Whooping Cough In Babies: Symptoms, Treatment, And Tips

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Pertussis or whooping cough in babies is a contagious upper respiratory tract infection that causes violent, uncontrollable cough fits, making breathing difficult. When a person takes deep breaths after coughing, it causes a “whooping” sound, hence the name. The condition can occur at any age but is more common in babies and young children. Timely detection and treatment are essential to avert severe complications, highly likely to occur in babies under one year of age. Vaccination is the most effective way to prevent this infection from affecting people across ages. Keep reading to know more about whooping cough and how it can be treated and prevented in babies.

What Is A Whooping Cough?

A whooping cough, also called pertussis, is a condition where the infant has sporadic episodes of severe cough that ends with a distinct “whooping” sound as the child tries to inhale between coughs (1).

The intense fits of coughs are called paroxysm, which gives the condition another name, called paroxysmal coughing. Whooping cough is colloquially called a ‘100-day cough’ since it can last for several months in the absence of treatment.

What Causes Whooping Cough In Babies?

A whooping cough is caused by the bacteria Bordetella pertussis (2). The bacteria invade the mouth, the throat, and the alveoli in the lungs. Once inside the body, it binds to the cells of the respiratory system and releases cytoxin, a type of toxin that affects the cilia, a hair-like structure lining the respiratory tract.

The cilia keep the airways clean by moving the mucus and debris out of the lungs. The cytoxin disables their movement, and the person is forced to cough violently to keep airways clean and get the mucus out, leading to a whooping cough.

How Does A Baby Get Whooping Cough?

Babies get whooping cough when they come in close contact with an infected person, who can spread the pertussis bacteria by sneezing or coughing through droplet infection.

The bacteria is highly contagious and 80% of those with poor immunity, including babies, can develop whooping cough by inhaling the bacteria (3).

What Increases The Risk Of A Baby Getting Whooping Cough?

The following factors can increase the risk of whooping cough in babies:

  • Babies less than six months old: Infants and toddlers of any age are at a higher risk of getting the infection, but the most susceptible are babies below the age of six months (4). Young infants do not make adequate antibodies to defend themselves from pathogens, which makes them vulnerable to diseases.
  • Immunocompromised infants: Babies with AIDS or a form of cancer may have a greater risk of developing whooping cough.
  • Non-immunized babies: Infants who have not been vaccinated against pertussis also have a greater chance of contracting the disease.

Should the baby get infected, identifying the symptoms early on is important to prevent the condition from getting worse. Find out how.

What Are The Symptoms Of Whooping Cough In Infants?

The symptoms of whooping cough develop one to three weeks after the baby contracts the bacteria. There are three stages of symptoms (1) (5).

The first stage (first and second weeks of infection)

The early signs of whooping cough in babies include:

  • A runny nose
  • Sneezing
  • Occasional mild cough, which sounds normal and not like whooping cough
  • Low-grade fever, where the body temperature is between 98.7 and 100°F (37 – 37.7°C) (6).

The second stage (third week of infection)

At this stage, the symptoms are distinct to acute whooping cough. Rush your baby to the doctor when you notice stage two symptoms.

  • Coughing happens in episodes or fits, i.e., paroxysmal coughing. The baby would cough continuously for some time before it stops. After several minutes, the coughing begins again and the pattern continues.
  • An episode of paroxysmal cough lasts for 15-30 seconds. During this time, the baby’s face may redden or turn blue and will return to normal after the coughing stops.
  • The sound of coughing feels loud, noisy, and dry like a whoop.
  • Intense, noisy inhalation, which resembles a whooping sound, interludes each cough. The sound is made since the baby has difficulty breathing.
  • The coughing seems to get louder and harsher after each episode.
  • A baby may have a hard time inhaling and exhaling due to the cough. You may notice the infant often runs short of breath while coughing.
  • Shortness of breath may cause apnea, which is a pause in the baby’s breathing.
  • Crying and fussiness will accompany every episode of coughing.
  • The infant may vomit while coughing, especially if a cough is triggered by feeding.
  • May develop a high fever above 101°F (38.3°C).
  • May cry without tears and urinate less often, indicating dehydration.

The third stage (fourth week of infection onwards)

The following are the third-stage whooping cough symptoms in babies:

  • There is a gradual decrease in instances of whooping and vomiting. Whooping while coughing and vomiting may stop entirely by the sixth week.
  • It may seem that the baby is getting better, but by the next week, whooping starts again.

The baby will continue to display intermittent stages of whooping cough for more than ten weeks, which is more than two months, if treatment is not initiated.

How Is Whooping Cough In Babies Diagnosed?

Your baby is diagnosed with whooping cough through the following steps (9):

  • Learning about symptoms: The doctor will ask parents about the symptoms such as the presence of the tell-tale whooping sound while coughing. If your baby has a bout of whooping cough at the doctor’s clinic, then the doctor will be able to diagnose the condition right away.
  • Testing the mucus sample: A small sample of mucus from the baby’s nose and mouth are collected through cotton swabs and sent for laboratory analysis.
  • Blood test: Blood test confirms the presence of antibodies in the blood indicating infection.

Treatment for pertussis begins once the diagnosis confirms the condition.

How Is Whooping Cough In Infants Treated?

The treatment of whooping cough lasts for two weeks with 50% chances of hospitalization. It is imperative to start treatment by the third week of illness to ensure a speedy recovery. So be observant and take the baby to the doctor once the symptoms of acute whooping cough are evident, around the second week.

The following medications and procedures treat whooping cough in babies (8):

  • Antibiotics: Antibiotics are used to treat whooping cough since it is a bacterial infection. Your baby may need to get intravenous (IV) antibiotics. The doctor would prescribe an antibiotic based on your baby’s age and the severity of the infection.
  • Oxygen supply: Since the baby may have trouble breathing, oxygen is given to the baby. Generally, giving oxygen helps the respiratory distress. Very rarely, CPAP (continuous positive airway pressure) maybe used.
  • Medication to alleviate fever and pain: If the baby seems to be in a lot of pain and has a fever, then they may get a dose of acetaminophen (paracetamol) to subdue the symptoms.

Babies who are hospitalized have the right conditions around for quick recovery. But if your baby is not hospitalized for the treatment, you will have to observe some essential home care measures.

How To Manage The Baby’s Whooping Cough At Home?

You may take the following home care tips for whooping cough in babies:

  1. Lots of rest: Rest is essential since the constant bouts of coughing can leave the baby exhausted. Avoid traveling and taking the baby outdoors for extended durations, to prevent strain. Maintain a comfortable ambient temperature inside the baby’s room to keep them comfortable.
  1. Keep the surroundings clean: Keep the baby’s surroundings clean to minimize the baby’s risk of developing secondary respiratory infections. Wipe the baby’s personal items like toys and utensils with baby-safe disinfectant liquids. Also, wash the baby’s clothes in warm water.
  1. Cool-mist humidifiers: A cool-mist humidifier makes breathing easier for an infant by improving the humidity levels in ambient air. Always choose cool-mist humidifiers over a warm-mist or steam humidifiers, which can increase the risk of burns for the baby (9).
  1. Give plenty of fluids: If the baby is younger than six months, then additional feeds can provide the extra fluids that the baby needs. Older infants can have soups and purees along with sips of water every now and then.
  1. Provide small, frequent meals: If the baby is on solids, then give small portions of food more frequently than larger portions in a few servings each day. It reduces the chances of gagging, nausea and prevents vomiting.
  1. Prevent triggers: Avoid exposing the baby to irritants like smoke and dust that can trigger a fit of whooping cough.

If your baby is not hospitalized during treatment, then the doctor will prescribe medicines that you need to administer at home. Alternatively, you may have to visit the hospital once in a day for the doctor to provide IV antibiotics to the baby.

Treatment along with home care can last for two to three weeks, although it can extend depending on the intensity of the symptoms and the infant’s age.

Even if the pertussis bacteria is eliminated by the end of the treatment, the baby may continue to have whooping cough for a few more weeks.
Treatment is necessary because, if left untreated, whooping cough in infants can lead to the onset of complications.

What Are The Complications Of Untreated Whooping Cough In Babies?

If left untreated, whooping cough may lead to the following problems (10):

  1. Sleep apnea: A baby can have constricted airways that could lead to chronic sleep apnea where their lungs do not get adequate air for respiration. Sleep apnea is the leading complication of whooping cough, with about 61% affected babies developing it.
  1. Pneumonia: The pertussis bacteria can cause a widespread lung infection called pneumonia, which can lead to several other problems.
  1. Encephalopathy and seizures: In rare cases, the bacteria may reach the brain causing a brain infection called encephalopathy. The bacteria could also result in seizures, irrespective of the infection of the brain.
  1. Death: About 1% of infants with whooping cough face the risk of death. It is quite rare though and may only happen when the coughing is entirely ignored by the parents for weeks and months together.

Whopping cough is very painful for the baby and they may have to suffer for weeks together. Therefore, take precautionary measures to avoid the onset of the problem.

How To Prevent Whooping Cough In Babies?

The following steps can help you keep pertussis at bay:

  • Vaccination during pregnancy: You can pass your baby the antibodies needed to fight the pertussis bacteria by getting the diphtheria, tetanus, pertussis vaccine (DTaP vaccine) when you are pregnant.
    Immunization should happen anytime between the 27th and the 36th week of pregnancy (11). A vaccination during gestation allows the baby to be born with some immunity against the whooping cough bacteria.
  • Vaccinate the infant: A baby must get five shots of DTaP vaccine at the age of 2 months, 4 months, 6 months, between 15-18 months, and later between 4-6 years (12). The vaccine is safe for infants and may cause some minor, temporary side effects such as redness at the site of injection, mild fever, and vomiting. However, vaccination is the mainstay of prevention against pertussis.

The DTaP vaccine may not provide 100% immunity against pertussis bacteria, and you will still have to observe precautions. But it reduces the risk of infection, and the number of whooping cough cases has significantly come down, thanks to the DTaP vaccination (13).

  • Vaccinate the others in the household: Since whooping cough is contagious, it can pass from an adult to the baby. So the adults and other children in the household, who haven’t already been vaccinated, should also get the DTaP vaccine to protect themselves and the baby from the infection.
  • Cover your mouth and nose if you have a cold: Simple precautionary steps like covering your mouth and nose while sneezing or coughing can the prevent the transfer of bacteria to the baby. Pertussis infection in adults may not manifest into whooping cough due to better immune response. But you may still carry the bacteria and unknowingly pass it to the baby.

Anyone in the family with a cold or respiratory infection must stay away from the baby. Wear a mask when around the baby and wash hands before touching the baby or any items that the baby might use.

Immunization is the single most effective way to protect infants from whooping cough.

Below we answer a few more questions on the topic.

Frequently Asked Questions

1. Can babies get whooping cough even after vaccination?

The DTaP vaccine is almost 90% effective but an immunized infant may get whooping cough if others in the family are not immunized and if other precautions are not taken. However, immunized infants display a lower intensity of symptoms and better response to treatment. The baby also has a lower risk of developing sleep apnea, breathlessness, and vomiting (14).

2. If everyone in the family is vaccinated, does my baby still need DTaP vaccine?

Yes. For the best protection, get your baby vaccinated even if everyone else at home has been vaccinated.

3. Can whooping cough happen more than once?

Yes. Whooping cough can affect more than once, but usually when the baby is not vaccinated. Sometimes, a baby may recover from a less severe bout of whooping cough and get severely infected with pertussis again. Therefore, vaccination is vital for the prevention of multiple pertussis infections.

Since whooping cough is a contagious disease, consult a pediatrician if your child has come in contact with an infected person. Notice if they’ve developed any symptoms and report to their doctor for early treatment. The treatment for whooping cough in babies usually includes medications and antibiotics. If treated early, whooping cough in babies will be over in a few days. Follow good personal hygiene practices to prevent the spread of the infection. Also, consider vaccinating yourself and your baby against pertussis to prevent the infection.

References:

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  1. Whooping Cough (Pertussis) in Children.
    https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=P02533
  2. Whooping Cough Can Kill.
    https://healthcare.utah.edu/the-scope/shows.php?shows=0_jfki4c5p
  3. Pertussis (Whooping Cough).
    https://www.chop.edu/conditions-diseases/pertussis-whooping-cough
  4. Whooping Cough is Deadly for Babies.
    https://www.cdc.gov/pertussis/pregnant/mom/deadly-disease-for-baby.html
  5. Pertussis (Whooping Cough) Signs and Symptoms.
    https://www.cdc.gov/pertussis/about/signs-symptoms.html
  6. Myths And Facts About Fevers In Children And Infants.
    https://healthcare.utah.edu/the-scope/shows.php?shows=0_zzvhzkjk
  7. Pertussis (Whooping Cough) Diagnosis and Treatment.
    https://www.cdc.gov/pertussis/about/diagnosis-treatment.html
  8. Whooping Cough: What Parents Need to Know.
    https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Whooping-Cough.aspx
  9. Caring for Your Child’s Cold or Flu.
    https://healthychildren.org/English/health-issues/conditions/flu/Pages/caring-for-Your-childs-cold-or-flu.aspx
  10. Pertussis (Whooping Cough) Complications.
    https://www.cdc.gov/pertussis/about/complications.html
  11. Update on Immunization and Pregnancy: Tetanus Diphtheria and Pertussis Vaccination.
    https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/09/update-on-immunization-and-pregnancy-tetanus-diphtheria-and-pertussis-vaccination
  12. 2022 Recommended Immunizations for Children from Birth Through 6 Years Old.
    https://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf
  13. Vaccine (Shot) for Whooping Cough (Pertussis).
    https://www.cdc.gov/vaccines/parents/diseases/pertussis.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fparents%2Fdiseases%2Fchild%2Fpertussis.html
  14. Pertussis (Whooping Cough) Pertussis Frequently Asked Questions.
    https://www.cdc.gov/pertussis/about/faqs.html

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Dr. Mubina Agboatwalla

(MBBS, DCH, MCPS)
Dr. Mubina Agboatwalla is a well-known pediatrician, practicing paediatrics since the last 20 years in Karachi Pakistan. She is the head of the department of Pediatrics in Karachi Liaquat Hospital, as well as her private practice in three specialist clinics in Pediatrics. She is also a Public Health Specialist specializing in preventive health including nutrition, breastfeeding and infectious diseases especially... more

Rohit Garoo

Rohit Garoo is a zoologist-botanist turned writer with over 8 years of experience in content writing, content marketing, and copywriting. He has also done an MBA in marketing and human resources and worked in the domains of market research and e-commerce. Rohit writes topics related to health, wellness and development of babies. His articles featured on several notable websites, including... more

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