Pneumonia in a newborn child

About pneumonia in a newborn child

Features of bronchopulmonary system in fetus and newborn.

There is no air in the fetal lungs in utero. But he starts breathing from the 23rd week of pregnancy. However, before this period, gas exchange in the fetal lungs can not yet be carried out because of anatomical and functional immaturity.

By the time of birth, the baby's lungs are filled with amniotic fluid. At the first inhalation in a full-term baby, the inspiratory volume is approximately 70 ml, with almost all the alveoli open. Amniotic fluid is rapidly absorbed into the blood and interalveolar space. In preterm infants, the first inhalation is more difficult, because in addition to the immaturity of the respiratory system they are deficient in the nervous cardiovascular system and many metabolic processes.

The breathing of a born child is intermittent, uneven. There are pauses, in full-term children they last for 1-6 seconds, in premature infants - 5-12 seconds.

The causes of susceptibility of newborns to pneumonia:

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immaturity of 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 weakly functioning, the cough reflex is reduced;
the airways along the entire length are narrow, which causes difficulties in the passage of air;
the ribs are located horizontally, the intercostal muscles are poorly developed, so the chest excursion is reduced;
immaturity of the nervous system aggravates the insufficiency of the respiratory system.

These features, as well as a unique response of the immune system, make newborns particularly vulnerable to pneumonia.The vulnerability of babies exists, even if the pregnancy was good, the birth was not complicated, 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 joins.

Pneumonia in newborns is an acute infectious lung disease that can develop as an independent disease or as a complication. It runs pretty hard. The death rate from illness in children 1 month is 30-40%. The frequency of occurrence in term infants varies between 0.5-1%, in preterm infants - up to 10%.

Inflammation of the lungs in newborns is classified into the following forms:

focal;
segmental;
interstitial.

By causal factor:

hospital-acquired;
out-of-hospital.

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

congenital pneumonia (infection is transmitted from the mother through the placenta);
intrauterine (when infected with amniotic fluid in the lungs);
intranatal (bacteria fall during labor from the genital tract of the mother);
postnatal (the disease developed after birth in the hospital or at home).

Causes of pneumonia in a newborn baby:

bacteria;
viruses;
mushrooms;
pneumocysts;
mycoplasma;
chlamydia.

In most cases, mixed pneumonia is observed, for example, bacterial-viral. The frequency among the viruses is dominated by adenoviruses, influenza viruses and parainfluenza. Among the bacteria - Staphylococcus aureus, pneumococcus, alpha-hemolytic streptococcus. The share of Klebsiella, bacteria of the intestinal group, and protease in the structure of pathogens has significantly increased.

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 cyanotic shade of the skin, does not cry at once, weakly or does not cry at all, little moves with hands and feet, reflexes are weak. When feeding in such children, there is abundant regurgitation. Breath weakened, on exhalation a groan is heard, sometimes there is a semblance of coughing. In addition to the respiratory system, cardiovascular, digestive (bloating, abdominal pain, enlarged spleen) of the child's system suffer. Body temperature is normal, or reduced. At full-term children there may be a fever from the second day of the disease. Symptoms last about 3-4 weeks. This type of inflammation is characterized by severe course and high mortality.

Pneumonia, which develops in the first days of a child's life, has a long hidden 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 put, because a microbial infection quickly joins it.Influenza pneumonia of the newborn is characterized by an unexpected beginning. Body temperature rises to 39 ° C or more, convulsions, anxiety, refusal to eat, meningeal symptoms appear. It is also possible atypical flow with a temperature of up to 38 ° C and without strong signs of intoxication. A feature of this type of pulmonary inflammation is the destruction of blood vessels and hemorrhage in all the organs of the child. Such children may have consequences in the form of encephalitis, meningitis, hemorrhages in vital organs, otitis, pyelonephritis.

Pneumonia caused by the parainfluenza virus develops in parallel with the inflammation of the pharynx. Clinically, it proceeds more easily than influenza, intoxication is less pronounced, the temperature rises slightly. But weakness, a decrease in reflexes, pale extremities are still present.

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

Chlamydia and mycoplasmal pneumonia occur most often in utero. They not only hard to leak, but are also difficult to treat. For these pneumonia is characterized by cough, swelling, and sometimes an eruption. These diseases often lead to fatal outcomes.

What are the differences between the course of pneumonia in term and premature infants? In preterm infants:

Symptoms such as dyspnea, cyanosis of the skin, respiratory depression predominate;
increased temperature is rare;
complications from both the lungs and other organs are more common;
from the mouth a foamy liquid is released;
pneumonia often causes sepsis;
the disease lasts a long time and leaves behind irreversible consequences.

Treatment of pneumonia in newborns

The main thing in therapy of pneumonia is antibacterial therapy. Most of the infectious agent at the time of antibiotic prescription is not yet known, so the doctor makes his assumptions. If the drug is selected correctly, then within 2-3 days there will come an improvement in the condition. Otherwise, you need to change the medication for others.

Newborns use three groups of antibiotics: penicillins, cephalosporins and macrolides. The most effective for starting therapy are protected penicillins (amoksiklav, augmentin, fleumoclave, unazin). If there is a suspicion of chlamydia or mycoplasma, the choice falls on macrolides (azithromycin, clarithromycin, roxithromycin). Cephalosporins are used as alternative drugs. Treatment of a child with antibiotics is carried out at least 10-14 days.

When identifying the pathogen to antibiotic therapy, it is possible to attach treatment with specific immunoglobulins (antistaphylococcal, antigrippic, anti-syncope, etc.).

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

The position of the child also matters. If the inflammation of the lungs is one-sided, then the kid is put on a healthy side, and if bilateral - change side every 2 hours. It is advisable that the mother or the medical personnel give the child a chest massage by tapping. This will also facilitate the departure of mucus. From physiotherapy in the acute phase is allowed only the microwave on the chest area.

What are the consequences of pneumonia for a child?

Time is of the utmost importance. The earlier treatment is started, the better the prognosis for the child.If the treatment is started in the first day, then pneumonia can be cured without a trace. But if antibiotic therapy is started late, the consequences can be very different. Infection can spread to healthy areas of the lungs, to the pleura, then pleurisy develops. Sepsis is a fairly frequent and formidable complication. With prolonged destruction of tissues in the lung cavities are formed. Features of children's lung tissue cause rapid development of pulmonary edema and respiratory failure.

The long-term consequences develop after months and years after the disease. This can be: transition to a chronic form, adhesions between the lungs and pleura, disruption of normal lung function, frequent soreness in a more adult age.

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Pneumonia in newborns

Pneumonia of the lungs in newborns - infectious inflammation of the 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, 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 causative agent penetrates the baby through the placenta from the mother);
intrauterine antenatal, is caused by pathogens that have penetrated into the fetal lungs from amniotic fluid;
intranatal, 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 department of neonatal pathology (nosocomial), 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, tuberculous and hemophilic rods (with antenatal and intranatal pneumonia);
streptococcus group B, cytomegalovirus, chlamydia, fungi of the genus Candida and herpesvirus type II (with intranatal pneumonia);
Klebsiella, Pseudomonas aeruginosa, intestinal yucca, proteas, staphylococci (with nosocomial aspiration pneumonia in newborns);
mixed bacterial-bacterial, viral-bacterial.

Acquired home pneumonia most often occur against the background of 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

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

If the mother and child are discharged home, during the first month they must be accompanied by a doctor for patronage. He will look after the state of the baby, and he needs to talk about all the alarming symptoms, for example, about the child's lethargy, frequent regurgitation and liquid stool, rejection of the breast, fast fatigue when sucking.

If the child has a fever, do not wait for another doctor to come. Urgently call an ambulance. Cough in infants may be mild, but it is important to pay attention immediately to coughing. Also, alert the appearance of discharge from the nose in the child and shortness of breath. Shortness of breath leads to symptoms of blue on the feet, on the face and hands. The sick child has a faster appearance of diaper rash.

To be afraid to pass pneumonia at the child it is not necessary, in fact signs of illness or disease rarely arise without rising of temperature. And it needs to be periodically measured for prevention purposes.

The doctor, who regularly examines and listens to the child, can easily detect pneumonia.

What treatment is prescribed for pneumonia in newborns?

Antibiotics of a wide spectrum of action are always used for the treatment of pneumonia. The child needs careful care to avoid overcooling and overheating. It is important to monitor the hygiene of his skin, often change the position of his body, feed exclusively from the horn or using a probe. Applying to the breast of a sick infant, doctors will be allowed only if it is in a satisfactory state, namely, with the disappearance of intoxication and respiratory failure.

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

Consequences of pneumonia in newborns

Children who have had pneumonia (especially bilateral pneumonia in newborns) are prone to repeated illnesses. After discharge for them should be repeatedly conducted courses of vitamin therapy, give bioregulators (extract of aloe and eleutterococcus) for 3-4 months. And within 1 year the child will be under clinical supervision.

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Consequences and treatment of intrauterine pneumonia in newborns

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

The cause of the appearance of this kind of pneumonia is the ingestion of the infected infected amniotic fluid at the time of birth or the hematogenous penetration of the pathogen from the sick mother.

Diagnosis of intrauterine pneumonia

The main diagnostic criteria for intrauterine pneumonia:

Signs of pneumonia appear from 1 to 3 days of life.
At delivery of a roentgen on 3rd day of a life of the child focal or infiltrative shadows are taped.
When the microflora is sown in the mother and child of the first days of life, identical analyzes are observed.
At a lethal outcome of a newborn on the 4th day, the inflammatory process in the lungs is determined.

Auxiliary diagnostic criteria:

Histological examination of the placenta can reveal an inflammatory process in the womb of the mother.
With an increase in the liver and spleen, the pathology in the baby's body is determined.
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 sluggish, weak, and the skin is cyanotic. There may be no reflexes of swallowing and sucking, muscle hypotension.

Other symptoms include:

dry skin accompanied by hemorrhagic rash;
limbs edematous;
in full-term children, the temperature rises, in preterm infants, on the contrary, decreases to 34-35 degrees;
shortness of breath accompanied by dyspnoea;
on the 2nd-3rd day the rales are audible;
regurgitation and vomiting;
lack of body weight;
possible development of heart failure;
asphyxia;
enlargement of the liver.

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

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

1 degree - mild frequent breathing, the entrainment of the intercostal spaces is poorly expressed, cyanosis is poorly expressed in a calm state.
2 degree - with the help of auxiliary muscles, cyanosis is more pronounced.
3rd degree - frequent breathing, arrhythmia, apnea, movement of the head and additional musculature during breathing. Cyanosis is stable both in excitement and in a calm state.

Consequences of intrauterine pneumonia of the newborn and their treatment

Not always the treatment of congenital pneumonia can give a favorable result. Often the consequences of even timely treatment. These include the formation of atelectasis, which is characterized by the areas of the combined tissue of the lungs and the formation of connective tissue in the affected areas of the lungs. In future, with such pathologies, the lungs do not have the ability to fully perform their functions, which leads to emphysema. With such a disease, the child develops toxicosis, which is difficult to treat.

The main therapeutic measures of pneumonia and its consequences:

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

Consequences of pneumonia in children with a delayed diuresis.

Most often, the effects of this disease are manifested through difficulty urinating. Delay diuresis is treated with diuretics, which should appoint a doctor. It often requires the help of a catheter, which is inserted into the bladder.

The forced diuresis is carried out in three directions, such as:

Elimination of dehydration.
Establishment of water-salt metabolism.
Prevention of excessive fluid in the body.

Basic treatment

If suspected of pneumonia, the child is isolated from the mother and transferred to the neonatal department. There he is placed in a cuvette, where a supply of moistened oxygen is provided. A small child is prescribed a course of antibiotics. If the condition worsens, artificial ventilation is used, this process is most often performed in the intensive care unit, where the heavy baby is transferred.If the treatment was not performed correctly, then pneumonia can go to the chronic stage.

Causes of intrauterine pneumonia

The most common pathogens are streptococci from group B, also influenza and parainfluenza viruses, adenoviruses, mycoplasma. Infection of the fetus can occur if a pregnant woman with late gestation is ill with the flu or ARVI.

Other causes of infection include:

Healthy lifestyle during pregnancy for the prevention of pneumonia

chronic infections of the mother;
use of steroid drugs during pregnancy;
hypoxia of the fetus in the womb;
genetic diseases of the lungs and other internal organs.

A child can become infected with an infection leading to pneumonia in two main ways:

Bronchogenic, when the infection penetrates through the lungs.
Hematogenic, when the infection occurs in utero through the infected blood of the mother.

Another way of infection can be when the child passes through the birth canal and swallows the amniotic fluid that is infected. There are cases of infection after the birth of the baby.

Prevention of pneumonia in newborns

Preventive measures of this disease provide for the protection of the body of a pregnant woman in order to prevent infection with her flu or acute respiratory illness, especially in the second half of pregnancy.

Other preventive measures of a pregnant woman include the following actions:

Timely opening of a registration card, a regular visit to a polyclinic and the delivery of all necessary tests.
The nutrition of the future mother must be varied and balanced, rich in vitamins and minerals.
A significant role is played by the rejection of bad habits and the maintenance of a healthy lifestyle.

At delivery, doctors should take all measures to avoid fetal asphyxia. After the baby was born, do not allow the infection to enter the room where it is. It is very important not to overcool the baby during this period. And also the importance of mother's milk in raising the immune system of a child has been proven for a long time.

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How does pneumonia develop in newborns?

Pneumonia in newborns is a fairly common disease that a baby can get infected while in the womb or directly in the process of giving birth.

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

How is pneumonia diagnosed?

As a rule, pneumonia of newborns is diagnosed even within the walls of a medical institution and is further controlled by health workers. If the disease made itself felt, when the baby was already at home, the parents simply will not be able to overlook the problem! The child becomes capricious, the temperature of his body increases significantly, accompanied by a strong cough. Trying to cope with the disease is not categorically recommended, because in most cases this leads only to a deterioration in the condition of the baby.

Among the most common ways of infection can be identified:

Transplacental. In this case, the unborn child is infected by penetrating the pathogen through the mother's placenta. In order to avoid such an outcome, a woman should be extremely cautious, avoiding places of congestion, especially in the period of aggravation of epidemics of infectious diseases.
Antenatal. Bacteria pathogens penetrate the baby's airways from the amniotic fluid and cause rapid infection. To treat an unborn baby is a rather complicated process, therefore, in the absence of pronounced indications, doctors are waiting for his birth.
Intranatal. In this case, infection of infants occurs directly during the delivery process, especially if the child is given a cesarean section. The cause is not necessarily an infection in the mother's birth canal. It can also be invisibly present in the environment.
Postnatal. This path suggests that the infection affects the already born baby, who is in the maternity ward, as well as at home. However, spending time on finding out who is at fault is not recommended for parents. Their main task is to find a qualified doctor who can prescribe a quality and effective treatment for the baby.

What dangerous and frightening for the parents would not be intrauterine pneumonia, it should not introduce parents into a state of stupor. The problem can and must be fought! However, this will take time.

How is pneumonia treated?

As soon as newborns are diagnosed with pneumonia, the doctor immediately places them in a medical facility where they will be provided with qualified care. Trying to challenge the decision of the doctor and convince him that at home will be carried out the best care, will be an unpardonable mistake! The fragile children's organism is in the stage of development and simply can not cope with a strong infection. He definitely should be helped, however, only on the condition that medication does not harm other body systems.

In this case, a key role in this issue is played by a properly prescribed course of antibiotics, which allows to normalize the temperature and to stop the progressive inflammation. Such a course is prescribed to babies without fail, regardless of the form of the disease and its severity. Simultaneously, the child will take a powerful vitamin therapy, which will support the body and give him the strength to fight the disease on his own.

As a rule, visible signs of pneumonia pass in 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 that at home in case of pneumonia in newborns, parents will need to give the baby only medicines!

Essential aid can be provided by methods of traditional medicine that are evaluated as an alternative way of treatment. One of them is well-known to many mustard plasters, which, in agreement with the pediatrician, can be placed and infants. However, in this matter, parents should be extremely careful, so that after their application on the delicate skin of the crumbs there are no burns left.

Help in the fight against pneumonia can and honey, whose healing properties are known to almost everyone. It should be mixed with birch buds and boiled for 10 minutes. To water the child with this mixture should be immediately before going to bed. A mixture of honey and birch buds is good because it does not cause allergies and can be used not only when the inflammation of the lungs is treated, but also for any other infectious disease. However, before using it, consultation with a pediatrician is an integral procedure!

Prevention of pneumonia in children

The development of intrauterine pneumonia in newborns does not depend on the baby in any way and entirely falls on the conscience of the parents. The future mother should be extremely accurate and once again do not provoke the development of diseases. In an impoverished day or during the progression of infections from contacts with a large number of people it is desirable to abstain! After all, it is often in them that the causes of infection lie. A truly important for a woman during pregnancy is exclusively the health of her child. All other desires can wait.

In the event that parents suffer from an infectious disease, they should minimize contact with the child and must wear gauze bandages on their faces!

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

The health of a newborn child should be given due attention, because at this age many surprises are possible. In the event that the symptoms of pneumonia are already felt, do not despair! After all, timely treatment to a doctor for sure will solve all the problems and give the baby a healthy and happy childhood.

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Causes and methods of treatment of pneumonia in newborns

Pneumonia in newborns, the causes of which are characterized by intrauterine infection of the fetus or its infection during childbirth, is an acute inflammation of pulmonary tissue of an infectious origin, accompanied by a violation of the respiratory process. According to statistical data, this disease is diagnosed in 1% of full-term and in 12-15% of premature infants. Successful recovery of the child and its normal development in pneumonia will depend on the timeliness of the detection of pathology and the effectiveness of the prescribed treatment.

The problem of pneumonia in a newborn child