Neonatal pneumonia is one of the very many neonatal diseases that doctors and mothers watch out for during pregnancy, during the labor or childbirth process, and after childbirth. This is because, amongst the wide range of causes of neonatal fatality, pneumonia seems to have achieved a very important position as a major cause of neonatal mortality.
With the purpose of the respiratory tract being for the exchange of gas, pneumonia interferes with this process thereby causing shortness of breath, labored and irregular breathing, and coughing in the newborn. If this interference persists, hypoxia (deficiency of oxygen in some tissues), which leads to seizures due to brain damage and other complications, seems to be a major contention in many forms. This is to be treated immediately with antibiotics. Meanwhile, hypoxia and electrolyte disorders should be corrected by airway treatment, drugs, and timely auxiliary oxygen therapy.
What Are the Causes of Neonatal Pneumonia?
There is a very wide range of variations of neonatal pneumonia. However, these variations are grouped and studied according to their causes which include;
- Improper care
- Inhalation of some substance and immature swallowing reflexes
During pregnancy, and after childbirth, the mother and child are to avoid contact with people that seem to have upper tract respiratory tract infection and places that seem to be air polluted. Immediately after birth, all sorts of microorganisms have multiple free gate passes and improper care is the master key to that gate.
Immediately a baby is born, the baby is wrapped properly to prevent cold. If this immediate warmth is not provided, it takes only a few minutes before the baby contracts neonatal pneumonia. Also, when newborns are kept in rooms with fans and air conditioners, there are high chances of pneumonia being contracted.
Inhalation of Some Substances, and Immature Reflexes
Some newborns have immature swallowing reflexes and uncoordinated swallowing movements. These poor reflexes lead to the inhalation of meconium, milk, amniotic fluid, and other secretions that might have contaminated by pneumonia pathogens.
Most of the time, neonatal pneumonia is caused by infections. This causative agent is the most popular because its time of infection is not streamlined. It can be;
- During pregnancy
- During childbirth
- After childbirth
- During treatment
Mothers who have pneumonia tend to infect their unborn children as there is a mixture of blood and other fluids. Also, if the mother contacts a respiratory tract infection during pregnancy, it is most likely that the unborn child will also contact it as pathogens gain entrance to the fetus through the placenta and amniotic membrane.
When a woman is in labor, in most cases, the amniotic sac breaks (water break). Sadly, if this sac ruptures prematurely and childbirth has not occurred with 6-24 hours, the amniotic fluid that remained will become infected by bacteria (like listeria, Group B streptococcus, etc) from the birth canal. If a baby is infected by this means, that child is to receive special care and attention.
Also, if there is any form of delayed labor, or acute labor, or improper disinfection of the birth canal, pneumonia can be contracted as the baby might inhale contaminated secretions during the birthing process.
After childbirth, if the baby has any skin infection, sepsis, or umbilitis, their pathogens are transmitted to the lungs by blood and the newborn stands a chance of having pneumonia.
If the newborn comes in contact with any form of upper tract respiratory tract infection, it is also a pass to contacting neonatal pneumonia.
Neonatal pneumonia can also be contracted during treatment if the doctors and nurses are careless with instruments and other things. Pneumonia is contracted during the treatment when;
- Newborns are administered broad-spectrum antibiotics,
- There is no standard and firm disinfection system,
- The incubator has high humidity which encourages the multiplication of aquatic bacteria,
- A ventilator has been used for too long,
- Medical staff fail to wash their hands before commencing treatment,
- The tracheal intubation is not disinfected properly, and
- Low pathogenic bacteria, anaerobic bacteria stick to some devices like oxygen masks, nebulizers, sputum suction, etc.
What Are the Symptoms of Neonatal Pneumonia?
In a newborn that has neonatal pneumonia, the region around the mouth and nose is seen to be blue. At the early stage, the baby will experience very fast and labored breathing that is usually accompanied by extreme difficulties, irregular coughing, and spitting. Most times, when the baby is being breastfed, the baby chokes on the milk or refuses the milk. The child might be cold and restless. However, a symptom to always watch out for is when the baby vomits foam.
How Can I Confirm If My Baby Has Neonatal Pneumonia?
Confirmation of neonatal pneumonia is done by two methods;
- Laboratory inspection which involves taking of blood picture, examination of antibodies, and etiological diagnosis.
- The auxiliary inspection involves a chest x-ray examination. This inspection distinguishes between interstitial pneumonia (caused by intrauterine virus infection), bronchial pneumonia (caused by amniotic fluid which is seen to thicken the lungs texture), and other complicated forms of neonatal pneumonia-like meconium aspiration, etc.
How Can Neonatal Pneumonia Be Prevented?
Even though neonatal pneumonia claims a thousand lives of newborns, it can still be prevented by following these methods;
- Expecting mothers should go for a prenatal checkup diligently.
- Pregnant women should ensure a very high degree of personal hygiene during pregnancy to prevent infections.
- After birth, proper hygiene such as disinfection of nursing utensils should be practiced to a very high degree.
- If the baby has a skin infection, ensure to treat it immediately.
- The mother should put o a facemask while breastfeeding if she has a cold.
- Avoid contact with patients that have cold or any respiratory tract infection.
What Are the Treatment Methods For Neonatal Pneumonia?
Neonatal pneumonia has a wide range of causes and newborns are very sensitive to medications; therefore, consultation of a doctor is to be received before taking any medication on this issue. However, these are the treatment methods that will be administered:
1 Firstly, clear the respiration tract by sucking up nasal secretions and patting the back of the baby.
2 Antibiotic treatment should start immediately. This treatment is given according to the pathogen involved. If the pathogen is:
- Viral, treat with ribavirin or interferon
- Anaerobic infection, treat with metronidazole intravenous drip
- Chlamydia, treat with erythromycin
- Listeria, treat with ampicillin
- Gram-negative bacteria, treat with third-generation cephalosporins and ampicillin
- Group B hemolytic streptococcal pneumonia, treat with ampicillin and penicillin
- Gold grape cocci, treat with the first-generation cephalosporin
3 If the condition is very severe, you are to give oxygen. If the case is that of hypoxemia, try to maintain the blood oxygen level.
4 For those with spasm-less blood, temperature ensures to conserve their heat.
5 Give sedations to the ones experiencing convulsions.
6 Increase immune system function by human blood gamma globulin or human blood albumin.
7 In every step of treatment, supply the babies with nutrients and water to maintain water and electrolyte balance.
Are There Measures To Be Taken When Handling a Newborn That Has Neonatal Pneumonia?
Although treatment was given by a doctor, there are some measures to be taken as a guardian or mother so as not to aggravate the condition. These measures include:
- Always ensure the baby is lying in a head-high side position so that the airway should be unobstructed and secretions would be discharged easily.
- The baby’s lying position is to be changed frequently
- Always ensure there is cross-ventilation but make sure the baby does not get cold.
- As newborns with neonatal pneumonia sometimes reject milk, fluid and calories should be given together with glucose.
- If the baby still accepts milk but chokes while breastfeeding, stop immediately and give oxygen.
- Give the baby enough water as it helps in unblocking the respiratory tract, and replacing water lost by the fever, fast breathing, and sweating.
- Use a spoon to feed the baby milk. Do not use a bottle to prevent the child from choking
- If there is an obstruction in the nostrils by dry blood from injuries, use a soaked cotton swab to remove it.
What Complications Can Neonatal Pneumonia Lead To?
If any symptom that has been listed above is noticed, it is very necessary to reach for a hospital immediately. If treatment is delayed and pneumonia is prolonged other complications are developed. These complications include:
- Increased rate of heartbeat
- Edema of lower limbs
- Enlarged liver
- Respiratory failure
- Pus pneumothorax
- Toxic shock whose symptoms are very dangerous
- Toxic intestinal palsy
- Hypoxic encephalopathy (at first, its symptoms are very fierce and dangerous)
- Heart failure
- Unconsciousness as the child slips in and out of coma
Breathe is the stamp of life, therefore any form of threat on it should be treated with immediate effect, diligently, and with extreme carefulness. The importance of prenatal scans and extreme personal hygiene during and after childbirth should be emphasized to reduce the rate and aid treatment of neonatal pneumonia.