Whooping cough in babies: the symptoms to know — even without the whoop

Your baby has had a runny nose and a little cough for a week. Tonight a coughing bout came that would not stop: cough, cough, cough, then a gag, and for a moment that small face went bright red.

Here is the key point first: coughing bouts in a baby are a reason to get medical advice today, not next week. Whooping cough can be treated, and young babies usually get that treatment in hospital.

How to recognise whooping cough, which signs need 999 and how to protect your baby — section by section below.

How do you recognise whooping cough in your baby?

Whooping cough starts like a cold, with a runny nose and a sore throat, and a high temperature is uncommon. After about a week come coughing bouts that last a few minutes and are worse at night, sometimes followed by vomiting. Babies under 3 months may not whoop, so the whoop is not the sign to wait for.

The NHS page on whooping cough lists what follows that first week. Your child "will get coughing bouts that last for a few minutes and are worse at night". They may make a whoop, "a gasp for breath between coughs". And they "may bring up a thick mucus, which can make you vomit".

In babies, the picture is different. The NHS notes that "young babies under 3 months old and some adults may not 'whoop'", and that young infants "may have difficulty breathing after a coughing bout and may turn blue or grey". NHS inform, Scotland's health information service, adds the most important detail:

"In very young babies, the cough may not be particularly noticeable, but there may be brief periods where they stop breathing."

So a baby who does not whoop and has no temperature can still have whooping cough. What you watch for is the breathing during and after the bouts. How to tell other kinds of cough apart is covered in Cough in children.

Which warning signs need 999?

Call 999 or go to A&E if your baby has pauses where they stop breathing, or if their lips, tongue, face or skin turn blue or grey. The same goes for struggling to breathe, a seizure, or a baby who is difficult to wake. Other whooping cough symptoms under 6 months: urgent GP appointment or NHS 111.

The first point comes from NHS inform, which names "periods where breathing stops" as a reason for 999 or A&E. The colour change, the breathing difficulty and seizures are on the NHS whooping cough page's 999 list. The last point is from the NHS page on urgent help for babies and children under 5. Even if your baby starts breathing again on their own after a pause, treat it as a 999 call. A very high temperature in a baby is on the same NHS 999 list: 38C or higher under 3 months, or 39C or higher at 3 to 6 months.

Without those signs, there is a second, clear threshold. The NHS asks you to get an urgent GP appointment or help from NHS 111 if your baby is under 6 months old and has symptoms of whooping cough, or if a very bad cough is getting worse. For a child under 5, call 111 rather than using 111 online. The warning signs for fever, vomiting or a fall are sorted by situation in When to take your child to hospital.

Older than 6 months, coughing a little, feeding well and alert? Then this is not an A&E visit. Mention the cough to your GP all the same — the first stage of whooping cough looks exactly like a cold. Under 6 months, even mild symptoms count, so it is the urgent GP appointment or 111.

What happens at the GP — and will your baby need hospital?

If whooping cough is diagnosed within 3 weeks of the cough starting, the NHS says antibiotics are given to help stop it spreading to others. Babies under 6 months with whooping cough usually need hospital treatment, because they are the ones most at risk of complications.

Antibiotics do one job reliably, and it is not the cough. The NHS is direct about it: "Antibiotics may not reduce symptoms." Their purpose is to help stop the infection spreading to others. Which antibiotic, and at what dose, is a decision for your GP. If your child is prescribed a course, the NHS asks you to finish it, "even if you feel better".

Hospital is the usual path for young babies, not a sign that things are hopeless. The NHS says hospital treatment is usually needed for severe whooping cough, or if your baby is under 6 months old and has whooping cough. The reason is clear from the risks it lists for that age: babies under 6 months have an increased chance of dehydration, breathing difficulties, pneumonia and seizures.

What helps at home?

For older children recovering at home, the NHS advice is simple:

• Rest and plenty of fluids. Both are on the NHS list of things that help.
• Keep the mouth clear. NHS inform suggests cleaning away mucus and sick from your child's mouth.
• Skip cough medicines. NHS inform says they are not suitable for young children and are unlikely to be of much help.

How long does whooping cough last — and how long is it contagious?

Whooping cough lasts a long time. The NHS says the cough may last for several weeks or months, and NHS inform says it may be a few months before the bouts stop completely. Your child is contagious for up to 3 weeks after the coughing starts. Antibiotics shorten that time.

That long cough is the normal course, not a sign that treatment has failed. NHS inform describes the shape of it: the bouts eventually become less severe and less frequent over time. What matters during those weeks is the direction the bouts are taking.

The infectious period starts early. NHS inform says a person is infectious from about 6 days after they were infected, "when they just have cold-like symptoms", until three weeks after the coughing bouts start. That is why whooping cough often spreads before anyone suspects it.

For nursery and school, the NHS rule is: stay away until 48 hours after starting antibiotics, or 3 weeks after the cough started if no antibiotics were given.

How do you keep track of the coughing bouts?

Do not count in your head — note each bout as it happens: the time, roughly how long it lasted, whether your baby gagged or was sick afterwards, and how they looked. Over the days you see whether the bouts are getting more frequent or less, and your doctor can see it too.

Bouts that are worse at night are exactly the ones you forget. At 3am you know it was a bad one. By morning you no longer know whether it was the third or the fifth, or whether your baby fed afterwards.

In Mona you log each bout with the time and a short note such as "long, sick afterwards" in a few seconds, along with feeds. The history view shows you over the weeks whether the nights are getting calmer. If antibiotics are prescribed, the medication log records every dose with the time — even when you take turns at night.

Your GP will ask: When did the cough start? How many bouts were there last night? Is your baby sick afterwards, and still feeding enough? Have they been near anyone with a long-lasting cough? With a running record, you answer from your notes rather than from memory.

How can you protect your baby from whooping cough?

In the first weeks of life, the main protection comes from the whooping cough vaccine in pregnancy. The NHS recommends it around 20 weeks, from 16 weeks, ideally before 32 weeks. Your baby then gets the 6-in-1 vaccine at 8, 12 and 16 weeks, with further doses at 18 months and the pre-school booster.

The NHS page on whooping cough vaccination in pregnancy explains why it matters: "The immunity you get from the vaccine will pass to your baby through the placenta and provide passive protection for them until they are old enough to be routinely vaccinated against whooping cough at 8 weeks old." Missed it before 32 weeks? You can still have it later, even after the birth — the NHS says this is not ideal, because your baby is less likely to get protection from you, but it helps protect you and lowers the chance of passing it on.

Who	When (NHS)
Pregnant women	Around 20 weeks, from 16 weeks — ideally before 32 weeks
Babies	6-in-1 vaccine at 8, 12 and 16 weeks, and 18 months
Pre-school children	4-in-1 pre-school booster at 3 years 4 months

On safety, the NHS is clear: the vaccine has been used routinely in pregnant women in the UK since October 2012, and an MHRA study of around 20,000 vaccinated women found no evidence of risks to pregnancy or babies.

The NHS pregnancy vaccination page also notes that whooping cough rates have risen recently, and that babies who are too young to start their vaccinations are at greatest risk.

Frequently asked questions about whooping cough in babies

Can my baby have whooping cough without whooping?

Yes. The NHS says young babies under 3 months old may not whoop. NHS inform adds that in very young babies the cough may not be particularly noticeable, but there may be brief periods where they stop breathing. A missing whoop does not rule whooping cough out. If your baby stops breathing, call 999 straight away.

Does a baby with whooping cough have a temperature?

Usually not much. The NHS says a high temperature is uncommon in the first, cold-like stage, and NHS inform mentions only a slightly raised temperature. So a normal temperature is not reassurance on its own. Under 3 months, a temperature of 38C or higher is a 999 or A&E sign on the NHS urgent help page.

How long is whooping cough contagious?

According to NHS inform, someone with whooping cough is infectious from about 6 days after they were infected, while they still only have cold-like symptoms, until three weeks after the coughing bouts start. Antibiotics shorten that time. That is why the NHS asks you to start a prescribed course as soon as possible.

Can my child go to nursery with whooping cough?

Not while they are contagious. The NHS says to stay off school, work or nursery until 48 hours after starting antibiotics, or 3 weeks after the cough started if no antibiotics were given. Antibiotics shorten the time your child needs to stay at home.

Can a vaccinated child still get whooping cough?

Yes. NHS inform says protection from the childhood vaccine tends to wear off after a few years, and having had whooping cough before does not make you immune either. It tends to be less serious in older children and adults. That is why the pregnancy vaccine matters even if you were vaccinated as a child.

Do cough medicines help with whooping cough?

No. NHS inform advises avoiding cough medicines, because they are not suitable for young children and are unlikely to be of much help. What helps is rest, plenty of fluids and clearing mucus or sick from your child's mouth. Antibiotics are about stopping the spread rather than easing the cough.

Does the vaccine in pregnancy really protect my baby?

Yes. The NHS says vaccinating pregnant women has been highly effective in protecting young babies until their own first vaccination at 8 weeks. Your antibodies pass to your baby through the placenta. An MHRA study of around 20,000 vaccinated women found no evidence of risks to pregnancy or babies.

Summary: when to call 999, when to call 111?

Situation	What to do
Periods where breathing stops · blue or grey lips, tongue, face or skin · struggling to breathe · seizure · difficult to wake · 38C or higher under 3 months (39C or higher at 3 to 6 months)	Call 999 or go to A&E
Baby under 6 months with any symptoms of whooping cough, even mild ones · a very bad cough that is getting worse	Urgent GP appointment — or call 111
Child over 6 months with symptoms of whooping cough, such as coughing bouts or being sick after coughing	Speak to your GP practice or call 111
Child over 6 months coughing a little, feeding well and alert	Mention it to your GP — log the cough and feeds in Mona
Cough lasting more than 3 weeks	See your GP