In the last few years, the world was distracted by the emergencies of a new respiratory tract disease called Covid-19 and for a while, it eclipsed an older pulmonary infection that has been claiming the lives of millions of people, predominantly children, from around the world since the 19th century. That infectious killer is Pneumonia.
Pneumonia affects people of all ages but it is especially dangerous in children whose immune system has yet to be fully developed. In fact, Pneumonia is the biggest infectious killer of young children worldwide. Every year, it claims the lives of more than 800,000 children under the age of five, including some 190,000 newborns who are especially vulnerable to the infection.
In Malaysia, Pneumonia is the Number One killer of young children. According to the Department of Statistics (DOSM), it is among the Top Five cause of death in Malaysian children contributing 3.9% of under-five deaths in 2006 which increased to 5.1% in 2016. However, since the introduction of the Pneumococcal Conjugate Vaccine (PCV) in 2020, DOSM has shown that under-five deaths statistics for Pneumonia have dropped to 2.8% in 2020 and 2.1% in 2021. However, it also showed that in 2023, 13.3% of deaths in Malaysia were caused by Pneumonia alone.
*The pneumococcal vaccine is now a part of the National Immunisation Programme (NIP) and is available free-of-charge to all children below the age of five at all government clinics. In an effort to expand the programme to those who have missed out, the free pneumococcal vaccination has been extended to those born between 2018 and 2019 until 31 May 2024.
What is Pneumonia?
Pneumonia is an acute respiratory infection that affects the lungs. The lungs, which are made up of small sacs called alveoli, are supposed to fill with air when a healthy person breathes. However, in someone who has Pneumonia, the alveoli are filled with pus and fluid, making it difficult to breathe in oxygen for the bloodstream, which will lead to a lack of energy supply to the organs. If left untreated, it can cause death.
What Causes Pneumonia?
There is no one single cause of Pneumonia. The infectious agents could be viruses, bacteria fungi and even chemicals.
Symptoms of Pneumonia?
Symptoms can be hard to recognise in children as they may come and go and range from mild to serious depending on the health status of the child. If Pneumonia is mild, the child may feel unwell or have a dry cough and these symptoms may come and go at first. In babies, the symptoms can be vague as they may become fussy or irritable and have trouble feeding. As the disease progresses they may exhibit trouble breathing and you may see their ribs or nostrils flaring as they try to suck in air or they may bob their heads with each breath.
For toddlers and preschoolers, these symptoms may include:
As Pneumonia progresses, additional symptoms may include:
Bring Your Child to the Doctor Straightaway
If you notice these signs and symptoms, you child needs to be treated immediately. Even if you are not sure whether your child is just having a cough and cold, or something more serious, it is better to have a doctor check the child over to allay or confirm your suspicion.
Complications may arise if treatment is delayed. They include:
Bacteraemia: The infection spreads into the bloodstream, leading to septic shock and blood pressure dropping to a dangerous level.
Lung abscesses: Pockets of pus may build up in the lungs. The child may also cough out pus and have a high fever.
Pleurisy: The pleura (two layers of tissue enveloping the lungs) become swollen and cause a sharp chest pain when breathing deeply. If the swelling is not treated, fluid may fill the area between the pleura, causing pleural effusion (“water around the lungs”) and empyema (pus collection).
Respiratory and Organ failure: Without oxygen being transferred to the bloodstream and the removal of carbon dioxide due to the lungs being unable to function properly, organs such as the kidney and heart may start to fail. This situation is life threatening.
Risk Factors
Pneumonia is an opportunist infection. As mentioned above, it is not caused by one single pathogen but by many different factors. It can infect a child after a lesser lung infection such as a cough and cold and it can infect a child over and over again.
The most common cause of Recurrent Pneumonia is Aspiration Syndrome where the child inhales food or liquid into the lungs or even saliva, stomach contents such as its digestive juices or vomit. All of these things carry bacteria that affect the lungs.
Children with compromised immune systems are naturally at higher risk. Their immune system may be weakened by malnutrition or undernourishment. Other risk factors include:
How to Prevent Pneumonia
Preventive measures for Pneumonia are the same as for Covid-19. As Pneumonia is contagious and can be spread via air-borne droplets from a cough or sneeze, do practice the proper Cough Etiquette which is to:
A: Cough and Sneeze Etiquette
B: Wash Hands Frequently
As Pneumonia can be spread through touching surfaces, wash the hands with soap and water before and after eating, after going to the toilet or out to play, and after playing and sharing toys and other objects such as doorknobs, handles, or table tops with other children. Studies have shown that improved handwashing with soap and water reduces the risk of Pneumonia because it lowers exposure to bacteria.
C: Avoid Sharing Toys and Other Utensils with Other Children who are Sick
Make sure your child does not share drinking cups, spoons, face cloths, towels or toothbrushes with other children, especially in a childcare centre where communal caring and feeding is often practised.
B: Avoid Touching the Face, Eyes and Mouth
Remind children not to touch their face, rub their eyes or put their fingers in their mouth.
C: Wear Face Masks
A face mask can help give extra protection against infection especially when going to crowded, poorly ventilated places.
D: Eat a Balanced Diet, and Maintain Physical Exercise
Eating a balanced diet supports children’s overall well-being and growth. Include lots of fruits and vegetables, protein, wholegrains and legumes as well as dairy to provide the necessary nutrients, fats, vitamins and minerals for the child’s overall health.
Not only is nutrition required for a healthy, strong body, gut health has also been found to have a beneficial and supportive role in conferring immunity for the lungs as well as controlling the development of opportunistic bacteria such as those that cause Bacterial Pneumonia.
Another study says gut health not only regulates immune responses of the in the Digestive System/Digestive Tract but also increases immunity for all the organs, including the lungs, against respiratory diseases.
In fact, several other studies say gut health can even influence the susceptibility and severity to Covid-19 and other infectious pathogens that damage the lungs and other vital organs.
Gut health refers to having a rich and diverse Digestive System/Digestive Tract microbiome (or intestinal flora which consists of trillions of bacteria and microbes) and one way to achieve this is by increasing microbiome diversity in the gut.
This can be done by eating a wide range of plant-based foods which are high in fibre to feed and grow the beneficial bacteria contributing to a healthy gut microbiome or gut health. These fibre-rich plant foods such as vegetables, fruits, nuts, seeds and whole grains, are called prebiotics.
Alongside eating fibre-rich foods, one should also eat fermented foods like Yoghurt, Kefir (drinkable yoghurt), Tempeh, Apple Cider Vinegar, Pickles and so on to put in good bacteria; healthy fats (such as polyunsaturated Omega 3 and 6, vegetable oils); and good quality protein like fish and lean meats.
As for physical exercise, half an hour of activity like walking, jumping, dancing, running and playground activity can build physical strength, happier minds and strengthen the body’s natural immunity. Exercise and a raised heart rate causes antibodies and white blood cells – the body’s immune system cells for fighting viruses, bacteria and other pathogens – to circulate more rapidly so they could detect illnesses earlier than they might have before.
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Morinaga Chil-kid
Morinaga Chil-kid, a Japanese formula milk for children aged one to seven, is packed with over 45 essential nutrients such as ARA and DHA and other Long Chain Polyunsaturated Fatty Acids, Galacto-ogliosaccirides (GOS which are prebiotics made out of plant sugars), 5 Nucleotides (which are the basis of nucleic acids such as DNA), plus 27 Vitamins and Minerals.
Some of the Vitamins and Minerals include Vitamins A, B1, B6, B12, Folic Acid, C, D, E, K1 as well as Zinc, Calcium, Iron, and many others. Specially formulated in a balanced ratio of protein, fat and energy, the milk is specifically designed to meet the nutritional needs of fast-growing Asian children.
Morinaga Chil-kid is made less sweet and has a mild vanilla taste that makes it specially palatable for children.
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