Whooping Cough in Babies and Toddlers

You may think that whooping cough is one of those childhood illnesses that were eradicated decades ago. Unfortunately, it’s still quite common and has been on the rise since the 1980s. Babies younger than 6 months who haven’t yet had all of their immunizations are the most at-risk group. Luckily, there are vaccines that help prevent the infection.

Read on to find out what whooping cough is, what the symptoms are, what it sounds like, how whooping cough is treated, and what you can do to protect your little one.

What Is Whooping Cough?

Whooping cough, also known as pertussis, is a bacterial infection in the respiratory system that is caused by the Bordetella pertussis bacteria. The upper respiratory system is lined with cilia—tiny hair-like cells that aid in breathing. Pertussis attaches to the cilia, causing inflammation, making it very difficult to breathe.

Although people of any age can get whooping cough, it’s most dangerous in babies because oftentimes one of the symptoms—a whooping-sounding cough—isn’t that noticeable. Instead, if your baby has whooping cough, she may get a symptom called apnea—a pause in the normal breathing pattern that can make it a struggle for her to breathe and cause her face to redden.

About half of babies younger than 1 year old who get whooping cough need to be hospitalized because of the risk of complications. Try not to let this statistic frighten you. Instead, think of it this way: This is a condition that is worth knowing about, keeping an eye out for, and—above all—immunizing against.

Preventing Whooping Cough With the Vaccine

The best prevention and protection against whooping cough is vaccination. Experts recommend everyone get this vaccine.

There are two types of whooping cough vaccine: DTaP for children younger than 7 years, and Tdap for everyone else. Both shots also vaccinate against diphtheria and tetanus.

Whooping Cough Vaccine Doses

As part of your little one’s overall immunization schedule, experts recommend five doses of the whooping cough vaccine at these ages:

• 2 months old

• 4 months old

• 6 months old

• between 15 and 18 months old

• between 4 and 6 years old.

Since your baby can’t receive the first DTaP vaccination until he’s 2 months old, your healthcare provider will usually encourage expectant moms to get the whooping cough vaccine during pregnancy, usually in the third trimester. This enables you to pass on antibodies to your baby, which will protect him from the illness in his first few months of life.

About four out of five babies who come down with whooping cough catch it from someone at home. That’s why it’s so important that everyone in your household and anyone who will be in contact with your baby, such as a babysitter, also get vaccinated, if they haven’t already done so.

Whooping Cough Symptoms

The symptoms of whooping cough start to appear about 5 to 10 days after infection, but in some cases it may take as many as three weeks for symptoms to show.

Experts sometimes group the symptoms of whooping cough into three stages:

• First stage. This stage lasts about one to two weeks. At this point, whooping cough can look like the common cold. Symptoms may include a runny nose, mild fever, and the occasional cough.

• Second stage. This stage is when the more obvious symptoms of whooping cough show up. These symptoms typically get worse over time, and are especially bad at night. This stage typically lasts about 6 weeks, but if it’s a particularly bad case it can last up to 10 weeks. Symptoms include:

• Coughing fits. These coughing fits usually last until the air from the lungs clears. Upon inhaling, there is a high-pitched whooping sound; hence the name “whooping cough.”

• Vomiting. Sometimes the coughing may lead to vomiting during or after the coughing fit.

• Exhaustion. The coughing fits can also result in extreme tiredness.

• Third stage. This is the recovery stage. Full recovery usually happens gradually—over about two to three weeks, or sometimes even longer. During this time, there’s an increased risk of catching another kind of respiratory infection, but the coughing fits become less severe and less frequent.

What to Do if You Suspect Your Baby Has Whooping Cough

Early detection of whooping cough is crucial because treatment with antibiotics can reduce the severity of symptoms. Call your healthcare provider if you think your baby or someone in your immediate family has come in contact with someone who is infected, or if your baby has any of these symptoms:

• Long-lasting coughing fits

• The skin or lips turning red, purple, or blue

• Vomiting after coughing

• Coughs are followed by a whooping sound

• Trouble breathing or apnea—breaks in breathing

• Sluggish behavior.

There is a higher risk of complications associated with whooping cough if your baby is under 6 months old, so your baby’s healthcare provider may recommend hospitalization to decrease your little one’s risk of

• pneumonia

• slow breathing or apnea

• dehydration and/or weight loss because of difficulties in feeding

• seizures

• brain damage.

If your baby is in need of hospitalization, she will be monitored closely. Your little one may have respiratory discharge suctioned, be given oxygen and intravenous fluids, and may be isolated to ensure the infection doesn’t spread to others. Your baby will be in good hands in the hospital, where this type of specialized treatment will promote a speedy recovery.

Whooping Cough Diagnosis

In order to diagnose whooping cough, the healthcare provider will conduct a physical examination and take a swab of mucus from your baby's nose, or collect a sample by flushing the nose and back of the throat with saline. The sample will be tested in a laboratory for the presence of the Bordetella pertussis bacteria.

How to Treat Whooping Cough at Home

If your baby is ill with whooping cough and his healthcare provider has determined he’s not in need of hospitalization, you can nurse him back to health at home with care similar to that of a common childhood illness like a cold, but with some extra steps and precautions:

• Administer antibiotics to your child just as your provider has prescribed.

• Ensure your home is free from irritants that might worsen your child’s cough, such as smoke, dust, cooking smells, and aerosol sprays.

• Use a cool misting vaporizer to help loosen mucus in your little one’s respiratory tract and soothe his throat.

• Give your child plenty of fluids to prevent dehydration. If he shows any signs of dehydration (tiredness, dry mouth, a decrease in urination, weakness, dizziness, headache, crying without tears), report it to your healthcare provider immediately.

• Make sure your child sticks to eating smaller meals every few hours to decrease the chance of vomiting.

• Do not give him cough medicine unless instructed by your healthcare provider. Cough medicine typically does not help with whooping cough and it isn't considered to be safe or effective for children for children younger than 6.

How Does Whooping Cough Spread?

The pertussis bacteria can be found in saliva and mucus, so whooping cough spreads when an infected person coughs, sneezes, or even laughs.

If someone in your home has whooping cough, make sure all family members practice good handwashing to help prevent its spread.

The incubation period—the period between infection and when symptoms appear—is about 5 to 21 days. The contagious period starts before symptoms appear and lasts for as long as two weeks after coughing begins. Treatment with antibiotics can help shorten the contagious period.

Rare Side Effects of the Whooping Cough Vaccine

It’s very rare that your baby would experience any side effect to the whooping cough vaccine. In some rare cases, side effects do occur but are very mild. These may include fever, vomiting, redness, swelling, or pain around the spot where the needle went in. More serious side effects, which are even rarer, may include a fever higher than 105 degrees, nonstop crying for hours, or seizures. See your healthcare provider immediately if any of these side effects occur in your child after vaccination.

Whooping cough isn’t something to take lightly, but it can be prevented if both you and your child are vaccinated according to your healthcare provider’s recommendations. Simply following your provider’s immunization schedule will give you lots of peace of mind and help ensure your baby’s happy and healthy development.

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How we wrote this article

The information in this article is based on the expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.