Pneumothorax in children

A pneumothorax happens when air leaks out of the lung. This page has information for parents and carers on pneumothorax in children.

We also have information on pneumothorax in adults.

What is a pneumothorax?

A pneumothorax happens when air leaks out of the lung. The air becomes trapped in the space between the outside of the lung and the ribcage. The air squashes the lung and can cause some or all of the lung to collapse.

Pneumothorax comes from two Greek words:

  • pneumo – air
  • thorax - chest.

If there is not a lot of air and the pneumothorax is small, it can get better with time. If there is a large amount of air, it can make it hard for your child to breathe and will need urgent treatment.

A bilateral pneumothorax is when air leaks out of both lungs and causes them to collapse – but this is rare.

The pleural space

The outside of the lungs and the inside of the ribs are each covered by a membrane lining (a thin piece of skin). Normally, these surfaces are in very close contact with a small amount of fluid in the space. This fluid acts as a lubricant, allowing the lung to expand and contract during breathing. A pneumothorax occurs when air gets into the space between the lung and the inside of the ribs.



What causes a pneumothorax in children?

There are many causes of a pneumothorax. The most common causes are listed in this section.

Primary spontaneous pneumothorax

Sometimes the air leak may happen suddenly, for no apparent reason in an otherwise healthy child. This is called primary spontaneous pneumothorax (PSP) and it happens most often to children aged 14 to 17. It affects around 3 in 100,000 children, especially tall, thin boys.

PSP happens due to a small tear on the outer part of the lung. The reasons for this aren’t always clear, but researchers currently believe that this happens when blebs and bullae on the lung burst.

What are blebs and bullae?

Blebs are small air-filled blisters that can form on the surface of your lung. Bullae are pockets of air that can form within your lung tissue. More research is being done into how they are formed and why they are often found in around people with PSP.

Secondary spontaneous pneumothorax

An existing lung condition can weaken the surface of the lung and make it more likely to tear. Conditions that can cause a secondary spontaneous pneumothorax in children include:

Environmental factors

Smoking tobacco is one of the main risk factors for primary spontaneous pneumothorax, especially in teenagers. Vaping and smoking cannabis can increase the risk of pneumothorax too.

Passive smoking is also harmful to babies and children, as their lungs haven’t finished growing.

Stopping smoking

Stopping smoking is one of the best things you can do for your own and your child’s health. We have lots of resources and support to help you quit smoking on our website.


Pneumothorax in children is also associated with high levels of air pollution.

Familial pneumothorax

1 in 10 people who have a pneumothorax have a family member who has also experienced one. This is called familial pneumothorax.

If your child has a pneumothorax, or if there is a family history of pneumothorax, it’s important to get them tested for genetic conditions. It could lead to an underlying condition being diagnosed, like:

Causes of pneumothorax in babies

In babies, an air leak can also happen if:

  • they have breathing problems, such as respiratory distress syndrome (RDS)
  • they have breathed in meconium (the baby’s first poo) before they are born - this can get into the lungs and damage them
  • they are premature and their lung tissue is fragile.

What are the signs and symptoms of a pneumothorax?

Pneumothorax symptoms in babies

Symptoms are different in each child. Your baby may have no symptoms at all, or they might experience:

  • irritability and restlessness
  • rapid breathing
  • grunting
  • nostril flaring
  • pale or blue toned skin colour.

If your child has darker skin, it might be easier to see changes to their skin tone around their lips, tongue and gums, under their nails, or around their eyes.

Pneumothorax symptoms in older children

In an older child, the signs and symptoms of pneumothorax often come on while resting or during light activity. Look out for:

  • sudden, sharp stabbing pain on one side of the chest that gets worse when breathing in and out
  • feeling breathless
  • a cough.

If someone becomes breathless with sudden chest pain, diall 999.

Find out more about the signs of breathing problems in children and when to seek urgent medical help.

How is it diagnosed?

Doctors usually use X-rays to diagnose pneumothorax in children and adolescents. They will also watch your child's chest movements and listen to their breathing.

Pneumothorax in babies is sometimes found using a special light probe. The light shines onto the baby’s chest and will shine brighter in an area with an air leak. This test is painless, quicker and easier to carry out than an X-ray. However, your baby may still need a chest X-ray to confirm the diagnosis.

How is it treated?

Treatment for a pneumothorax will depend on:

  • the size of the air leak
  • whether the air is increasing which means the underlying lung may collapse more,
  • and what caused it.

In some cases, a pneumothorax will clear on its own. The air will be absorbed and disappear on its own with time. After about a week, your child may have another chest X-ray to check that the air leak is gone.

If your child has an air leak caused by an underlying lung condition or chest trauma, they are more likely to need treatment. The aim is to remove the air from the chest space and relieve any pressure causing the lung to collapse. This allows your child’s lungs to expand so they can breathe easily again.

A doctor may insert a small plastic tube (also called a chest drain) or needle to remove the air from your child’s chest. They may also need to be given extra oxygen.

What is a chest drain?

A chest drain is a flexible plastic tube. It’s inserted through the chest wall, after the area is numbed. The drain allows air out but not back in, so your child’s lung can re-inflate. There’s more information about chest drains on the GOSH website. A chest drain is usually inserted under general anaesthesia in children (your child won’t be aware it’s happening or feel any pain). If your child needs a chest drain, they will probably be moved to a specialist hospital where healthcare professionals that are trained to look after children with chest drains are available.

How long will it take for my child to recover?

Most children recover from a pneumothorax within a few days. They may have follow-up appointments and chest X-rays.

Will it happen again?

If your child has a spontaneous pneumothorax, there is up to a 50% risk that it will happen again. This seems to happen more in children than in adults and usually happens within two years following the initial pneumothorax.

If a pneumothorax happens more than once on the same side, your child might have a small operation to ensure it cannot happen again. This will involve a doctor sealing the weak areas on the edge of their lung where the air leaks are happening.

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