The main symptoms of neonatal pneumonia include rapid breathing, frothy saliva, a mucusy sound in the throat, nasal congestion, poor mental state, and decreased milk intake. Sometimes, there may be increased vomiting and diarrhea. Severe cases may have coughing, usually not severe, occasionally accompanied by fever, but less frequent. Severe pneumonia may present with difficulty breathing, blue discoloration of the face or lips, refusal to breastfeed, abdominal distension, and even signs of heart or respiratory failure.