased muscle tone.
• Manifestations from other organs and systems - enlarged liver and spleen, early jaundice (yellowing of the skin before the 3rd day of a child’s life).

Symptoms of pneumonia in newborns - photo gallery

With pneumonia in newborns, breathing is impaired; wheezing may be heard during auscultation. With congenital pneumonia, prolonged jaundice is a common symptom. Lack of oxygen in the tissues manifests itself in the form of cyanosis (cyanosis) of the limbs or lips.

It is important to know that an increase in body temperature in newborns with pneumonia is an optional sign. In the first days of life, children may experience hypothermia (body temperature below 36 degrees). This indicates reduced immune reactivity and severe intoxication.

The most common cause of pneumonia in medical institutions is Staphylococcus aureus. A feature of staphylococcal pneumonia is a strong intoxication syndrome (body temperature above 38.5 °C, breathing problems). The child quickly develops respiratory failure.

Staphylococcus destroys lung tissue, resulting in the formation of cavities and bullae filled with pus. The inflammatory process often spreads to neighboring tissues, and pleurisy develops. Staphylococcal pneumonia, complicated by an abscess or pleurisy, is often the cause of death in newborns.

Specifics of congenital pneumonia in infants:

• Clinical and radiological manifestations of the disease occur in the first 72 hours of a child’s life.
• The source of infection is the mother - she is sown with the same pathogenic flora as the baby.
• The child often has infectious foci in organs adjacent to the lungs.
• An enlargement of the liver and spleen is typical from the first day of the baby’s life.
• Inflammatory changes are detected in the placenta after childbirth.

Features of pneumonia in premature infants

• The onset of the disease with nonspecific signs - poor sucking, increased excitability of the child, pallor or cyanosis of the skin, decreased body temperature, sleep disturbance, loss of body weight or its increase due to edema.
• Late manifestation of respiratory disorders (at 1–2 weeks of life).
• Complications of pneumonia are more common than in full-term newborns.
• Foamy discharge from the mouth. This occurs as a result of congestion in the lungs.
• Premature babies are more likely to develop blood poisoning due to pneumonia.

The most common cause of pneumonia in premature newborns is pneumocystis. The course of such pneumonia lasts 4–8 weeks and is divided into several stages:

1. Initial manifestations (first 1–2 weeks of illness). Characterized by nonspecific symptoms in the form of sluggish sucking, poor weight gain, increased breathing during bathing and sucking. Sometimes there is a slight cough and loose stools (diarrhea).
2. The height of the illness (2–4 weeks of illness). It manifests itself as severe shortness of breath (increased number of breaths up to 80–140 per minute), paroxysmal cough, change in skin color (blue, gray). Body temperature rarely rises.
3. The resorption (repair) stage is characterized by the slow disappearance of shortness of breath, cough, and signs of intoxication.

Video from Dr. Komarovsky’s school about pneumonia in children

Treatment

Treatment of newborns continues until the acute period of the disease subsides (about 2 weeks). During the period of resorption of pneumonia, supportive and restorative therapy is used.

Treatment of pneumonia in newborns is carried out only in a hospital setting under the strict supervision of a neonatologist!

The main aspects in the treatment of pneumonia in newborns are:

1. Protective mode. Maintaining optimal temperature and air humidity (+24...+26 °C in the room with a humidity of 60–70%). For premature babies weighing up to 1.5 kg, the temperature in the incubator is maintained at +34...+36 °C. Overheating is undesirable, as is hypothermia. Regular ventilation of the premises is required. It is not recommended to swaddle babies and limit their movements; it is necessary to frequently change their body position during the day.
2. Feeding. If the baby is in serious condition or very premature, he is fed through a tube or by drip. For this purpose, breast milk or adapted formulas are used. When the condition improves and the sucking reflex is formed, the child is fed with a spoon or breast. In a severe condition, the child is not able to absorb the entire required amount of nutrition, so between feedings he is given liquid (glucose, oral) through a probe or pipette.
3. Oxygen therapy is the introduction of heated and humidified oxygen through a mask, catheter, or into an incubator.
4. Antibacterial therapy - depending on the pathogen and type of pneumonia.
5. Immunocorrective therapy - administration of immunoglobulins, blood plasma.
6. Treatment of cardiovascular failure is the use of cardiac glycosides for health reasons, diuretics.
7. For obstructive syndrome (bronchospasm), bronchodilators (for example, Alupent) are used.
8. Sanitation of the upper respiratory tract - removal of mucus using an electric suction.
9. Vibration massage - stroking, light tapping, squeezing the chest from the sides.

Treatment of pneumonia in newborns - photo gallery

Stronger children are fed from a bottle with a nipple Weak newborns are fed through a tube It is important for a newborn child to maintain a constant body temperature and humidity level - for this he is placed in an incubator. The baby is supplied with humidified oxygen through a mask or nasal catheter

Combinations of antibiotics for different types of pneumonia - table

Antibacterial therapy is carried out intravenously - stream or drip. Treatment with antibiotics should be for at least 5 days, sometimes their use is extended to 10 days.

Possible complications and consequences

1. Pleurisy is an inflammation of the pleura (the membrane that covers the lungs). Occurs when the infection moves from the pulmonary focus to adjacent tissues.
2. An abscess is the formation of a cavity in the lung filled with pus.
3. Sepsis is an infectious blood infection and the spread of infection throughout the body with the formation of many foci of infection.
4. Atelectasis - collapse of part of the lung;
5. Pneumothorax is the entry of air into the pleural cavity; normally it should not be there.

Intrauterine pneumonia in newborns, the consequences of which can be very dire, is a very common pathology. This is an infectious disease that develops in the first days of a child’s life.

The cause of this type of pneumonia is the child’s ingestion of infected amniotic fluid at the time of birth or hematogenous penetration of the pathogen from a sick mother.

Diagnosis of intrauterine pneumonia

Main diagnostic criteria for intrauterine pneumonia:

1. Signs of pneumonia appear between 1 and 3 days of life.
2. When taking an x-ray on the 3rd day of a child’s life, focal or infiltrative shadows are revealed.
3. When sowing microflora in the mother and child in the first days of life, identical analyzes are observed.
4. If a newborn dies on the 4th day, an inflammatory process in the lungs is determined.

Auxiliary diagnostic criteria:

1. Histological examination of the placenta can reveal the inflammatory process even in the womb.
2. When the liver and spleen are enlarged, pathology in the baby’s body is determined.
3. Blood tests reveal the presence of inflammation.

Symptoms of intrauterine pneumonia

Symptoms appear on the second or third day after birth. Already during childbirth, it is noticeable that the child is lethargic, weak, and the skin is bluish. Swallowing and sucking reflexes and muscle hypotonia may be absent.

Other symptoms include:

• dry skin accompanied by hemorrhagic rash;
• swollen limbs;
• in full-term infants the temperature rises, in premature infants, on the contrary, it decreases to 34-35 degrees;
• difficulty breathing accompanied by shortness of breath;
• on the 2-3rd day wheezing is heard;
• regurgitation and vomiting;
• lack of body weight;
• possible development of heart failure;
• asphyxia;
• liver enlargement.

Most often, pneumonia can develop due to a streptococcal infection in the womb.

With the development of respiratory failure, three phases of its formation are distinguished:

1. 1st degree – slight rapid breathing, retraction of the intercostal spaces is weakly expressed, cyanosis is weakly expressed in a calm state.
2. 2nd degree - auxiliary muscles are involved during breathing, cyanosis is more pronounced.
3. 3rd degree – rapid breathing, arrhythmia, apnea, movement of the head and additional muscles during breathing. Cyanosis is persistent both during excitement and in a calm state.

Consequences of intrauterine pneumonia in a newborn and their treatment

Treatment of congenital pneumonia may not always give a favorable result. Consequences of even timely treatment are common. These include the formation of atelectasis, which is characterized by areas of adhesive lung tissue and the formation of connective tissue in the affected areas of the lungs. In the future, with such pathologies, the lungs are not able to fully perform their functions, which leads to emphysema. With this disease, the child develops toxicosis, which is difficult to treat.

Basic therapeutic measures for pneumonia and its consequences:

1. Elimination of peripheral circulation and its blockade. This procedure is carried out in order to eliminate the centralization of blood flow and reduce the activity of the brain, which is also involved in this process.
2. Detoxification of the body. This therapy is carried out in order to remove toxins accumulated in the body, correct the water-electrolyte and alkaline-acid balance, and saturate the internal organs with good blood supply.
3. Elimination of heart failure.
4. Prevention of disseminated vascular coagulation, and if it occurs, quality treatment.
5. Elimination of symptoms of pneumonia.

Consequences of pneumonia in children with delayed diuresis.

Most often, the consequences of this disease manifest themselves through difficulty urinating. Delayed diuresis is treated with diuretics, which should be prescribed by a doctor. Often, the assistance of a catheter is required, which is inserted into the bladder.

Forced diuresis is carried out in three directions, such as:

1. Elimination of body dehydration.
2. Establishment of water-salt metabolism.
3. Avoiding increased fluid levels in the body.

Basic treatment

If pneumonia is suspected, the child is isolated from the mother and transferred to the neonatal department. There he is placed in an incubator, where humidified oxygen is supplied. A small child is prescribed a course of antibiotics. If the condition worsens, artificial ventilation is used; this process is most often carried out in the intensive care unit, where a seriously ill baby is transferred. If the treatment was not carried out entirely correctly, then pneumonia can progress to the chronic stage.

Causes of intrauterine pneumonia

Most often, the causative agents of the disease are streptococci from group B, as well as influenza and parainfluenza viruses, adenoviruses, and mycoplasma. Infection of the fetus can occur if a pregnant woman in the last stages of pregnancy falls ill with influenza or ARVI.

Other causes of infection in a child include:

• chronic maternal infections;
• use of steroids during pregnancy;
• hypoxia of the fetus in the womb;
• genetic diseases of the lungs and other internal organs.

A child can get an infection that leads to pneumonia in two main ways:

1. Bronchogenic, when the infection enters through the lungs.
2. Hematogenous, when infection occurs in utero through the infected blood of the mother.

Another route of infection may be when a child passes through the birth canal and ingests infected amniotic fluid. There are cases of infection after the birth of a baby.

Prevention of pneumonia in newborns

Preventive measures for this disease include protecting the body of a pregnant woman in order to prevent her from becoming infected with influenza or acute respiratory disease, especially in the second half of pregnancy.

Other preventive measures for a pregnant woman include the following:

1. Timely opening of an account card, regular visits to the clinic and passing all the necessary tests.
2. The expectant mother's diet should be varied and balanced, rich in vitamins and minerals.
3. A significant role is played by giving up bad habits and leading a healthy lifestyle.

During delivery, doctors must take all measures to avoid fetal asphyxia. After the child is born, do not allow infection to enter the room where he is located. It is very important not to overcool the baby during this period. The importance of mother’s milk in boosting the child’s immune system has also long been proven.

About pneumonia in a newborn baby

Features of the bronchopulmonary system in the fetus and newborn.

In utero, the fetal lungs do not contain air. But he begins to make breathing movements already from 23 weeks of pregnancy. However, before this period, gas exchange in the lungs of the fetus cannot yet occur due to anatomical and functional immaturity.

At birth, the baby's lungs are filled with amniotic fluid. When a full-term baby takes his first breath, the inhalation volume is approximately 70 ml, with almost all alveoli opening. Amniotic fluid is quickly absorbed into the blood and interalveolar space. In premature babies, taking the first breath is more difficult because, in addition to the immaturity of the respiratory system, their nervous cardiovascular system and many metabolic processes are imperfect.

The newborn baby's breathing is intermittent and uneven. There are pauses; in full-term babies they last 1-6 seconds, in premature babies - 5-12 seconds.

Reasons why newborns are susceptible to pneumonia:

• immaturity of the pulmonary elements, few muscle fibers in the walls of the respiratory tract;
• a dense network of capillaries and lymphatic vessels, loose connective tissue between them;
• the ciliated epithelium is still poorly functioning, the cough reflex is reduced;
• the airways are narrow throughout their entire length, which causes difficulty in the passage of air;
• the ribs are located horizontally, the intercostal muscles are poorly developed, so the excursion of the chest is reduced;
• immaturity of the nervous system aggravates the failure of the respiratory system.

These features, as well as the peculiar response of the immune system, make newborns especially vulnerable to pneumonia. The vulnerability of babies exists, even if the pregnancy proceeded well, the birth was not complicated, and there is no hereditary pathology.

Causes of pneumonia in newborns

Pneumonia of newborns is treated by neonatologists. They define this disease as infectious, although sometimes it can develop as a result of aspiration, but sooner or later the infection still attaches.

Pneumonia in newborns is an acute infectious lung disease that can develop as an independent disease or as a complication. It is quite difficult. The mortality rate from the disease in children 1 month old is 30-40%. The incidence rate in full-term infants ranges from 0.5-1%, in premature infants - up to 10%.

Pneumonia in newborns is classified into the following forms:

• focal;
• segmental;
• interstitial.

By causative factor:

• hospital;
• out-of-hospital.

Depending on the circumstances of infection, the following types of pneumonia are distinguished:

• congenital pneumonia (infection is transmitted from the mother through the placenta);
• intrauterine (when infected amniotic fluid enters the lungs);
• intrapartum (bacteria enter during childbirth from the mother’s genital tract);
• postnatal (the disease developed after birth in a maternity hospital or at home).

Causes of pneumonia in a newborn baby:

• bacteria;
• viruses;
• mushrooms;
• pneumocystis;
• mycoplasma;
• chlamydia.

In most cases, mixed pneumonia is observed, for example, bacterial-viral. In terms of frequency, adenoviruses, influenza and parainfluenza viruses predominate among viruses. Bacteria include Staphylococcus aureus, pneumococcus, and alpha-hemolytic streptococcus. The proportion of Klebsiella, intestinal bacteria, and Proteus in the structure of pathogens has increased significantly.

Symptoms of pneumonia in a newborn

Pneumonia in newborns will manifest itself differently depending on the pathogen and the conditions of infection.

Congenital pneumonia is characterized by the development of suffocation at birth. The child is born with a bluish tint to the skin, does not scream immediately, screams weakly or not at all, moves his arms and legs little, and has weak reflexes. When feeding, such children experience profuse regurgitation. Breathing is weakened, a groan is heard when exhaling, and sometimes a semblance of cough appears. In addition to the respiratory system, the child’s cardiovascular and digestive (bloating, abdominal pain, enlarged spleen) systems are also affected. Body temperature is normal or reduced. Full-term infants may have fever from the second day of illness. Symptoms last about 3-4 weeks. This type of inflammation is characterized by severe course and high mortality.

Pneumonia that develops in the first days of a child’s life has a long latent period. The first signs can be observed only on the 5th day of life and later. The severity of the course depends on the infection that caused the disease.

The diagnosis of viral pneumonia is difficult to make because it is quickly associated with a microbial infection. Influenza pneumonia in a newborn has an unexpected onset. Body temperature rises to 39 °C and higher, convulsions, anxiety, refusal to eat, and meningeal symptoms appear. An atypical course with a temperature of up to 38 ° C and without strong signs of intoxication is also possible. A feature of this type of pulmonary inflammation is damage to blood vessels and hemorrhages in all organs of the child. Such children may have consequences in the form of encephalitis, meningitis, hemorrhages in vital organs, otitis, and pyelonephritis.

Pneumonia caused by the parainfluenza virus develops in parallel with inflammation of the pharynx. Clinically, it is milder than influenza, intoxication is less pronounced, and the temperature rises slightly. But weakness, decreased reflexes, and pallor of the limbs are still present.

Staphylococcal pneumonia in children can be a complication of sepsis or occur as an independent disease. It is severe with high fever, severe toxicosis, hemorrhages, and pleurisy. The heart, nervous system, and kidneys are also affected.

Chlamydial and mycoplasma pneumonia most often occur in utero. They are not only difficult, but also difficult to treat. These pneumonias are characterized by cough, swelling, and sometimes a rash. These diseases are often fatal.

What are the differences in the course of pneumonia in full-term and premature infants? In premature newborns:

• symptoms such as shortness of breath, cyanosis of the skin, increased breathing predominate;
• fever is rare;
• complications both from the lungs and from other organs are more common;
• foamy fluid comes out of the mouth;
• Pneumonia is often followed by sepsis;
• the disease lasts a long time and leaves behind irreversible consequences.

Treatment of pneumonia in newborns

The main thing in the treatment of pneumonia is antibacterial therapy. Most often, the causative agent of the infection is not yet known at the time the antibiotic is prescribed, so the doctor makes his own assumptions. If the drug is chosen correctly, the condition will improve within 2-3 days. Otherwise, the medications need to be changed to others.

Three groups of antibiotics are used in newborns: penicillins, cephalosporins and macrolides. Protected penicillins (amoxiclav, augmentin, flemoclav, unasin) are considered the most effective for initial therapy. If there is a suspicion of chlamydia or mycoplasma, then the choice falls on macrolides (azithromycin, clarithromycin, roxithromycin). Cephalosporins are used as alternative drugs. The child is treated with antibiotics for at least 10-14 days.

If a pathogen is identified, treatment with specific immunoglobulins (antistaphyllococcal, anti-influenza, anti-pseudomonas, etc.) can be added to antibiotic therapy.

Inhalations are an integral part of the treatment of lung diseases. Oxygen is inhaled through aqueous solutions, sodium bicarbonate, saline, acetylcysteine, lazolvan, trypsin, chymotrypsin. Oxygen reduces respiratory failure, and mucolytics thin sputum.

The position of the child also matters. If the pneumonia is unilateral, then the baby is placed on the healthy side, and if it is bilateral, the side is changed every 2 hours. It is advisable for the mother or medical personnel to massage the baby's chest by tapping. This will also make the mucus easier to clear. In physical therapy in the acute phase, only microwave therapy on the chest area is allowed.

What are the consequences of pneumonia for a child?

Time is of the essence. The earlier treatment is started, the better the prognosis for the child. If treatment is started on the first day, then pneumonia can be cured without a trace. But if antibiotic therapy is started late, the consequences can be very different. The infection can spread to healthy areas of the lungs, to the pleura, and then pleurisy develops. Sepsis is a fairly common and serious complication. With prolonged tissue destruction, cavities form in the lungs. The characteristics of the lung tissue of babies cause the rapid development of pulmonary edema and respiratory failure.

Long-term consequences develop months and years after the illness. These may be: transition to a chronic form, adhesions between the lungs and pleura, disruption of normal lung function, frequent pain in adulthood.

How does pneumonia occur in newborns?

Pneumonia in newborns is a fairly common disease that a baby can become infected with while in the womb or directly during childbirth.

Just a few decades ago, this diagnosis jeopardized not only the health, but also the life of the child, but today the situation has changed radically. Of course, the baby will have to undergo complex treatment, but the chances of his survival will be much higher.

How to diagnose pneumonia?

As a rule, pneumonia in newborns is diagnosed within the walls of a medical institution and is then under the control of medical workers. If the illness makes itself felt when the baby is already at home, the parents simply cannot help but notice the problem! The child becomes capricious, his body temperature rises significantly, accompanied by a severe cough. Trying to cope with the disease on your own is categorically not recommended, because in the vast majority of cases this only leads to a worsening of the baby’s condition.

Among the most common routes of infection are:

1. Transplacental. In this case, the unborn child is infected by penetration of the pathogen through the mother's placenta. In order to avoid such an outcome, a woman must be extremely careful, avoiding crowded places, especially during periods of worsening epidemics of infectious diseases.
2. Antenatal. The pathogenic bacteria enter the child's respiratory tract from the amniotic fluid and cause rapid infection. Treating an unborn baby is a rather complicated process, so in the absence of clear indications, doctors wait until it is born.
3. Intrapartum. In this case, infection of infants occurs directly during the birth process, especially if the woman in labor undergoes a cesarean section. The reason for this is not necessarily an infection in the mother's birth canal. It can also be invisibly present in the environment.
4. Postnatal. This route assumes that the infection affects an already born baby, both in the maternity ward and at home. However, parents are strongly discouraged from wasting time trying to find out who is to blame. Their main task is to select a qualified doctor who can prescribe high-quality and effective treatment for the baby.

No matter how dangerous and frightening intrauterine pneumonia may be for parents, it should not put parents into a state of stupor. The problem can and should be dealt with! However, this will take time.

How is pneumonia treated?

As soon as pneumonia is diagnosed in newborn children, the doctor immediately places them in a medical facility where they will receive qualified care. Trying to challenge the doctor's decision and convince him that the best care will be provided at home will be an unforgivable mistake! A fragile child's body is in the development stage and simply cannot cope with a severe infection. He should definitely get help, but only on the condition that the drug treatment does not harm other systems of the body.

In this case, a correctly prescribed course of antibiotics plays a key role in this matter, allowing to normalize the temperature and stop progressive inflammation. This course is prescribed to children without fail, regardless of the form of the disease and its severity. At the same time, the child will take powerful vitamin therapy to support the body and give it the strength to fight the disease on its own.

As a rule, visible signs of pneumonia disappear within a week, while full recovery takes several weeks. A small patient can be discharged home for further rehabilitation in about 10 days. However, this does not mean at all that at home, in case of pneumonia in newborns, parents will need to give their baby exclusively medications!

Traditional medicine methods, which are evaluated as an alternative method of treatment, can also provide significant assistance. One of them is mustard plasters, well known to many, which, in agreement with the pediatrician, can also be placed on infants. However, parents should be extremely careful in this matter so that after using them there are no burns left on the baby’s delicate skin.

Honey, whose healing properties are known to almost every person, can also help in the fight against pneumonia. It should be mixed with birch buds and boiled for 10 minutes. The child should be given this mixture immediately before going to bed. The good thing about a mixture of honey and birch buds is that it does not cause allergies and can be used not only when treating pneumonia, but also for any other infectious disease. However, before using it, consultation with a pediatrician is an essential procedure!

Prevention of pneumonia in children

The development of intrauterine pneumonia in newborns in no way depends on the baby and falls entirely on the conscience of the parents. The expectant mother should be extremely careful and not once again provoke the development of diseases. On a bad day or during the progression of infections, it is advisable to refrain from contact with large numbers of people! After all, often these are the causes of infection. What is truly important for a woman during pregnancy is the health of her child. All other desires can wait.

If parents suffer from an infectious disease, they should minimize contact with the child and be sure to wear gauze bandages on their faces!

Such, at first glance, simple methods of protection make it possible to exclude the presence of a disease in a child such as intrauterine pneumonia, which is categorically not recommended at such a tender age!

The health of a newborn child should be given due attention, because at this age many surprises are possible. If the symptoms of pneumonia have already made themselves felt, do not despair! After all, a timely visit to a doctor will certainly solve all problems and give the baby a healthy and happy childhood.

Pneumonia in newborns

Pneumonia in newborns - infectious inflammation of lung tissue - is one of the most common infectious diseases. It is dangerous for any baby, especially when it comes to bilateral pneumonia in newborns. Unfortunately, the statistics today are as follows: pneumonia in newborns is diagnosed in 1% of full-term and 10-15% of premature babies.

Types and causes of pneumonia in newborns

In medicine, the following types of pneumonia are distinguished depending on the cause of the disease:

• congenital transplacental (the pathogen enters the baby through the placenta from the mother);
• intrauterine antenatal, caused by pathogens that penetrated from the amniotic fluid into the lungs of the fetus;
• intrapartum, occurs when the baby passes through the mother’s birth canal infected with microorganisms;
• postnatal pneumonia, in which infection occurs after birth in a maternity hospital, in the neonatal pathology department (nosocomeal), or at home.

The most common causes of pneumonia in newborns are:

• infections of toxoplasmosis, listeriosis, rubella, herpes (with congenital transplacental pneumonia in newborns);
• streptococci of groups B and O, gestal mycoplasmas, tuberculosis and Haemophilus influenzae (for antenatal and intrapartum pneumonia);
• group B streptococci, cytomegaloviruses, chlamydia, Candida fungi and herpes virus type II (for intrapartum pneumonia);
• Klebsiella, Pseudomonas aeruginosa, Escherichia coli, Proteus, staphylococci (with nosocomeal aspiration pneumonia in newborns);
• mixed bacterial-bacterial, viral-bacterial.

Acquired domestic pneumonia most often occurs against the background of ARVI (acute respiratory viral infection) caused by adenoviruses.

Secondary pneumonia, which is a manifestation or complication of sepsis, aspiration syndrome, is often caused in newborns by streptococci, staphylococci or gram-negative flora.

Symptoms of pneumonia in newborns

In the case of intrauterine infection, doctors will detect signs of pneumonia in a newborn even before discharge, because often the first signs of pneumonia begin to appear immediately after the birth of the child.

If a mother and child are discharged home, a doctor must come to their home for patronage during the first month. He will monitor the baby’s condition, and he needs to talk about all the alarming symptoms, for example, the baby’s lethargy, frequent regurgitation and loose stools, refusal to breastfeed, and rapid fatigue when sucking.

If your child’s temperature rises, you should not wait for the doctor’s next visit. Call an ambulance immediately. Cough in infants may be mild, but it is important to immediately pay attention to coughing. The appearance of nasal discharge and shortness of breath in a child should also alert you. Shortness of breath leads to symptoms of blueness on the feet, face and hands. A sick child develops diaper rash more quickly.

There is no need to be afraid of missing pneumonia in your child, because signs of the disease rarely appear without a rise in temperature. And it needs to be measured periodically for preventive purposes.

A doctor who regularly examines and listens to a child can easily detect pneumonia.

What treatment is prescribed for pneumonia in newborns?

Broad-spectrum antibiotics are always used to treat pneumonia. The child needs careful care to avoid hypothermia and overheating. It is important to monitor the hygiene of his skin, often change the position of his body, and feed exclusively from a horn or using a tube. Doctors will allow breastfeeding of a sick baby only if its condition is satisfactory, namely, if intoxication and respiratory failure have disappeared.

In addition to the listed treatments, physiotherapy (microwave and electrophoresis), vitamins C, B1, B2, B3, B6, B15, the use of immunoglobulins, mustard and hot wraps twice a day, and blood plasma transfusions are also prescribed.

Consequences of pneumonia in newborns

Children who have had pneumonia (especially double pneumonia in newborns) are prone to recurrent illnesses. After discharge, they should be given repeated courses of vitamin therapy and bioregulators (aloe and eleutherococcus extract) for 3-4 months. And for 1 year the child will be under medical supervision.

Everything is fine, but then the diagnosis is intrauterine pneumonia!!! this is dangerous, what are the consequences?

Answers:

Olga

INTRAUTERINE PNEUMONIA is an infectious lung disease that occurs during intrauterine infection of the fetus and manifests itself in the first hours and days of a newborn’s life. More often observed in premature babies.
The causative agents of the disease are most often group B streptococci, influenza viruses, parainfluenza, adenoviruses, respiratory syncytial virus, mycoplasma. Infection of the fetus occurs when pregnant women become ill with respiratory viral diseases in the last weeks of pregnancy and shortly before childbirth.
Symptoms of the disease most often appear at birth or within 24-48 hours after birth. Children are born in serious condition, lethargic, pale or cyanotic. From the first hours after birth, a sharp decrease in reflexes (including sucking and swallowing) and muscle hypotonia are observed. Physiological erythema is mild or absent; dry skin, hemorrhagic rash, and pyoderma are often observed. In many children, swelling of the subcutaneous tissue forms on the lower extremities and abdomen, caused by metabolic disorders and increased permeability of the vascular wall. Body temperature in full-term infants rises to 37-40 °C, in premature infants it is reduced to 34-35 °C. From the moment it is established, breathing is rapid and shallow, sometimes arrhythmic, groaning, shortness of breath is accompanied by retraction of the pliable parts of the chest, and attacks of respiratory arrest. Regurgitation and vomiting are often observed in newborns. Physiological loss of body weight exceeds 15-30%. As the severity of the general condition increases, the manifestations of respiratory failure intensify. Breathing becomes shallow and arrhythmic. Along with pneumonic symptoms, newborns show signs of cardiovascular disorders. Prognostically unfavorable symptoms include changes in the boundaries of the heart (narrowing or expansion), the appearance of systolic murmur, attacks of cyanosis, signs of peripheral circulation disorders (pallor of the skin, acrocyanosis, marbling, hypothermia of the extremities).
The vast majority of patients have an enlarged liver. In the blood - leukocytosis or leukopenia.
When pneumonia develops due to aspiration of infected amniotic fluid during childbirth, signs of the disease appear quickly. Pallor and cyanosis of the skin, shortness of breath, attacks of asphyxia, and increased body temperature are noted. Pneumonia is often combined with atelectatic and edematous-hemorrhagic changes in the lungs.
The course of pneumonia caused by group B streptococci differs in some ways. Infection occurs in utero - as a result of an ascending infection or through contact of the fetus with infected tissues of the birth canal - during childbirth. The disease usually progresses rapidly, often ending in death within 1-2 days.
Recognized on the basis of anamnesis data predisposing to early infection of the fetus (acute and chronic infectious diseases of the mother, uterine bleeding during pregnancy, etc.), factors of early clinical signs of the disease, results of X-ray, bacteriological, virological studies of the contents of the respiratory tract, detection of pathogenic flora in amniotic fluid.
Pneumonia of newborns.
Forecast. The outcome of intrauterine pneumonia depends on the degree of maturity and reactivity of the newborn’s body, as well as on the type of pathogen and the timeliness of the use of therapeutic measures.

Freya

Why not ask your doctor this question IMMEDIATELY?? ? There is a lot of information in the search engine. It is treatable, not fatal.

How long does it take to treat pneumonia in a newborn? Are the chances of recovery high? What could be the consequences?

Answers:

liza liza

Apparently, the baby is in a hospital, i.e., under the constant supervision of doctors, so be patient and under no circumstances doubt his recovery.
In general, pneumonia is treated within 21 days; the course of treatment includes antibiotics. Don't rush to be discharged home. After discharge, the recovery period will begin. Find a good pediatrician and gastroenterologist (dysbacteriosis usually appears after antibiotics).
Olga, EVERYTHING WILL BE OK!!!

Galina Chernyavskaya

It is very unpleasant when a child is sick, and even at such an early age, my daughter, at 3 years old, had left-sided pneumonia and was treated for 21 days. 4 days is not enough, wait and don’t be upset, hope for the best, pray for good things, go to church, light a candle for yourself and your baby, if you can’t do it yourself, your relatives will do it for you. Hope for the best!

Olya boss

antibiotics and time, if one antibiotic is not enough, then add a second one and donate blood again for ESR

Fairy Winged

My daughter also had unilateral pneumonia, she was treated right in the maternity hospital for 18 days, first she was injected with one antibiotic for 7 days, then with a second, stronger one. The only side effect we had was dysbacteriosis, which was quickly cured. There, in the maternity hospital, I talked with the mothers of children who also had pneumonia (some had unilateral, some bilateral), everyone was cured and discharged, but in general, of course, I don’t know the statistics on pneumonia. 4 days is not a long time, everything will be fine, let the baby recover.

Just LANA

Firstly, a lot depends on your confidence that your child will recover! Secondly, if the baby is strictly under the supervision of doctors and nurses, then there is no need to worry too much. If the child was born healthy, there are no pathologies, then the chances are especially good. Consequences: the baby is registered after this disease for a certain time, the downside is that the immune system is greatly weakened. Speedy recovery for the little one!

Mhlu

Necessarily!! ! Rub your feet and hands every two hours. You also need to rub and massage the back and chest 3-4 times a day. As your condition improves, the number of rubbing your legs and arms can be reduced to eight.

Sergei Balanenko

Thanks girls for your feedback

Intrauterine pneumonia is the most common cause of death in newborns. After birth, the lungs are the most important organ that helps the child adapt to life in the environment. Lung damage disrupts this process, so often these children are immediately admitted from the delivery room to the neonatal intensive care unit for intensive care and mechanical ventilation.

Causes of intrauterine pneumonia in newborns

The most common causes of intrauterine pneumonia are the presence of viruses and bacteria in the body of a pregnant woman, which can penetrate the hematoplacental barrier to the fetus and infect the lungs. One can assume the likelihood of intrauterine pneumonia if a pregnant woman has suffered from acute respiratory viral infection or another infectious disease in late pregnancy.

The cause of pneumonia in newborns can be aspiration (swallowing) of amniotic fluid during prolonged labor or post-term pregnancy. Meconium (original feces) entering the respiratory tract of a newborn is especially dangerous. The risk of fetal pneumonia is higher in premature babies.

Signs of intrauterine pneumonia in newborns

The first signs of intrauterine pneumonia may appear in the first hours or days after birth. These symptoms include:

• shortness of breath;
• bluish color of the skin;
• moaning sounds.

Treatment of intrauterine pneumonia in newborns

Having suspected pneumonia in a newborn child, a neonatologist should transfer him to the neonatal department, place him in an incubator with a constant supply of humidified oxygen, and immediately prescribe antibacterial therapy. If the condition worsens and it is necessary to transfer the child to artificial ventilation, the child is transferred to the neonatal intensive care unit.

Consequences of intrauterine pneumonia

Even if timely medical care helps the baby survive, it can leave consequences in the form of the formation of atelectasis (areas of collapsed lung tissue) or the replacement of areas of inflammation with connective tissue. The altered areas of the lung tissue of such a child cannot perform their function, and subsequently emphysema (areas of increased airiness of the lung tissue) may develop in such lungs.

Prevention of intrauterine pneumonia is the prevention of acute respiratory viral infections and influenza in the mother, especially in the last weeks of pregnancy.

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 precisely 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. Caring for the patient 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.

Pneumonia in a newborn baby is an inflammation of the lungs that develops immediately after birth or in the first twenty-eight days of the baby’s life. A feature of pneumonia in such young children is that the inflammatory process quickly spreads to both lungs, and the child’s condition worsens every minute. Complications of the disease are very serious, so you need to know the main symptoms and principles of treatment for such a pathology.

ICD-10 code

J10-J18 Flu and pneumonia

Epidemiology

Pneumonia statistics indicate a high percentage of the disease in children born from pathological pregnancy and childbirth. In mothers who are active carriers of dangerous viral and bacterial infections, pneumonia, as a manifestation of generalized infection, occurs in 78% of cases. Among the total number of patients, premature babies are 40% more likely to have congenital pneumonia, even with uncomplicated pregnancy.

Causes of pneumonia in a newborn baby

Pneumonia is an acute inflammatory process of the lung tissue, which is accompanied by the accumulation of inflammatory exudate inside the alveoli and symptoms from the respiratory system. Despite such a young age, pneumonia can occur in newborns just as often as in older children. This is due to many factors and reasons. Different pathogens play a role in the development of different types of pneumonia in newborns. Therefore, in order to understand the etiology of pneumonia, you must first consider what types there are.

Based on the time of onset of symptoms, congenital and neonatal pneumonia are distinguished. Congenital pneumonia manifests itself in the first three days after birth. The cause of such pneumonia is viruses that penetrate the blood-brain barrier. Therefore, the main causative agents of such pneumonia are considered to be systemic viruses from the TORCH group - rubella virus, cytomegalovirus, herpes viruses, toxoplasmosis and syphilis. If we are talking about such an infection, then the infection occurred in the early stages of pregnancy transplacentally and pneumonia may be one of the manifestations of intrauterine infection. Congenital pneumonia can also be caused by bacteria - chlamydia, mycoplasma, listeria, ureaplasma, candida, trichomonas. Then there is a high probability that the infection occurred during childbirth or before the birth itself.

The causes of neonatal pneumonia depend on the period of occurrence: early (up to 7 days) pneumonia and late (from 7 to 28 days of life) pneumonia are distinguished. Early pneumonias are those whose causative agents can be stationary flora - infection occurs in the delivery room, in the premature ward, during mechanical ventilation. Then the probable causes can be considered staphylococci, Escherichia coli, Pseudomonas aeruginosa, Klebsiella. Late pneumonia occurs already when infected with domestic flora and more often it is an association of viruses with bacteria.

Risk factors

Such a precise division by etiological factors is very important, since approaches to the treatment of such pneumonia differ. But fortunately, not all children get sick; there are risk factors for this pathology, which include:

1. complicated pregnancy and maternal illnesses lead to disruption of the formation of the normal protective barrier - the placenta;
2. pathological childbirth - caesarean section, use of obstetric forceps - all this increases the risk of additional infection;
3. chronic or acute infectious diseases of the mother affecting the reproductive system and urinary tract increase the risk of infection during passage through the birth canal;
4. meconium aspiration during labor;
5. applying resuscitation measures for the child or performing mechanical ventilation;
6. prematurity, birth trauma or central nervous system damage;
7. improper sanitary and epidemiological conditions in the delivery room.

Pathogenesis

The pathogenesis of the development of pneumonia in a newborn is associated precisely with the immaturity of his respiratory system, which increases the risk of infection and the rapid development of the infectious process. Under the influence of pathogenic flora that penetrates the lungs, due to the presence of intensive blood supply, pathogens quickly spread through the bloodstream to both lungs. In this case, an inflammatory process occurs in the alveoli, the severity of which develops over minutes and hours. This disrupts the gas composition of the blood and severe hypoxia of the cells occurs - they lack oxygen precisely at the moment when it is needed most after birth. Lack of oxygen quickly disrupts the functioning of the brain, and then other internal organs, so intoxication develops very quickly. Such features of pathogenesis affect the clinical course of pneumonia in newborns.

Symptoms of pneumonia in a newborn baby

Clinical manifestations of congenital pneumonia appear immediately after birth or several hours later. As a rule, even before birth, pneumonia is slightly compensated for due to the fact that the baby is fed through the placenta. When a child is born, two circles of blood circulation begin to function and the lungs expand after the first breath. And then, a few hours after birth, tissue hypoxia increases and symptoms of congenital pneumonia appear. The first signs of the disease are manifested by a general severe condition - the child is born with a cyanotic or pale gray complexion, there may be a petechial rash due to intoxication. The child has a weak cry and depressed innate reflexes due to hypoxia of the central nervous system. Respiratory disturbances are also pronounced, as the body tries to restore the required amount of oxygen in the lungs by increasing breathing. This is manifested by shortness of breath, and when examining the baby, attention is drawn to the retraction of the intercostal spaces and areas above and below the collarbones, and the retraction of the sternum during breathing. Against the background of respiratory failure, tachypne and rapid heartbeat are determined. This is accompanied by weight loss due to breast abandonment, which further complicates the situation. All symptoms increase very quickly and, against the background of increased body temperature, convulsions often occur.

Features of the course of neonatal pneumonia, especially the community-acquired form, are its milder course. The lungs are affected, but against the background of relative compensation of the child’s body to the external environment. During the period when there were no symptoms, the child managed to breastfeed a little, which gave not only strength, but also factors of immune defense against infections. Therefore, the symptoms of neonatal pneumonia are not as pronounced, but they are similar. The child becomes restless and the body temperature rises. Against this background, shortness of breath appears with the participation of additional muscles in this. Intoxication increases more slowly, but it is also pronounced and depends on the speed of spread of the infection.

Bilateral pneumonia in a newborn is very common. This occurs due to the fact that the child’s body is not able to limit the inflammatory process within one segment, as in an older child. In addition, a constant horizontal position and wide bronchi with thin alveolar septa only contribute to the rapid spread of infection further to new areas. Therefore, there is no need to talk about focal pneumonia of the newborn. But unilateral pneumonia can occur in the initial stages of the disease, and especially if we are talking about late neonatal pneumonia. Then it is often right-sided in nature due to the fact that the right bronchus is wider and shorter than the left. But the process quickly spreads to the other lung, which is important in treatment.

Stages

During a clinical examination, the degree of respiratory failure is determined in order to accurately speak about the severity and the need for oxygen support or mechanical ventilation. The degree of respiratory failure can be compared with the severity, taking into account other clinical symptoms. A mild form of pneumonia in newborns is accompanied by shortness of breath and cyanosis, which appear when the child is restless; there are no symptoms from other organs, since the acidosis is moderate.

Moderate pneumonia is characterized by shortness of breath and cyanosis at rest, generalized cyanosis with anxiety, tachycardia, tachypnea, and a decrease in the level of cell oxygen saturation.

Severe pneumonia in newborns is accompanied by severe respiratory disorders, convulsions, central nervous system symptoms and the need for mandatory mechanical ventilation.

The stages of pneumonia do not differ from those in adults, the only thing is that inflammation spreads quickly and some pathogens quickly cause necrosis (staphylococcus, influenza virus, pneumocystis).

Forms

The main types of pneumonia depend on the duration of infection and the onset of symptoms.

Thus, congenital pneumonia has its manifestations immediately after birth - the child has a low degree of adaptation (low Apgar score) and manifestations of respiratory failure are immediately visible. Intrauterine pneumonia in a newborn is characterized by systemic symptoms, since the virus passes through the placenta and has the ability to penetrate many internal organs. Therefore, against the background of respiratory symptoms, other manifestations are also expressed - there may be a generalized rash on the child’s body, congenital heart defects, blindness, damage to the brain or ventricles, and enlarged liver.

Pneumonia in newborns after cesarean section is caused by bacteria that are on the instruments or in the delivery room. Therefore, it has principles of diagnosis and treatment close to early neonatal.

Aspiration pneumonia in a newborn develops against the background of meconium aspiration in a child. This can be due to post-term pregnancy or a long anhydrous period. The microflora of such pneumonia can be not only opportunistic, but also anaerobic. In addition, meconium itself is an aggressive substance that can damage the lung tissue itself.

Pneumonia in a premature newborn has its own characteristics, since his body is underdeveloped, including the respiratory and immune system, which cannot respond to infection so quickly. Therefore, in premature infants, the onset of pneumonia is gradual with an increase in general weakness, hypotension, and hyporeflexia. Then the symptoms of intoxication and respiratory failure come to the fore, while other symptoms are less pronounced. Due to the underdevelopment of the thermoregulation center, premature babies tend to have low temperatures, but they cannot have a fever. In addition, objective and laboratory data do not indicate the presence of pneumonia. Premature babies have a very high risk of complications from pneumonia and the development of sepsis.

There are some features of the course of viral and bacterial pneumonia. Viral pneumonia in newborns is often catarrhal in nature, but with a pronounced intoxication syndrome, and bacterial pneumonia is purulent in nature. Purulent pneumonia in a newborn is most often caused by intracellular pathogens, such as chlamydia. At the same time, it is very difficult for the cells of the immune system to reach the bacteria, which is accompanied by the formation of a large amount of pus. This is accompanied by symptoms from the respiratory system and pronounced destructive processes in the lungs.

Complications and consequences

The body of a newborn has a low level of protective forces, which contributes to the rapid spread of infection in the child’s body. Therefore, complications can develop over several hours with serious consequences. All complications of pneumonia can be divided into pulmonary and extrapulmonary. Pulmonary complications include pleurisy (inflammation of the pleura), atelectasis (collapse of a lung particle), pneumothorax (accumulation of air in the chest cavity, which compresses the lungs from the outside). These complications can occur as early as the second day of untreated pneumonia. Extrapulmonary complications develop due to the spread of infection by lymphogenous or hematogenous routes. These include acute otitis media, hemorrhagic syndrome, disseminated intravascular coagulation syndrome, hemodynamic disorders, persistence of fetal communications, and sepsis. Such a common infection when the lungs are affected can quickly cause the pathogen to enter the bloodstream and develop bacteremia. Sepsis for such a small child can be fatal, since removing the bacteria in this case is a very difficult task.

Among the later consequences, children who have had pneumonia experience a more frequent development of rickets and anemia, which must be taken into account when further caring for the child after discharge from the hospital.

Diagnosis of pneumonia in a newborn baby

The mother's history of pregnancy and childbirth can provide a lot of information about what type of pneumonia and what the etiological factors may be. Therefore, you need to ask in detail about all episodes of the mother’s illness, chronic infections and studies during pregnancy.

Diagnosis of pneumonia based on external symptoms should also include an objective examination. In case of pneumonia, percussion of the chest will reveal a shortened percussion sound. When auscultating the lungs, there may be weakened breathing, but moist rales and crepitus are observed only in 10-15% of cases of children with pneumonia. Therefore, you should not rely so much on objective symptoms, and here visual changes from other systems play an important role. Therefore, laboratory and instrumental diagnostic methods play a key role in confirming the diagnosis.

Tests that could confirm the etiology of pneumonia in newborns are not so informative. This is due to the fact that immediately after birth the child undergoes physiological adaptation of all organs and systems, including the circulatory system. The number of blood cells is increased, and physiological leukocyte crossover occurs on the fifth day. Therefore, changes in laboratory data that may indicate pneumonia are not as specific as in older children. But the main changes are an increase in the number of leukocytes over time and the absence of leukocyte crossover on the fifth day of the child’s life.

If it is necessary to carry out specific treatment for pneumonia in a child or the therapy carried out is ineffective, then it is possible to examine the mother for viruses and bacteria that could cause the disease in the baby. For this purpose, a serological blood test is performed to determine antibodies to certain pathogens.

Instrumental diagnostics have priority in confirming the diagnosis of pneumonia. Today, no doctor can make such a diagnosis without a chest x-ray. This method allows you to clearly determine the degree of lung damage and the localization of the process. X-ray signs of pneumonia in a newborn are deflation of the lungs and increased vascular pattern in the initial stages of the disease, and then inflammatory-infiltrative changes of a confluent nature appear.

Differential diagnosis

Differential diagnosis of pneumonia should be carried out with hyaline membrane disease, aspiration syndrome, congenital malformations of the lungs, diaphragmatic hernia, heart pathology and central nervous system injuries, which are accompanied by respiratory failure.

The symptoms of congenital pneumonia and respiratory distress syndrome are very similar, so radiography can be considered the main diagnostic method. With RDS, the lungs have a “cotton wool” appearance, while with pneumonia, the lesions are more confluent and clear-cut. But it is still difficult to differentiate these pathologies, so the principles of treatment for both pathologies are not particularly different.

Heart pathology can be excluded using ultrasound data, which makes it possible to assess the condition and function of the heart. Congenital lung defects can also be diagnosed on x-rays, as can a diaphragmatic hernia.

It is very important to differentiate the etiology of pneumonia, because the approach to treatment is different.

Treatment of pneumonia in a newborn baby

A feature of the treatment of pneumonia in newborns is that it is necessary to use not only etiological methods, but also pathogenetic and symptomatic ones. Indeed, for such a baby, even the air temperature matters, since hypothermia threatens a sharp deterioration in the condition. Therefore, you need to start treatment with a regimen.

The most appropriate mode for a newborn with pneumonia is the incubation mode, since the correct temperature mode can be used. The average temperature in the incubator for babies is 32-34 degrees, and the air humidity is 80-90% in the first days. It is very important to provide oxygen support, which can also be done directly into the incubator.

Feeding a child with pneumonia should continue with breast milk, total caloric intake should be limited but with an increase in the frequency of feedings. Only after such measures can we talk about other drug therapy.

The treatment period for pneumonia in newborns ranges from 14 to 20 days, depending on the severity of the process. Antibiotics for pneumonia in newborns are considered the main and mandatory means of treatment. In this case, treatment is carried out with two drugs, the methods of application of which are only parenteral (intramuscular and intravenous).
Treatment is carried out in stages: there are several courses of treatment depending on the type of antibiotic used. For the first course, a b-lactam antibiotic (semi-synthetic penicillin or 2nd generation cephalosporin) is prescribed in combination with aminoglycosides. If this combination of drugs is ineffective, second-course drugs are prescribed - cephalosporins 3-4 with amikacin or vancomycin.

What indicators are important in the treatment of neonatal pneumonia? First of all, they focus on the severity of shortness of breath, blood saturation and intoxication syndrome. The effect of treatment is assessed 48-72 hours after the start of therapy, and if there is no effect, then another line of therapy is used.

Along with antibiotics, it is necessary to use probiotic drugs, since dysbiosis in such children can cause diarrhea and dehydration, which will further worsen the condition.

Detoxification therapy should be carried out to correct hemodynamic disorders and restore metabolic systems. To do this, calculate the infusion based on the child’s weight, taking into account all losses and needs. If it is necessary to correct the function of vital organs, inotropic, antispasmodic and other drugs are added to the treatment.

Oxygen support is required for the child, since metabolic disorders have a very bad effect on the cardiovascular system. If the child is in an incubator, free oxygen may be supplied or through a mask. If the child is weak or premature and correction of the act of breathing itself is necessary, then special oxygen supply devices with constant positive pressure in the respiratory tract are connected. Mechanical ventilation for pneumonia in a newborn is used when the degree of respiratory failure is extremely severe and the child needs support for the very act of breathing.

The main medications used in the treatment of pneumonia in newborns are as follows:

1. Cefuroxime acetyl is a second-generation beta-lactam antibiotic that is used because of its bactericidal effect on many extracellular opportunistic microorganisms. In the treatment of pneumonia, this drug is used intravenously or intramuscularly. The dosage of the drug is from 50 to 100 milligrams per kilogram of weight per day. Side effects are possible if they affect the stomach - colitis or dysbacteriosis develops, which is manifested by bloating and stool disturbances. Precautionary measures - do not use the drug if your mother or close relatives are allergic to penicillin antibiotics.
2. Amikacin is an aminoglycoside antibiotic that is effective against staphylococcus, Klebsiella, Escherichia coli and some other bacteria that play a significant role in lung damage in utero. In the treatment of pneumonia in newborns, a dosage of 15 mg/kg/day in 2 doses is used. Side effects - sleep disturbance, drowsiness or lethargy, damage to the renal parenchyma, stool disorders. Precautions - do not use if you have kidney damage.
3. Vancomycin is an antibiotic from the glycopetide group that is effective against many gram-positive bacteria, as well as some anaerobes. It can be used for allergies to penicillin antibiotics. The dosage of the drug on the first day is 15, and then 10 mg / kg / day in 2 doses for children for the first seven days, and for older people the same dosage three times a day. Side effects may occur with rapid administration in the form of anaphylactic reactions, or later there may be hearing impairment or effects on the kidneys. Precautionary measures - the drug can cause inflammatory changes in the veins, so slow administration is recommended, changing the injection site.
4. Lactovit is a drug that contains lactobacilli, which form lactic acid and prevent pathogenic bacteria from multiplying. Thanks to this, the drug creates favorable conditions for the development of beneficial intestinal microflora. At the same time, an important factor is that such bacteria are completely resistant to antibiotics, and therefore can be used against the background of antibacterial therapy. The dosage sufficient to restore microflora and normalize the function of intestinal motility in children is half a sachet per day in two doses. The powder can be dissolved in milk and given to the baby before feeding. Side effects are diarrhea, stool discoloration, and rumbling in the intestines.

Vitamins and physiotherapy treatment for pneumonia in a newborn, they are not used in the acute period. When a child is recovering from an illness, massage and some procedures aimed at resolving adhesions can be used.

Vitamins can be taken by a nursing mother, which improves the baby’s lung tissue regeneration processes and speeds up recovery.

Traditional treatment of pneumonia in a newborn

It must be said that treatment of a newborn at home is not carried out under any circumstances, therefore folk remedies are not used for such babies. But considering that the mother feeds the baby with breast milk, with which many beneficial substances and immune factors can be transferred, the mother can use traditional methods. Knowing about women at risk who have had similar cases in their history or during a complicated pregnancy, it is possible to take some homeopathic remedies for the purpose of prevention. But any appointments should be only on the recommendation of a doctor.

Mom can use herbal teas that help eliminate toxins:

1. Tea made from linden leaves and viburnum fruits can be used in small quantities after each feeding. For this tea you need to take thirty grams of linden leaves and the same amount of viburnum berries per liter of water. You need to drink 50 grams of tea, so the baby will receive these beneficial substances at the next feeding.
2. Raspberries, as a natural antioxidant, have high antiviral and antibacterial activity. But it has a high degree of allergenicity in the body, so taking raspberry tea can be no more than twice a day. It is better to use fresh raspberries to make tea, if the season permits. But raspberries from a jar should be given less preference than pods from a raspberry bush, which has more beneficial properties. Tea should be made as usual with the addition of some berries or pods.
3. Buckthorn berries can also be used to make medicinal tea. Before this, you need to let the berries sit in sugar for two weeks, and then add two berries to the water to make this tea. You can drink two or three times a day.
4. A decoction of the leaves of coltsfoot and wild rosemary can be used already during the period of active recovery of the child, which improves the discharge of purulent sputum and improves breathing. To do this, make tea from 60 grams of leaves of both herbs and one liter of water, and mother takes 50 milliliters twice.

Homeopathy It can also be used during pregnancy by the mother, and until the child fully recovers from the disease.

1. Witch hazel is a homeopathic remedy of natural plant origin. The drug can be used for diseases in children who were born prematurely due to a pathological course of pregnancy. The method of using the drug is for the mother for three weeks. Dosage – five grains three times a day. Side effects can be in the form of insomnia or stool disturbances in the form of bowel movements, which requires reducing the dose by half.
2. Phosphorus is a homeopathic remedy of inorganic origin. This remedy acts by enhancing the synthesis of immune cells of the nonspecific immune system. It is used in the treatment of pneumonia in children when the medicine is added to the mother’s diet. Dosage of the drug: two drops every six hours in tea or water for mother. Side effects are possible in the form of allergic reactions. Precautionary measures - do not use the drug if you suspect congenital defects in the baby.
3. Argentum nitricum is a complex preparation of inorganic origin. It is used to treat babies born at term or post-term after cesarean section. Method of use of the drug in tablets. The dosage of the drug for the mother is one tablet every six hours in the acute period. Side effects can only be in the form of allergic manifestations.
4. Thuja compositum is a homeopathic remedy of natural plant origin, which is recommended for use specifically to normalize the recovery of the body after discharge home. This plant is an excellent remedy for restoring a child’s appetite and adapting to the outside world after suffering from respiratory pathology. Method of application - in the form of drops, dissolving them in clean water. Dosage – three drops per fifty grams of water for mother three times a day. Side effects are often observed in the form of bowel dysfunction and insomnia. Precautionary measures - cannot be used if there is a family allergy to coniferous trees.

Recovery of a newborn after pneumonia is not so fast, since not only clinical recovery with elimination of the pathogen is necessary, but it is also necessary to restore normal functioning of the lungs, heart and control of vital functions. With pneumonia, the natural process of synthesis and restoration of surfactant levels is disrupted, so it takes time for the normal function of the respiratory system. In total, if there are no complications, then the acute period may end after four weeks, but full recovery comes after three to four months. At this time, the child requires the most gentle and attentive home care, adequate nutrition and good care.

Forecast

The prognosis for pneumonia may be favorable if treatment is started on the first day. The longer diagnosis and treatment are delayed, the less chance there is of avoiding all complications. The mortality rate from pneumonia in newborns is very high, especially in premature infants.

Pneumonia in a newborn develops more often against the background of pathologies of pregnancy, childbirth or prematurity. This is caused by the child’s low immunity, which must be taken into account when treating such children. Complications of pneumonia are very serious, so it is important to prevent the disease. But every mother should remember that the best prevention is the birth of a healthy and strong baby and feeding him with breast milk.

It is important to know!

Changes in the color of children's stool can cause concern for young, inexperienced parents. Sometimes it is justified, but generally the greenish tint of infant feces is completely acceptable and does not in itself convey information about the child’s illness.

Pneumonia itself is a serious disease, and if we are talking about small children, the situation can be critical. Congenital pneumonia in newborns is not so rare, and this is due to the fact that during pregnancy the expectant mother suffers an infectious disease. This subsequently affects the child, and the disease progresses in the first three days.

When a baby is born, the symptoms are immediately visible, and the painful condition is accompanied by asphyxia, which occurs during childbirth, and the fact that the child is premature.

Breasts are a special category of patients, since their defenselessness and vulnerability to severe infection is obvious. The physiological characteristics of the baby contribute to the fact that the risk of getting sick increases significantly. The narrow passages in the bronchi and larynx do not allow us to say that a baby can fight for life just like an adult. The mucous membrane in babies is prone to swelling, and removing sputum from the lungs is quite a difficult task. All systems have not yet been launched; they are not capable of functioning fully. The lungs are more filled with blood than in adults, less elastic and therefore vulnerable.

Despite the fact that inflammation can occur in a baby outside the hospital, most often, the most severe cases occur when infected in the womb. It may also be the consequences of previous diseases, such as ARVI, whooping cough, measles.

With congenital pathology, the risk that the disease will be more severe than usual is quite high.

The symptoms of pneumonia that was acquired in utero can be determined by the following signs:

• the skin has a bluish tint, the most pronounced manifestations are in the lips and tongue, the legs and arms may be bluish;
• the cry at birth is very weak or not heard at all, since inflammation of the lung tissue does not allow it to manifest itself in full force;
• breathing is uneven, noise and wheezing are heard;
• the temperature in children born on time is significantly elevated, as for not full-term, it is below 36 degrees;
• the child is lethargic, reacts poorly to stimuli, reflexes are reduced;
• swelling of the legs may occur;
• the gag reflex is pronounced, constant regurgitation is observed, both after meals and between them;
• weight decreases, the umbilical cord falls off much longer than in healthy children, and the wound in the navel area may become inflamed.

The symptoms that indicate that infection occurred during childbirth are similar, but there are certain differences:

• high body temperature;
• refusal to eat, regurgitation is constantly observed, and vomiting occurs;
• lips and the area around the nose acquire a bluish tint;
• the stool is disturbed, constant abdominal pain, the child is capricious and sleeps poorly;
• in full-term babies, breathing is noisy, with wheezing, while not full-term babies breathe weakly and rarely;
• intoxication of the body does its job, and this period is characterized by: weakness, drowsiness, poor reaction.

Types

The incubation period is short and can range from several hours to seven days. Several forms of pneumonia in newborns, intrauterine and acquired, have been identified. Congenital ones received during pregnancy are divided into:

• transplantental, in which the pathogen enters the baby through the mother’s placenta;
• intrapartum, when infection occurs during the passage of the child through the birth canal;
• antenatal, in which infection occurs through amniotic fluid and affects the lungs.

After birth, the baby is also at high risk of getting sick, since the body is weakened, the immune system is not yet working, or is weak, which leads to infection. A distinction is made between infection outside the hospital, when a baby is admitted already infected, and in-hospital infection, if pneumonia occurs during a stay in the maternity hospital. This can also happen in the intensive care unit or in the pathology department. It should be noted that clinical manifestations also have a certain qualification, and they are divided into several types:

1. Focal, in which the focus and area of ​​the lesion are quite large. The disease develops progressively, over about one week, or a sudden, rapid development over three days, while the course of the disease occurs in a mild form, easily treatable with certain groups of antibiotics;
2. segmental does not manifest itself in any way; only with the help of radiography can compaction in the segments of the lungs be determined, and it is usually caused by a viral infection. Both ARVI and influenza can cause it. There may be similarities with the segmental form, the symptoms are similar in the initial stage, but the overall picture, which can be identified using radiography, appears only after 2 weeks;
3. lobar differs in that its manifestation is influenced by the child’s allergic resistance to infection. Against the background of bacterial diseases, this can be extremely rare, since the child’s body has not encountered such an infection and does not perceive it;
4. The intertitial form is characterized by compactions and is accompanied by an allergic reaction. Rashes and peeling appear on the skin, which may indicate the nature of the disease.

Causes

Several causes that can cause this severe manifestation of pneumonia are divided into subgroups. The most common is bacterial infection. These can be streptococci, anaerobic microorganisms that can exist in an oxygen-free environment, or bacteroids that live in the soil. Listeria can also be found there.

Viruses can also cause the disease, with cytomegavirus and herpes being particularly common. Herpes occurs against a background of reduced immunity. If during pregnancy the mother suffered one of the forms of herpes, then there is a high risk that the baby will be born with a pathology. Therefore, it is so important to follow all the rules and recommendations of doctors.

Fungal pathogens are also observed, which, with a weakened immune system, become more active and penetrate the lower respiratory tract.

Much depends on what chronic diseases the woman suffered from, how she carried the child, and under what conditions.

Combined pneumonia can also be observed in newborns, the consequences of which are not always good. It is important that there is an experienced specialist nearby who can determine that the baby is sick and take the necessary measures. It is diagnostics that is in the foreground; sometimes the baby’s life depends on the speed of decision-making.

Prevention

First of all, it is worth paying attention to the state of the epidemiological situation in the maternity hospital. It is this factor that is significant. Most often, congenital pneumonia in newborns occurs inside the hospital, which is associated with poor hygiene. Recently, the mortality rate from pneumonia was a significant percentage, measures were taken and certain requirements were adopted that helped to avoid many troubles.

At the moment, all conditions have been created to localize the infection as soon as possible and avoid death.

Prognosis for the course of the disease depends on many factors, and with timely detection of the disease and implementation of operational measures to neutralize the cause of the disease, the success of therapeutic actions is guaranteed.

Breastfeeding is advisable, since through breast milk the child receives all the necessary enzymes, the mother’s immune protection, and this prevents the penetration and activation of the virus in the baby’s body.

After the birth of a child, it is better not to expose the child to the risk of infection, not to stay in public places, and try to isolate him from potential patients. The baby's body is so weak that it can accept any infection, and thereby be at risk of getting sick.

It is important for a mother, before becoming pregnant, to eliminate all inflammatory processes in the body, cure all possible diseases, and only then plan a pregnancy.

Treatment

Each child should have an individual approach, since only after a thorough examination of the mother’s pathology, determining whether she has diseases, can effective treatment be prescribed. It is advisable to stay in a hospital, and, at the first signs of illness, a prerequisite for a speedy recovery is the provision of qualified assistance. In this case, you cannot do without antibiotics, and for a little one this is always fraught. But, with the right approach, everything can be corrected, and sometimes the child’s life depends on the doctor, mother, and loved ones.

Carry out regular monitoring of body temperature and respiratory rate. The skin and mucous membranes must always be in perfect condition. Breastfeeding is indicated, good nutrition is the key to successful treatment.

Immunoglabulins and antibiotics are indispensable drugs during treatment; only with their help can the disease be defeated.

Complications

If therapy was carried out in a timely manner and adequate drugs were prescribed to help localize the disease, then the prognosis for the treatment of a disease such as congenital pneumonia in newborns is quite favorable. Within a few weeks everything will return to normal and the baby will be healthy.

If the disease is neglected, respiratory failure, toxicosis, and refusal to eat appear, which leads to death.

In premature babies, the risk of developing dysplasia is high, the lung tissue does not function at full capacity, and re-exacerbation of diseases associated with the bronchopulmonary system occurs. This often leads to death.

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