Causes of pneumonia in a newborn

An infection can pass from the pregnant parent before birth or enter around delivery. After birth, a newborn may be exposed to germs from close contact, the environment, or another infection. Viral illnesses such as influenza and COVID-19 can affect breathing, while bacterial infection can involve the lungs and may occur with infection elsewhere. Pneumonia can also be part of a serious bloodstream infection such as sepsis. A newborn may not develop a strong cough or obvious fever; poor feeding, unusual sleepiness, fast breathing, grunting, pauses in breathing, or a change in colour can be more noticeable.

Contact a maternity, neonatal, or paediatric service promptly if a newborn is breathing differently, feeding less, or seems unusually difficult to wake. Keep the baby away from people who are unwell, wash hands before handling, and follow clinical advice about feeding and monitoring. Do not give a newborn cough or fever medicine unless a clinician specifically advises it. Assessment may include observing breathing, checking oxygen levels, and tests to identify infection.

Seek emergency help for blue or grey lips, pauses in breathing, severe effort with breathing, grunting, collapse, or a baby who cannot feed. Urgent assessment is also needed for fever, low temperature, repeated vomiting, marked sleepiness, new chills, or rapidly worsening breathing. Do not wait for a cough or phlegm before seeking help.

Could this be pneumonia, influenza, COVID-19, or sepsis? What breathing and feeding changes should I monitor? Which tests and treatments are needed, and where should I go if symptoms worsen?