Whooping Cough (Pertussis) (Child)

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 pharmacies 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 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 1 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 a serious condition called Reye syndrome. It may result in severe liver or brain damage.

Also:

• 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 get medical advice

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

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

• Earache, sinus pain, headache

• 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 the following occur:

• Child has trouble breathing or stops breathing

• Child has very fast breathing:

  • Birth to 6 weeks: over 60 breaths per minute

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

  • 3 to 6 years: over 35 breaths per minute

  • 7 to 10 years: over 30 breaths per minute

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

• Child loses consciousness or has convulsions (seizures)

• Unusual fussiness, drowsiness, or confusion

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 they are at least 4 years old.

Use a 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 them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

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

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

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

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

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

• A fever of ___________ as advised by the provider