Whooping Cough (Pertussis) (Child)

Whooping cough (pertussis) is a bacterial infection in the respiratory tract. It's a very serious illness in babies under 1 year of age. It may cause milder illness in older children and adults.

Pertussis is highly contagious and is spread through the air by coughing or sneezing. The illness starts with a runny nose, mild cough, congestion, and low-grade fever. Babies may have brief periods when they don't breathe (apnea). Later symptoms may include:

  • Prolonged coughing spells that cause a "whooping" sound when breathing in

  • Gagging or vomiting with or after coughing

  • Feeling very tired

Antibiotics are used to treat this illness. They work best when given as early as possible after diagnosis. They also help prevent further spread of the infection. Even after treatment, it may take months for the cough to go away completely.

Vaccines prevent pertussis. The vaccine effect lessens after 5 to 10 years. Teens and adults who were vaccinated as a child can get a mild form of pertussis and may spread the illness to unvaccinated babies and children. Be sure to ask your healthcare provider whether you or your teen needs a booster vaccine. Pregnant women should be given a booster vaccine before delivery to help protect the newborn from developing this infection.

Home care

  • Medicines. Give your child medicine as prescribed by the healthcare provider. Be sure to give your child antibiotics as directed until they are gone, even if your child feels better. If your child does not finish the antibiotics, the infection may come back and be harder to treat.

  • Cough. Coughing is a normal part of this illness. A cool mist humidifier at the bedside may be helpful. Don't give over-the-counter cough and cold medicines to children under 6 years unless the child's healthcare provider has advised you to do so. These medicines can cause serious side effects, especially in infants under 2 years of age. For older children, contact the healthcare provider before giving your child an over-the-counter cough or cold medicine. 

  • Fluids. Fever increases water loss from the body. For babies under 1 year old, continue regular feedings. Ask your healthcare provider about oral rehydration solution. You can find these in grocery stores and drugstores without a prescription. Ask the pharmacist for help in selecting one.  For children over 1 year old, give plenty of fluids like water, juice, lemonade, or ice pops.

  • Activity. Keep a child with a fever at home resting or quietly playing. Encourage frequent naps. Your child should stay home from daycare or school until 5 days of antibiotics are completed. If no antibiotics are given, keep the child home until 21 days after the cough started.

  • Sleep. Periods of sleeplessness and irritability are common. Give your child plenty of time to sleep.

    • For children 1 year and older: Have your child sleep in a slightly upright position. This is to help make breathing easier. If possible, raise the head of the bed slightly. Or raise your older child’s head and upper body up with extra pillows. Talk with your healthcare provider about how far to raise your child's head. 

    • For babies younger than 12 months: Never use pillows or put your baby to sleep on their stomach or side. Babies younger than 12 months should sleep on a flat, firm surface on their back. Don't use car seats, strollers, swings, baby carriers, or baby slings for sleep. If your baby falls asleep in one of these, move them to a flat, firm surface as soon as you can.

  • Nasal congestion. Ask your child's healthcare provider about using a rubber bulb syringe to clear an infant's nose.

  • Fever. Ask your child's healthcare provider whether to give over-the-counter medicines to help ease fever, fussiness, or discomfort. Never give aspirin to anyone under 18 years of age who is ill with a fever. It may cause severe liver damage.

In addition:

  • Wash your hands well with soap and water for at least 20 seconds before and after caring for your child. (You don't need antibacterial soap.) This helps prevent the spread of the illness.

  • Don't expose your child to tobacco smoke. This can make the cough worse and your child sicker.

  • Check that people who live with or care for your child are up-to-date on their pertussis vaccine.

Follow-up care

Follow up with your child's healthcare provider, or as directed.

When to seek medical advice

Call your child's healthcare provider right away if your child has any of the following:

  • Cough that becomes severe, with gagging, vomiting, or turning blue

  • Earache, sinus pain, headache

  • Unusual fussiness, drowsiness, or confusion

  • Repeated vomiting

  • Signs of dehydration, including very dark urine, little or no urine, sunken eyes, cracked lips, and feeling of thirst

  • Fever (see Fever and children, below)

Call 911

Call 911 if any of these occur:

  • Child has trouble breathing or stops breathing

  • Child has very fast breathing:

    • Birth to 6 weeks: over 60 breaths/minute

    • 6 weeks to 2 years: over 45 breaths/minute

    • 3 to 6 years: over 35 breaths/minute

    • 7 to 10 years: over 30 breaths/minute

    • Older than 10 years old: over 25 breaths/minute

  • Child loses consciousness or has convulsions (seizures)

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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