Health

How to prevent whooping cough

Whooping cough is on the rise in Ireland. With the disease most serious in babies under 12 months, the increase in reported cases has prompted health officials to urge pregnant women to get vaccinated.

Whilst most of us have heard about the illness, how much do we really know about it? And how can we prevent whooping cough?

About whooping cough

Also called pertussis, whooping cough is a highly infectious disease caused by bacteria found in the mouth, nose and throat of an infected person. It is a worldwide illness that can affect people of all ages, although most reported cases occur in children under the age of five.

Often, it requires admission to hospital, as sometimes it can be fatal. However, there are ways that parents can help protect their baby from contracting the illness.

Whooping cough prevention Immunisation is the most effective way to prevent infection and limit the spread of pertussis.

A vaccination is given to children as part of the six in one, at the age of two, four and six months. A booster vaccine dose is given between four and five years of age, as part of the four in one vaccine. Another booster dose is given in the first year of secondary school.

Because babies can’t be vaccinated until they are eight weeks old, the best way to keep them safe is to get vaccinated. Immunity from previous vaccinations lasts about ten years, which means that an adult or adolescent who has already been vaccinated may still get whooping cough.

Anyone who wants to reduce the risk of infection to themselves or to young babies can get the vaccine, which starts to work within two weeks. Health officials recommend vaccination for anyone in close contact with premature babies, babies with low immune systems, or pregnant women.

Pregnancy and whooping cough

Since 2013, the pertussis vaccine has been recommended during each pregnancy to provide protection to infants in the first few months of life. The best time to receive this is between 27 and 36 weeks of pregnancy, as this will give the baby the best protection; however, getting the vaccine in later pregnancy will also offer some protection too.

The vaccine stimulates the immune system to produce high levels of antibodies to the whooping cough bacteria. These antibodies will also pass to the baby in the womb and protect them during the first few months after birth. The antibodies a mum passes to her baby in the womb decline rapidly in the first six months, so the best way to protect your baby from whooping cough is to make sure they get the routine childhood vaccines at two, four and six months.

Because the antibodies a person develops after vaccination decline over time, the vaccine is recommended in every pregnancy a woman has.

Babies born before 32 weeks are not protected, as they won’t get enough antibodies while in the womb. According to the HSE, the best way to protect them is to:

• Make sure other children in the house are fully vaccinated.

• Make sure all unvaccinated teenagers or adults in the house get a whooping cough vaccine. Ideally they should get the vaccine two weeks before contact with the baby.

• Keep yourbaby away from anyone with a cough until they have had two of their routine vaccinations (at four months of age).

Whooping cough symptoms

As well as the prevention of whooping cough, knowing what symptoms to look out for is also important.

  • Whooping cough causes long bouts of coughing and choking, making it hard to eat, drink or breathe.
  • Infants may turn blue from lack of air, or vomit after a coughing spell. Frequent vomiting after violent coughing spells and loss of appetite can result in severe weight loss.
  • The characteristic ‘whoop’ sound can be heard between these coughing spells, although not everyone who is infected gets the ‘whoop’.
  • Different parts of the body may also be affected.
  • Most cases involve some degree of collapsed lung and/or pneumonia, although most do not experience permanent lung damage.
  • There may be altered consciousness or convulsions, which up to one in 70 babies can suffer.
  • Around one in 1,000 may develop encephalopathy (inflammation of the brain).

Treatment of whooping cough

Once infected, an individual with pertussis can be infectious for four to five weeks from the onset of the illness. Greatest infectivity happens early on in the illness, even before the cough has developed, which means an infected person can transmit the infection before they know they have it.

Antibiotic treatment can shorten the contagious period by stopping the risk of infection to other people; however, it won’t shorten the length of the illness and the cough.

People who have or may have pertussis should stay away from infants until properly treated. Treatment of people who are in close contact with pertussis cases is also an important part of prevention. Lasting up to three months, the disease results in around half of babies under six months being admitted to hospital.

Immunisation is the most effective way to prevent infection and limit the spread of pertussis.

Whooping cough in Ireland

• In recent years, there has been an increase of whooping cough cases among infants, some of whom are too young to have received the three primary doses of vaccine necessary to provide protection.

• Pertussis outbreaks have been reported from both community and school settings. In 2015, there have been 110 cases year to date, compared with 60 over the same period last year.

• Half of all 73 whooping cough cases last year were in children under 12 months, according to the Health Protection Surveillance Centre.

• Contact your GP or maternity hospital to arrange for the free vaccination.

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Treating baby’s cold
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Ask Allison

Q My sister-in-law and I both work three-day weeks and we help each
other out with child minding on our working days, which up until recently has worked out really well. Between us, our kids are aged between five and nine years – the problem is that it’s now become quite apparent that we have very different parenting styles. I prefer my two daughters (seven and nine) to have a structured day. For example, in my house, we have allocated times for television and iPads, etc. My sister-in-law, however, lets the kids run loose after school – homework is ignored and my kids end up wired after eating sugary treats all afternoon. I am considering looking at after-school childcare for the kids, but I’m worried that this is going to cause a family argument. Is there a diplomatic way that I can ask my sister-in-law to introduce some discipline into her child-minding days? It certainly doesn’t do her two kids any harm when I am minding them in my own house!

A
In a word, no, there is no diplomatic way to do this as it may very likely seem like your saying that your parenting style is better than
hers. As L’Óreal says, ‘now here comes the science bit.’ Dr. Kaylene
Henderson, a child psychiatrist, wrote a very interesting blog about ‘the
science behind the Mummy Wars’. She explains that before she had
children of her own she hadn’t been aware of how parents have a
very specific sense of the right parenting style. She also found that parents could be very definite in defending their chosen parenting style. Dr. Henderson, who describes herself as a curious, scientific, open-minded person, was surprised at how defensive parents could be and, at times, of their judgemental attitude towards each other. She explained the neurology of the Mummy Wars; okay, I’ll need you to bear with me for a second. Warning; I’m about to use some neuro-techie language.

Why do we judge each other?
As we have all had different experiences, this means that we all have very different memories stored in our brains. Most of our memories are ‘explicit’ memories – these are ones that we can recall easily such as important dates that mean something to us; important birthdays, special events or stories of and about our lives.
There is another type of memory called ‘implicit’ memory that plays a
key role in our parenting. This type of memory is the stuff that you do on autopilot. Psychologists call these heuristics or rules of thumb –
such as tying your shoelace, or driving your car (once you have learnt
to do both first!). Otherwise we’d really waste a huge amount of time
pondering over tasks that we have readily available to us. This seems to be where the science bit of our parenting style kicks in. This implicit memory goes all the way back to when you were an infant being parented by your parents. This is when you started the process of storing up how they did it into your memories.
Unless you make a conscious choice and effort to parent differently, what you saw and unconsciously learnt will be your automatic go-to parenting style.

We learn habits
This can really kick into gear when we feel our parenting style is
being mirrored or highlighted by disapproval from another parent. I know the cold sweat you feel when your child decides to make their outstanding bad behaviour performance at, of course, the most public and worst time. The implicit autopilot of how your parents dealt with these outbursts will flow unconsciously from you if you haven’t worked super hard to be aware and consciously change the old habits.
What’s happening for the on-looking parent is that they see you doing something they are used to doing, but you are doing it all wrong. Simply, because that is not how they know how to do it.

Find a way that works
You both have different parenting styles – who is to say which type is correct? You just need to know what works best for your family and that’s the bottom line. The irksome feelings won’t go away. You can talk to your sister-in-law, but I’m adding a caveat that it would be hard not to hurt her feelings. What we’re possibly looking at is that you prefer a more structured form of parenting, whereas your sister-in-law has a more permissive style. I’m not sure the two styles can mix, the mixture is a bit like oil and water.
If a collaborative shared form of parenting style can be agreed upon, then that is great, but our learnt hardwiring may prove difficult to change despite the intent to do so.
Perhaps, your own instinct of changing childcare might work best for you. In terms of making childcare work; the fit is ultimately the most
important aspect as you want a cohesive congruent feeling of the other caregiver to just ‘getting it’, like in any good partnership. Best of luck
with this and I wish you both well.

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ASK LUCY

Q My son is 18 months old and has just started saying his first words. It is an extremely exciting time in our house and my husband and I are eager to encourage his speaking as much possible. What advice would you give us on how we can foster this without bombarding and confusing him?

AThere is nothing better than hearing your baby begin to talk. All the hard work you have put in over the last two years is coming back tenfold.
Toddlers will vary significantly with ability and speed of which they talk however a guide would be about 50 words by 2 years of age. The most important thing to watch for is that your baby/toddler is cooing and babbling and begins to string sounds together like “Mama/Dada” They should have a wide range of speech sounds and like to imitate you and things they hear.
There are many ways that you can promote Speech and Language development at home:
1. Slowing down your own speech and taking time over conversations with your little one. Every day is a new experience when you are 18 months, nappy changes, bath time, baking a cake brings endless opportunity for you to interact and offer new words for them to hear and repeat. Make eye contact, smile and use exaggerated tones to keep things interesting and fun for your tot.
2. Review the toys that you have on offer to your tot and ensure that they give plenty of open ended play opportunities. Role play is a wonderful way to allow children to take the lead. Kitchens with lots of plates, cups and pots. Fill the pots with dry pasta and allow your child to cook and serve you. Playdoh, painting, gardening and sandpits are also great for allowing your child to take the lead and babble about what they are doing. Read plenty of books together and point and allow them time to answer any questions that you ask.
3. Limit screen time. Overuse of televisions and iPads do not give your child opportunity to interact in a two way manner.
4. Ask your child lots of open ended questions “What’s that?” “Where are we?” Point at things they know the answer to for boosting confidence (Car/ Car, etc.) When they don’t know the answer, explain it to them. Limit baby talk and speak clearly with good pronunciation, remember you are the teacher and they will copy you.
If you are concerned about your child’s speech and language development, be sure to speak with your GP or developmental Health Nurse. They are very skilled at understanding the difference between speech delays and spotting something that may require professional attention.
Enjoy watching their little brains absorb the world around them and listen to what they have to say. It won’t be too long before they won’t stop talking to you, asking “Why Mummy/ Daddy?” every 5 minutes….