Childhood interstitial lung disease (ChILD) is a rare disease and sensitization is needed in the recognition, diagnosis and treatment approaches. There is no formal approach to diagnosis or therapy in resource limited regions. We present a case of a 4-month infant who presented with all the criteria for diagnosis of ChILD. Lung biopsy being the gold standard is a challenge in our setting and diagnosis was based on clinical signs and imaging after ruling out of other similar respiratory conditions by way of individual trials of therapy. Monotherapy with prednisone showed clinical improvement within days of initiation