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, pale 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 sign. 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, grey). 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 infection moves from a 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.

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

Causes and risk factors

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

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

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

Important aspects:

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

Risk factors for developing the disease:

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

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

Symptoms

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

Signs of pneumonia in a newborn due to intrauterine infection:

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

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

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

• diarrhea;
• conjunctivitis;
• pustular skin lesions.

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

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

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

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

Dangerous symptoms of pneumonia in infants and newborns:

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

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

Complications

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

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

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

Treatment methods

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

Non-drug therapy

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

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

Drug therapy

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

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

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

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

Other treatments for pneumonia:

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

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

Pneumonia is a dangerous disease. In a newborn, pneumonia is especially severe. The disease develops either immediately after the baby is born or during the first month of his life. The peculiarity of inflammation in such babies is that the pathological process rapidly spreads to both lungs, and therefore the condition of the newborn is getting worse every minute. Complications of this pathology can be very serious and affect the child’s future life. Therefore, it is so important for new parents to know about the characteristic symptoms, treatment principles, causes and consequences of pneumonia in newborns.

It is believed that pneumonia is most often diagnosed in children born from pathological pregnancy and difficult childbirth. In addition, the majority of mothers are carriers of viral and bacterial infections, which the baby’s weak immunity is not yet able to fully resist. According to statistics, pneumonia is most often diagnosed in newborns after cesarean section and premature babies.

Main causes of the disease

An acute inflammatory process that occurs with damage to lung tissue is accompanied by a concentration of exudate inside the alveoli. As a result of this pathological phenomenon, symptoms from the respiratory system develop. Pneumonia in newborns, despite their early age, occurs as often as in older children. This is attributed to many factors.

For the development of pneumonia in infants, a prerequisite is the penetration of pathogenic microflora into the body. Success in the treatment of pneumonia in newborns largely depends on the timely determination of the type of pathogen and the selection of an antibiotic sensitive to it.

In the first months of life, children are diagnosed with congenital or neonatal pneumonia. In the first case, we are talking about intrauterine pneumonia in newborns, which manifests itself during the first three days after birth. Viruses that penetrate the placenta can provoke the development of this disease even in the perinatal period. The main causative agents of intrauterine pneumonia in newborns are considered to be microorganisms that cause infections from the TORCH group. These include:

• rubella;
• cytomegalovirus;
• herpesvirus;
• toxoplasmosis;
• syphilis.

As a rule, all pregnant women are tested for the presence of TORCH viruses in the body at the antenatal clinic. If the mother became ill with an infection in the first trimester, pneumonia was likely one of the complications of transplacental infection. A difficult pregnancy and illnesses suffered by a woman can lead to partial destruction of natural protective barriers.

The cause of pneumonia in newborns can be infection with pathogenic bacteria before birth or during passage through the mother's birth canal. The causative agents of the disease in this case may be:

• chlamydia;
• mycoplasma;
• candida;
• listeria;
• ureaplasma;
• Trichomonas.

Opportunistic microorganisms are also capable of causing neonatal pneumonia, which is distinguished by the timing of its occurrence (early - up to 7 days, later - from 7 to 28 days). These include staphylococcus, streptococcus, Escherichia coli, Pseudomonas aeruginosa, and Klebsiella.

Late pneumonia usually occurs after arriving home. Early forms of the disease can be caused by stationary flora. Typically, infection occurs in the delivery room or in the premature ward during artificial ventilation of the lungs. Other reasons for a child becoming infected in the maternity hospital are:

• Difficult childbirth. Pneumonia in a newborn after cesarean section or the use of obstetric forceps is a very common consequence.
• Chronic or acute infectious diseases of the mother affecting the genitourinary system.
• Meconium aspiration during childbirth.
• Resuscitation measures, including mechanical ventilation.
• Profound prematurity.
• Injuries during childbirth.
• Inconsistency of the situation in the delivery room with sanitary and hygienic standards.

Pathogenesis of the disease

Pneumonia in a newborn develops against the background of an immature respiratory system, which increases the risk of infection and the proliferation of pathogenic microflora. With intensive blood supply, pathogenic microorganisms that penetrate the body quickly reach the lungs. In this case, inflammation first originates in the alveoli. Pathological changes entail disturbances in the gas composition of the blood, so severe hypoxia is observed - the cells are sorely lacking oxygen. Its deficiency can affect the functioning of the brain, and then internal organs. Without treatment, the child will begin to become intoxicated throughout the body.

Symptoms in infants

It is impossible to say exactly how long pneumonia in a newborn is treated. In many ways, therapy depends on the severity of the disease and the severity of the clinical picture of the disease. The first symptoms of congenital pneumonia in a newborn may appear immediately after the baby is born, literally within a few hours. Manifestations of this dangerous disease for a child can be seen in his condition:

• the baby is born with a pale gray skin color;
• there may be a rash due to intoxication of the body;
• the baby is weakened, unable to scream loudly;
• innate reflexes are suppressed;
• increased breathing is observed;
• retraction of intercostal spaces;
• retraction of the sternum when inhaling;
• rapid heartbeat;
• body weight below the norm established for newborns;
• the child refuses the breast offered by the mother;
• high body temperature.

As symptoms increase, which happens quite quickly, the child may experience seizures. The congenital form of pneumonia is especially severe in infants. Every minute matters; without treatment, the baby will die.

Neonatal inflammation caused by community-acquired flora is characterized by a milder course, since by this time the baby has already gained a little weight, fed on mother’s milk, and acquired additional immune protection against pathogens. The symptoms of neonatal pneumonia are similar to those of congenital pneumonia, but are less severe. The newborn becomes restless, capricious, and loses appetite. Due to pulmonary inflammation, severe shortness of breath appears.

Features of the disease in infants

Bilateral pneumonia in newborns is quite common. This is due to the fact that the baby’s body is not yet able to fight the inflammatory process within the boundaries of one area, as in adults and older children. In addition, a constant lying position and fairly wide bronchi with small alveolar septa allow the infection to spread more quickly to other segments. Consequently, there is no need to talk about focal pneumonia in newborn babies.

In the initial stages of the disease, infants most often develop a one-sided form. In the majority of cases, this is exactly what happens with late neonatal pneumonia. The first lesion appears on the right side. This is due to the fact that the right bronchus is wider and slightly shorter than the left - this is a “standard” physiological feature. However, the inflammatory process quickly affects the left lung, so after losing a couple of days, bilateral pneumonia will have to be treated.

What could be the consequences

It is no secret that the immunity of a newborn child has not yet had time to strengthen. Accordingly, the baby’s body is practically unable to fight infection. If treatment is not started on time, complications develop rapidly, within the first hours or days. All possible problems that pneumonia can lead to are conventionally divided into pulmonary and extrapulmonary. The first group includes:

• pleurisy (inflammatory damage to the pleura);
• atelectasis (collapse of lung particles);
• pneumothorax (concentration of air in the sternum, leading to compression of the respiratory organs from the outside).

Such consequences of pneumonia in newborns can occur as early as the second day. Extrapulmonary complications are the result of hematogenous transmission of infection. These include otitis media, hemorrhagic syndrome, hemodynamic disorders, and sepsis. Any bacterial infection carries a risk for the child, since bacteremia (infection entering the bloodstream) threatens the baby’s death.

Some time after pneumonia, a newborn may experience complications in the functioning of the cardiovascular system, and there is also a possibility of developing rickets and severe anemia.

Diagnosis of the disease

Doctors draw basic information about a newborn’s illness from the mother’s medical history, history of pregnancy, childbirth, and the results of laboratory and instrumental studies. Next, an objective examination of the child is carried out.

With pneumonia, percussion of the chest is accompanied by a shortened, muffled tone. Newborns with pneumonia have weakened breathing, usually without moist rales or crepitus. You cannot rely only on external manifestations of the disease and visual changes from other systems. The key role in diagnosing pneumonia in infants belongs to laboratory and instrumental studies:

• clinical blood test (increased leukocyte counts);
• general urine analysis;
• chest radiography (establishing the degree of thoracic damage).

By the way, without an X-ray of your hands, no specialist will determine the diagnosis. Radiography allows you to find out the localization of the pathological process. Signs of pneumonia in a newborn in the image are deflation of the lungs, the severity of the vascular pattern (especially in the initial stages of the disease). Later, inflammatory and infiltrative changes occur.

Treatment of pneumonia in newborns

Pneumonia in a newly born child requires serious, thorough treatment and cannot be delayed. Therapy involves taking into account etiological, pathogenetic and symptomatic factors. Even the air temperature matters: for a weakened baby, the slightest overheating or cooling can cause a sharp deterioration in the condition. If a child was born prematurely, the incubator mode is the most suitable for him - only in this way will doctors be able to set the most comfortable temperature for him and provide oxygen support.

The average duration of treatment for pneumonia is 2-3 weeks - it all depends on the severity of the disease. The main medications are antibiotics. It is worth noting that the treatment is carried out comprehensively, using two antibacterial medications. Medicines are administered only parenterally (usually intramuscularly).

"Cefuroxime"

This is a beta-lactam antibiotic, which is used due to its bactericidal properties. The active substance inhibits the activity of many extracellular opportunistic and pathogenic microorganisms. In the treatment of pulmonary inflammation, this drug is administered by injection. The daily and single dosage is determined by the doctor, but usually it is no more than 100 mg per kilogram of the child’s weight over 24 hours.

Like any other antibacterial drug, Cefuroxime brings a number of adverse reactions. Most often, when using the drug, intestinal dysbiosis occurs, which is manifested by bloating, colic, and stool disorders. If the baby's mother or his close relatives are prone to an allergic reaction to penicillin drugs, this remedy should not be used.

"Amikacin"

An antibiotic from the aminoglycoside group, which leaves no chance for staphylococcal infections, E. coli, Klebsiella and other bacteria that can infect the lungs during the prenatal period. The optimal daily dosage for infants is 15 mg/kg of baby's weight. The drug is administered to the child twice a day for a week. Side effects include possible sleep disturbance and intestinal dysbiosis. Amikacin should not be used for kidney damage.

"Vancomycin"

The drug is a representative of a group of glycopeptides that are effective against most gram-positive and anaerobic bacteria. This drug is an alternative to Cefuroxime, as it can be used for allergies to penicillin antibiotics. The dosage for newborns is 10-15 mg/kg of the child’s weight. The daily amount of medication is divided into two doses. However, when prescribing this drug, the doctor must take into account that Vancomycin can cause inflammation of the vein at the injection site. The process of parenteral administration of an antibiotic requires caution and slowness.

Probiotics in the treatment of pneumonia

Of great importance are drugs that help restore the microflora disturbed by antibiotics - these are drugs containing lacto- and bifidobacteria. These include “Laktovit”, “Bifiform”, “Florin Forte” and many other products that create favorable conditions for restoring normal intestinal microflora. The dosage for the baby is determined by the attending physician. Some drugs are allowed to be dissolved in breast milk and given to the baby before direct feeding.

No self-medication!

It is unacceptable to give your child any antibiotics on your own. Realizing the danger of the disease, it is necessary to urgently show the child to the doctor. Heavy breathing, persistent fever, rapid heartbeat - all these symptoms indicate the need to provide qualified medical care to the baby.

When treating pneumonia in newborns, doctors primarily focus on the severity of shortness of breath and examination results. Experts evaluate the effect of treatment 2-3 days after the start of therapy. If there is no even minimal result, therapy is built according to a different scheme, which involves changing the antibiotic.

The prognosis of the disease is favorable if treatment was started on the first day. Otherwise, the chances of recovery and the absence of complications are dwindling every day. This is also confirmed by high mortality rates from pneumonia among newborns, especially those born prematurely.

Pneumonia can develop in a newborn in utero or appear as a result of infection of the lungs in the first days after birth. Premature babies are more likely to suffer from congenital pneumonia.

Depending on the nature of the occurrence of pneumonia in newborns, the following forms are distinguished:

• congenital;
• aspiration;
• acquired.

Congenital pneumonia develop in utero, provoked by infections transmitted through the placenta, contaminated amniotic fluid.

Aspiration occurs during aspiration (absorption of fluid into the lower respiratory tract) of amniotic fluid, especially in the last stages of pregnancy.

Acquired pneumonia develop in newborns, either hospital-acquired or hospital-acquired, during the first 2 days of hospital stay. Infection occurs through airborne droplets from surrounding adults.

The incidence of pneumonia among full-term newborns is 1%, and in children born prematurely – 10%. The incidence rate is even higher in premature newborns (40%) who are on mechanical ventilation.

The disease has a very high mortality rate - from 5 to 10% of cases, and there are also risk factors in the form of late recognition, congenital immunodeficiency conditions (AIDS).

Factors contributing to infection

Pneumonia in newborns is caused primarily by bacterial infection. Infection can occur in utero, during the passage of the fetus through the birth canal, in the first days of life.

Increase the likelihood of developing pneumonia in newborns:

• maternal diseases of an infectious nature;
• prematurity of the baby;
• resuscitation measures at birth, prolonged hypoxia in a newborn.

A prerequisite for infection during childbirth may be premature rupture of amniotic fluid and the existence of an anhydrous interval before birth lasting more than 12 hours.

Among the causative agents of inflammation in newborns, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Chlamydia, Proteus, Pneumocystis, and Mycoplasma are noted.

Routes of infection

Pneumonia can be a primary disease, or it can arise as a secondary source of infection during sepsis, a viral infection.

In primary pneumonia in newborns, the main methods of infection are:

• infection through the placenta from an infected mother during intrauterine development;
• penetration of amniotic fluid into the lungs during aspiration;
• by airborne droplets in the first days of life.

The development of the disease is facilitated by the imperfection of the child’s immune system and immaturity of the lung tissue, especially in premature infants. A common cause of congenital pneumonia in newborns is aspiration of infected amniotic fluid, which can result in pneumonia and sepsis.

Aspiration of amniotic fluid in utero occurs as a result of the baby taking premature breaths in late pregnancy.

At this stage of pregnancy, meconium can be detected in the amniotic fluid - fetal excrement, which, when entering the lungs, partially blocks the airways, causing overstretching of the alveoli.

The risk of aspiration of amniotic fluid with meconium is especially high in post-term infants. The likelihood of hypoxia during breech presentation of the fetus also serves as a risk factor for aspiration pneumonia, and an indication for cesarean section delivery.

If the newborn was born by cesarean section, pneumonia may still develop as a consequence of hypoxia 2 days after the operation.

Meconium aspiration syndrome is observed in 1.3% of newborns, and some of them develop pneumonia in the first 2 days.

Congenital pneumonia in a newborn can be caused by rubella, cytomegalovirus, penetrating the placenta from the mother. Lung disease can be a consequence of tuberculosis, malaria, listeriosis, syphilis, which a woman suffers from during pregnancy.

Nature of the disease

Pneumonia in newborns can occur as a bilateral or unilateral process, in terms of prevalence it can be focal, segmental, or lobar.

Focal pneumonia in newborns it is benign, can be treated with antibiotics, and resolves within 4 weeks.

How long is it treated? lobar pneumonia in a newborn, depends on the reactivity of the child’s immune system. This disease is extremely rare and is caused by a bacterial infection.

Segmental pneumonia caused by a virus, occurs after acute respiratory viral infection, recovery is noted in 2-3 weeks. The diagnosis of congenital pneumonia in newborns is established only when confirmed by radiographic data.

This is due to the fact that with some types of inflammation, for example, with the segmental form, the symptoms may be mild, and the disease is diagnosed only by changes on the radiograph.

Bilateral pneumonia in newborns is severe and characterized by high mortality.

Bilateral lung damage can be caused in infants by pneumocystis and chlamydia. In addition to lung tissue, the infection affects the cardiovascular system and reduces the level of hemoglobin in the blood.

Symptoms

Congenital pneumonia is characterized by the appearance of symptoms of respiratory and heart failure, which is accompanied by:

• disruption of the digestive system;
• regurgitation mixed with bile;
• marbled pallor of the skin;
• decreased body temperature;
• tachycardia, muffled heart sounds when listening;
• disruption of the digestive tract;
• enlarged spleen, liver;
• weak breathing with small-caliber bubble wheezing.

Cough and fever are not typical for newborns with intrauterine infection with pneumonia, but jaundice may develop.

Neonatal pneumonia, which occurs in the first days of life, is characterized by:

• refusal to eat, regurgitation;
• pale skin;
• high temperature;
• appearance;
• rapid breathing;
• decrease in blood pressure.

Treatment

If meconium is detected in the amniotic fluid and there is an increased risk of pneumonia, the newborn is provided with assistance and non-drug treatment during childbirth.

1. Even before the appearance of the shoulders, the contents of the nose and oral cavity, which is amniotic fluid with meconium, are sucked out with a thin catheter to prevent aspiration of the contents into the lungs.
2. If muscle tone is low, the trachea is intubated with a thin endotracheal tube.
3. Oxygen therapy is carried out, saturating the baby’s blood with oxygen.
4. According to indications, they are transferred to artificial ventilation for 1-2 days.

The prognosis for newborns with meconium aspiration syndrome is complicated not only by the risk of congenital intrauterine pneumonia, but also by neurological disorders due to cerebral hypoxia. About 1/5 of such children lag behind their peers in physical and psycho-emotional development.

Treatment of pneumonia in newborns is carried out only in a hospital using antibiotics and immunocorrective therapy.

According to indications, oxygen therapy is used to increase the concentration of oxygen in the blood - inhalation of a heated air-oxygen moistened mixture.

Depending on the nature of the infection, antibiotics are administered:

• for streptococcal, staphylococcal, enterococcal infections, infection with Klebsiella, Listeria, ampicillin, + clavulalate are administered;
• for infection with spirochete pallidum - penicillin;
• against Pseudomonas aeruginosa, Candida fungi, anaerobic Serratia bacillus - ceftazidime, cefeperazone;
• when infected with mycoplasmas, chlamydia, erythromycin is given intravenously.

Along with the use of antibiotics, therapy with antifungal drugs (Diflucan), vitamin therapy, and water-salt balance are monitored.

Prevention

The main prevention of pneumonia in newborns is the treatment of infectious diseases of the mother during pregnancy, compliance with the rules of child care in the first days after birth.

Of no small importance is the control of nosocomial infections and the use of disposable materials when caring for a child.

Complications

There is a risk of adverse effects from congenital intrauterine pneumonia in severely underweight preterm infants. In this case, the child is at risk of bronchopulmonary dysplasia.

Severe pneumonia in newborn full-term infants may be accompanied by atelectasis - collapse of the lung. With low reactivity of the immune system, the consequence of inflammation can be multiple organ failure and neonatal sepsis.

Forecast

The prognosis for full-term newborns who have had pneumonia that developed in utero or acquired in the first days of life is favorable. Children do not lag behind their peers and develop normally.

In premature newborns with significant weight loss, the prognosis is complicated by mycoplasma and bacterial pneumonia with the likelihood of developing bronchopulmonary dysplasia.

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

Table of contents:

Features of congenital pneumonia

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

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

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

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

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

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

Causes of congenital pneumonia in newborns

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

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

Features of TORCH complex infections

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

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

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

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

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

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

Please note

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

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

Features of intrauterine pneumonia of other etiologies

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

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

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

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

Special conditions for provoking congenital pneumonia

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

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

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

How does congenital pneumonia manifest?

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

Please note

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

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

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

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

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

Please note

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

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

Clinic of specific TORCH pneumonia and bacterial

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

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

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

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

Consequences of congenital pneumonia

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

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

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

Methods for diagnosing congenital pneumonia

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

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

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

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

Features of baby tests for suspected pneumonia

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

Please note

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

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

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

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

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

How to treat congenital pneumonia in a child?

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

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

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

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

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

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

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

What is the prognosis for babies?

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

Alena Paretskaya, pediatrician, medical columnist