Whooping Cough in Babies: Spot the Cough and Protect Your Infant

It started like an ordinary cold. Then, after a week, the cough changed: endless fits, especially at night, a face turning red, sometimes a vomit at the end. In an older child or an adult, it is exhausting. In a baby a few weeks old, whooping cough (pertussis) can become dangerous within hours.

Whooping cough has not gone away, far from it. France, for example, saw a sharp surge in 2024, with 46 deaths including 21 children under one year old, according to French health insurance (Assurance maladie). Infants too young to be vaccinated are the most exposed, and it is most often adults around them who pass it on. Here is how to recognise this cough, when to react as an emergency, and above all how to protect your baby.

What is whooping cough?

Whooping cough is a respiratory infection caused by a bacterium, Bordetella pertussis. It is extremely contagious: according to Assurance maladie, one sick person infects 15 to 17 others on average. It spreads through droplets released when coughing or talking.

The first signs appear about 10 days after infection, sometimes up to 3 weeks. Contagion starts in the cold-like phase, even before the coughing fits, which is why people let their guard down.

How do you recognise the whooping cough cough?

Whooping cough develops in two stages, according to Assurance maladie and the UK’s NHS.

1. A cold-like phase for one to two weeks: runny nose, a mild cough, little or no fever.
2. A phase of coughing fits: sudden, violent, repeated bouts of coughing, more frequent at night. The face turns red, puffy, sometimes bluish. At the end of the fit, the child catches their breath with a long, high-pitched intake of air, the famous “whoop”. The fits are often followed by vomiting.

Between fits, the child may seem fine, and the cough comes without fever. Untreated, the fits last 4 to 6 weeks, then the cough fades slowly over several weeks: this is the lingering cough that should make you think of whooping cough in an adult who has coughed for over a week without improving.

In infants, different signs

The NHS warns that babies under 3 months do not always make the whooping sound. They may, however, struggle to get their breath back after a fit and turn blue or grey. These pauses in breathing are the real danger. Whooping cough can also dehydrate them and cause pneumonia or convulsions.

For other toddler coughs, our guide to your baby’s cough helps you tell them apart; fast, wheezy breathing points more towards bronchiolitis.

Why is it an emergency in a baby?

Because the risk of a severe form is high before 6 months, and the baby is not yet protected by their own vaccines. Assurance maladie says an infant under 3 months with whooping cough is routinely admitted to hospital, to monitor their breathing.

The practical rule is simple:

• a baby under 3 months who coughs must be seen as soon as possible, in the emergency room if need be;
• a baby aged 3 to 6 months who coughs should see their doctor or paediatrician quickly;
• a child or an adult who coughs in fits, or whose cough lasts more than 7 days and gets worse, should also see a doctor, especially if they live with an infant.

How is whooping cough treated?

Whooping cough is treated with an antibiotic prescribed by the doctor, who chooses the medicine and the dose. The NHS specifies that the antibiotic, given within three weeks of the cough starting, does not always shorten the symptoms, but it limits contagion. Close contacts who are poorly protected, especially infants, may be given a preventive antibiotic, at the latest three weeks after contact.

At home, for an older child treated outside hospital, Assurance maladie advises:

• giving small amounts to drink and eat often;
• keeping them well upright before and after meals;
• clearing the nose if it is blocked;
• a room at 19 to 20 °C with humidified air, and no tobacco smoke in the home;
• no cough syrups or mucus thinners, judged ineffective and sometimes dangerous.

The patient stays home 3 to 5 days after starting the antibiotic, or three weeks after the cough began if not treated.

How can you protect your baby?

An infant’s protection rests on three pillars: their own vaccines, their mother’s vaccine during pregnancy and the vaccination of those around them.

Their vaccines, free in Morocco

In Morocco, the whooping cough vaccine is part of the National Immunisation Programme (PNI). It is included in the combined vaccine given at 2, 3 and 4 months, then boosted at 18 months and 5 years, according to the Ministry of Health’s child health record. The programme works well: according to WHO and UNICEF estimates, 96% of Moroccan children had received the first three doses in 2025. The details are in our vaccination schedule in Morocco, and the vaccine itself is covered in our article on the 2, 3 and 4-month vaccines.

Keeping to the dates matters: each dose strengthens protection, and a baby is not protected before starting their injections.

The mother’s vaccine during pregnancy

The antibodies made by the mother cross the placenta and protect the baby during the first weeks. The NHS offers it in every pregnancy, usually around 20 weeks, ideally before 32 weeks. Assurance maladie recommends it between 20 and 36 weeks of amenorrhoea, or just after birth if the mother has not been vaccinated, even if she is breastfeeding.

In Morocco, the PNI vaccinates pregnant women against tetanus and diphtheria, but we did not find a published official recommendation on whooping cough during pregnancy. Talk to your gynaecologist or midwife, and read our article on vaccines during pregnancy.

“Cocooning”: protecting the circle around your baby

The idea is to vaccinate the people who will be in close contact with the newborn: dad, brothers and sisters, grandparents, the nanny. In France, Assurance maladie recommends a booster for adults around the baby who have not been vaccinated for more than 5 years.

In Morocco, where a birth often brings the whole family together during the nfissa (the postnatal rest period) and the sbou3 (the naming ceremony on the seventh day), a few simple habits matter just as much:

• anyone who coughs, even “just a little”, avoids picking up and kissing the baby;
• everyone washes their hands before touching them;
• visits from relatives with colds are postponed;
• nobody ever smokes near the baby, or in the house.