Whooping Cough (Pertussis) and My Infant
Content reviewed against published CDC, AAP, NIH guidelines
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If your baby has been diagnosed with or you suspect whooping cough (pertussis) and my infant, here is what the evidence says.
The short answer
Whooping cough (pertussis) is a highly contagious bacterial respiratory infection that is especially dangerous for infants under 12 months, particularly those under 6 months who are too young to be fully vaccinated. Pertussis has been resurging in recent years despite vaccination efforts. The best protection for newborns is maternal Tdap vaccination during pregnancy (ideally at 27-36 weeks) and ensuring all caregivers are up to date on their Tdap boosters. Infants with pertussis often need hospitalization.
Key takeaways
- Whooping cough (pertussis) is a highly contagious bacterial respiratory infection that is especially dangerous for infants under 12 months, particularly those under 6 months who are too young to be fully vaccinated. Pertussis has been resurging in recent years despite vaccination efforts. The best protection for newborns is maternal Tdap vaccination during pregnancy (ideally at 27-36 weeks) and ensuring all caregivers are up to date on their Tdap boosters. Infants with pertussis often need hospitalization.
- Usually normal when: Your baby has a mild cold with a light cough that is improving over a few days
- Call your doctor if: Your baby turns blue or stops breathing during or after a coughing fit — call 911 immediately
- Varies by age — see the age-by-age breakdown below
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
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When to Seek Immediate Care
- Your baby turns blue or stops breathing during or after a coughing fit — call 911 immediately
- Your baby is under 3 months with any persistent cough, especially with vomiting or breathing difficulties
- Your baby has a whooping sound after coughing fits or has severe coughing episodes that leave them exhausted and unable to eat or drink
By Age
What to expect by age
0-2 months
This is the most dangerous period for pertussis. Infants this young may not have the classic "whoop" sound and instead may have episodes of apnea (pauses in breathing), turning blue, or simply stopping breathing. They are too young to have received their first DTaP vaccine dose. Protection comes from maternal antibodies (if the mother received Tdap during pregnancy) and from "cocooning" — ensuring everyone who comes in close contact with the baby is vaccinated. If your newborn has a persistent cough, especially with vomiting or any breathing difficulties, seek medical evaluation immediately.
2-6 months
Babies receive their first DTaP vaccine dose at 2 months, with additional doses at 4 and 6 months. Protection increases with each dose but is not considered reliable until after the third dose at 6 months. Symptoms of pertussis in infants include severe coughing fits that may end in vomiting, the characteristic "whoop" sound when gasping for air between coughs (though this is often absent in very young infants), turning red or blue during coughing fits, and exhaustion after coughing episodes. Pertussis can last 6-10 weeks and is sometimes called the "100-day cough."
6-12 months
After the third DTaP dose at 6 months, infants have better but not complete protection. A booster at 15-18 months provides additional immunity. If your older infant develops a cough that worsens over 1-2 weeks, occurs in intense fits, is followed by vomiting or a whooping sound, and does not improve with typical cold treatments, contact your pediatrician. Pertussis is diagnosed through a nasopharyngeal swab and is treated with antibiotics (usually azithromycin), which are most effective when started early in the illness.
What Should You Do?
When to take action
- Your baby has a mild cold with a light cough that is improving over a few days
- Your baby coughs occasionally during feeding — this can be related to swallowing and is usually not pertussis
- Your baby received their DTaP vaccines on schedule and has no known pertussis exposure
- Your baby has a cough that is worsening over 1-2 weeks rather than improving
- Your baby has coughing fits followed by vomiting or difficulty catching their breath
- Your baby has been exposed to someone diagnosed with pertussis
- Your baby turns blue or stops breathing during or after a coughing fit — call 911 immediately
- Your baby is under 3 months with any persistent cough, especially with vomiting or breathing difficulties
- Your baby has a whooping sound after coughing fits or has severe coughing episodes that leave them exhausted and unable to eat or drink
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Whooping Cough (Pertussis) and My Infant.
Things to mention
- Your baby has a cough that is worsening over 1-2 weeks rather than improving
- Your baby has coughing fits followed by vomiting or difficulty catching their breath
- Your baby has been exposed to someone diagnosed with pertussis
Observations to share
- Your baby has a cough that is worsening over 1-2 weeks rather than improving
- Your baby has coughing fits followed by vomiting or difficulty catching their breath
- Your baby has been exposed to someone diagnosed with pertussis
Urgent signs to report immediately
- Your baby turns blue or stops breathing during or after a coughing fit — call 911 immediately
- Your baby is under 3 months with any persistent cough, especially with vomiting or breathing difficulties
- Your baby has a whooping sound after coughing fits or has severe coughing episodes that leave them exhausted and unable to eat or drink
My notes
From ismybabyalright.com — free, evidence-based baby health guides
Related Conditions
Vaccine Side Effects in Babies and Toddlers
Mild vaccine side effects are very common, expected, and a sign that your baby's immune system is building protection. The most common side effects include fussiness, mild fever (under 101 F), soreness or swelling at the injection site, and increased sleepiness. These typically resolve within 24-48 hours. Serious vaccine reactions are extremely rare. The benefits of vaccination far outweigh the risks, protecting your child from potentially life-threatening diseases.
RSV in Babies: What to Know
RSV (respiratory syncytial virus) is a common virus that affects nearly all children by age 2. Most babies have mild cold-like symptoms, but some, especially young infants and those with underlying conditions, can develop breathing difficulties. Watch for fast breathing, flaring nostrils, or visible chest pulling - these are signs to seek medical care.
My Baby Is Breathing Fast
Babies normally breathe faster than adults. A normal respiratory rate for a newborn is 30-60 breaths per minute, slowing to 20-40 by age 1. Brief episodes of faster breathing during excitement, crying, or feeding are normal. However, persistently rapid breathing (tachypnea) at rest, especially with other signs of respiratory distress, may indicate a lung or heart problem that needs prompt evaluation.
Baby Wheezing
Wheezing is a high-pitched whistling sound heard during breathing out, caused by narrowed airways. In babies, the most common cause is a viral infection like bronchiolitis (often RSV). Many babies wheeze once or twice during their first viral illnesses and never wheeze again. However, wheezing with breathing difficulty always warrants medical evaluation.
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Month-by-Month Development
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When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is whooping cough (pertussis) and my infant normal?
When should I call the doctor about whooping cough (pertussis) and my infant?
When is whooping cough (pertussis) and my infant normal?
What causes whooping cough (pertussis) and my infant?
What should I mention to my pediatrician about whooping cough (pertussis) and my infant?
Is whooping cough (pertussis) and my infant normal at 0-2 months?
Is whooping cough (pertussis) and my infant normal at 2-6 months?
Should I go to the ER for whooping cough (pertussis) and my infant?
Does whooping cough (pertussis) and my infant go away on its own?
References
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Resources
Bottom line
Most cases of whooping cough (pertussis) and my infant are normal. Talk to your pediatrician if your baby turns blue or stops breathing during or after a coughing fit — call 911 immediately.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Related Medical Concerns
Vaccine Side Effects in Babies and Toddlers
Mild vaccine side effects are very common, expected, and a sign that your baby's immune system is building protection. The most common side effects include fussiness, mild fever (under 101 F), soreness or swelling at the injection site, and increased sleepiness. These typically resolve within 24-48 hours. Serious vaccine reactions are extremely rare. The benefits of vaccination far outweigh the risks, protecting your child from potentially life-threatening diseases.
RSV in Babies: What to Know
RSV (respiratory syncytial virus) is a common virus that affects nearly all children by age 2. Most babies have mild cold-like symptoms, but some, especially young infants and those with underlying conditions, can develop breathing difficulties. Watch for fast breathing, flaring nostrils, or visible chest pulling - these are signs to seek medical care.
My Baby Is Breathing Fast
Babies normally breathe faster than adults. A normal respiratory rate for a newborn is 30-60 breaths per minute, slowing to 20-40 by age 1. Brief episodes of faster breathing during excitement, crying, or feeding are normal. However, persistently rapid breathing (tachypnea) at rest, especially with other signs of respiratory distress, may indicate a lung or heart problem that needs prompt evaluation.
Baby Wheezing
Wheezing is a high-pitched whistling sound heard during breathing out, caused by narrowed airways. In babies, the most common cause is a viral infection like bronchiolitis (often RSV). Many babies wheeze once or twice during their first viral illnesses and never wheeze again. However, wheezing with breathing difficulty always warrants medical evaluation.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.