1. Kids may be breathing faster than usual or appear to be struggling to breathe. You might notice nostrils flaring, grunting, or the chest or neck muscles pulling in with each breath.

2. An early clue may be a fever that remains high, often above 101°F/38.3°C, for more than a day or two. Fever may not respond fully to the usual medicines and is often accompanied by tiredness or chills.

3. Some kids may cough so hard that it affects sleep or eating. A child may appear extra sleepy, cranky, or uninterested in playing.

4. Kids may appear unusually weak or unsteady. A child who usually is active and runs around may want to stay lying down, or is not able to stand for a long period.

5. Kids may refuse food or drinks. Kids with pneumonia often lose their appetite, not because they're picky, but because breathing takes so much energy. You might notice they’re drinking less than usual or turning away from their favorite snacks.