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November 1st, 2010
11:09 AM ET

Can breastfeeding prevent whooping cough?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Monday, it's Dr. Jennifer Shu, a pediatrician.

Question asked by Sara of Decatur, Georgia:

I am six months pregnant and have a couple of questions about babies who have recently died from whooping cough in California. How were they introduced to the bacteria? Can breastfeeding prevent this illness?

Expert answer:

Thanks for your question. Whooping cough, an illness caused by the pertussis bacteria, can cause severe respiratory symptoms and even death in young infants. In 2010, nearly 6,000 cases of whooping cough (including 10 deaths) have been reported so far in the state of California alone.

Officials report that half of the children who were sick probably got the infection from a parent or another caregiver and that nine of the 10 deaths occurred in infants under 2 months of age.

Older children and adults who have whooping cough often appear to have a bad cold or persistent cough that can be so severe that it causes vomiting. If left untreated, they usually get better on their own after several weeks, but giving antibiotics may help shorten the illness as well as decrease how contagious they are.

On the other hand, babies can become very ill from whooping cough. Because of their young age, immature immune system and delicate lungs, they are also more likely to have problems such as pneumonia, apnea (pauses or stoppages in breathing) or seizures related to the infection.

Babies under 6 months of age often do not make the typical "whooping" noise when they breathe in before coughing, so the diagnosis may sometimes be overlooked.

Although antibodies pass through the placenta to the baby during pregnancy, the ones that protect against pertussis are thought not to transfer well enough to help infants in the first few months.

Breastfeeding can certainly help provide immune protection against multiple illnesses, but not if a mother does not have immunity to a certain disease such as pertussis.

Since the pertussis vaccine's protection can wear off with time, a booster shot is recommended for adolescents at their 11-year-old checkup visit, as well as for adults who care for young infants, in order to protect from whooping cough until the babies have their own immunity.

This vaccine is given as Tdap, a relatively new vaccine that adds the pertussis component onto the original Td, or tetanus/diphtheria, booster shot. If it has been more than two years since a parent or caregiver had their last tetanus shot, the Tdap vaccine will be recommended now and again about every 10 years.

Infants typically receive the first part of the pertussis vaccine series at 2, 4 and 6 months as a component called DTaP. Until they get all three of these shots, they are more vulnerable to catching the disease.

For more information, I hope you will consult with your obstetrician or midwife for the best recommendations for your situation. Good luck!


soundoff (35 Responses)
  1. OhMmGee !

    ughhhhh , is this a desies ?? i'm really lost !

    November 1, 2010 at 12:03 | Report abuse | Reply
  2. Barely Survived Pertussis

    I was breastfeeding my daughter at the time she contracted Whooping Cough. I continued to pump and feed her breastmilk throughout the ordeal. Breastfeeding will not protect against Pertussis, though will provide a boost for your infants immunity to other illnesses. Please take this outbreak seriously...if your infant has an unusual cough, your other older children do, even you...get checked out. We came so close to losing our precious daughter to this horrible disease. And even when the infection is taken care of the residual effects lasted a YEAR. The mucus in the lungs/bronchial tubes is so difficult for them to expel that it would continually cut off her breathing. Do not take this lightly. It pains me to see children suffer and die over a preventable disease, let along the agony a parent encounters at the loss of a child.

    November 1, 2010 at 12:33 | Report abuse | Reply
  3. Larry

    Just get the vaccine. Guess that's just far too simple a solution for some of you rocket scientists out there.

    November 1, 2010 at 12:57 | Report abuse | Reply
    • enemell

      Larry, I am assuming that you know that DTap is given on a schedule, and immunity is complete until completion of the schedule?

      Importantly, the first shot cannot be given until an infant is about 2 months old. In the recent CA outbreak, several of the infants that died were too young to have even begun their vaccinations.

      The answer to the question is Yes. Yes, breastfeeding can give protection to an infant. Breastfed infants have stronger immune systems in general, and if the breastfeeding mother has immunity to Pertussis than that immunity will be passed through the breast milk to the infant. If the breastfeeding parent is not immune to Pertussis, then no – obviously that particular immunity will not be passed.

      Below is the recommended vaccination schedule for DTaP:

      Six shots between birth and age 12; one in adulthood.

      Recommended ages

      * At 2 months
      * At 4 months
      * At 6 months
      * Between 15 and 18 months
      * Between 4 and 6 years old
      * A booster shot at 11 or 12 years of age (called the Tdap)
      * For adults: a Tdap (for adults who've never had one) or Td booster every ten years

      November 1, 2010 at 13:19 | Report abuse |
    • KC_in_CA

      (1) 9 out of 10 of the deaths in California this year were infants TOO YOUNG TO GET THE VACCINE.

      (2) Even for those who get the vaccine, no vaccine if 100% effective even after you've received every recommended dose. I had to have the measles shot 3 times as an adult before I was actually protected.

      I'm sure the "rocket scientist" families who have lost babies this year would love to know how they could have prevented it. Since they could not prevent it, perhaps they could use a little compassion and less ridicule from the uneducated.

      November 1, 2010 at 17:19 | Report abuse |
  4. Barb

    Back in 1938 my sister contracted whooping cough at two weeks old. Our family physician told my mother if she had not been breast feeding my sister would have died. My sister is now 72 years old.

    November 1, 2010 at 13:38 | Report abuse | Reply
  5. Susan

    I think it's great when mothers choose to breastfeed. There is absolutely no conclusive evidence, however, to support the claim that breastfed children are healthier or have stronger immune systems that formula-fed babies. I'm not surprised that misinformation was ascribed in 1938, but please be careful of what is professed in 2010; mothers that choose not to, or are unable to breastfeed shouldn't be made to feel like they are in any way short-changing their children.

    November 1, 2010 at 14:32 | Report abuse | Reply
    • brent

      Well Susan, you would be wrong...you are not very well informed. Glad you're not the mother of my children.
      Cheers

      November 1, 2010 at 14:43 | Report abuse |
    • AMS

      In fact, there is conclusive evidence that breastfed babies/children have stronger immune systems than formula-fed babies, and there is evidence of long term health advantages in both babies who were breastfed as well as in their mothers. Mothers who choose to formula feed their babies NEED to be made aware that breastfeeding IS, in fact, a better option. Do some mothers have valid reasons for choosing formula over breastmilk? Yes, but they should make this decision with all of the facts in hand. Breastmilk is best.

      November 1, 2010 at 14:44 | Report abuse |
    • Joanna

      Um, there's actually an incredible magnitude of information proving just that. Breastfeeding leads to healthier babies. End of story. (Or, I really should say, breastfeeding leads to normal babies. Anything other than breastmilk leads to something that is subnormal. The whole 'gold standard' thing is a myth.)

      November 1, 2010 at 15:03 | Report abuse |
    • LIFETL

      Sorry folks, but a bottle fed baby can be just as healthy as a breast fed baby. I know I was bottle fed and hardly ever got sick and when I did get sick it was a simple cold or sinus infection. ON the other hand my sister was breast fed and she was always sick. One year she missed so much school my mom had to go to court b/c of it. I also had a friend that breast fed her baby and he had rsv and is, in generaly, a sickly child. I know in my mother's case, she ate healthy and did all the things her dr told her to do during and after her pregnancy. So condeming others b/c they do not breast fed is just plain wrong. Today w/ so many advances formula is not that bad. My oldest son refused my milk after about 2 wks of age and I had no choice but to bottle feed him. Its just not in the cards for everyone so chill out!

      November 1, 2010 at 15:25 | Report abuse |
    • Jenn

      I agree with LIFETL. I choose formula for my son because I knew I would have difficulties breast feeding (because of my own dietary issues and limitations). He is a happy healthy boy. He has never gotten sick, is very strong and is thriving. I hate it when people get almost militant and judgemental on mothers who do not breast feed. I have known too many babies that did not do well and thrive because they did not take to breast feeding, and their mothers refused to try formula. The healthiest babies/children I know are the ones that were on formula.

      Just like the other mother mentioned, when I had my son in January, they offered me the vaccine and I took it. I think they should also offer the fathers (or other mother in some cases) the vaccine as well.

      November 1, 2010 at 15:44 | Report abuse |
    • DoctorV

      It depends on what you mean by "healthier immune system." The babies' intrinsic immune system, i.e. circulating white blood cells and antibodies, will not necessarily be any different. But breast milk contains antibodies too (specifically IgA, just one type of many) that protect against pathogens on their way into the body. So they will not theoretically be any better at fighting infections, but should have a lower chance of being infected in the first place.

      November 1, 2010 at 15:45 | Report abuse |
    • FatSean

      Do you want processed food for your baby, or whole food?

      That was our choice. Studies do in fact show that breast feeding is an advantage. The various anecdotes posted here do nothing to sway me.

      November 1, 2010 at 16:12 | Report abuse |
    • Amy

      Susan! Where have you been?!? There are now so many studies showing direct benefit of breastfeeding against viruses and bacteria that it's purely silly to insinuate that it's just food. How about you go to Pubmed and just type in "breastfeeding" and "breastmilk." How about you take a look at just a few dozen of those studies. Just to make it easy, try to just read the ones from the last two years. It will take you awhile. Take notes.

      November 1, 2010 at 17:16 | Report abuse |
    • Susan

      Amy, please re-read my post; I never commented on either breastmilk or formula being "just food". I have been a pediatrician for over 35 years and my knowledge on this subject extends far beyond mere internet searches. I do not have a problem with breastfeeding, in fact my personal opinion is quite to the contrary– I do, in fact, have a problem with misinformation that is perpetuated by well-meaning people. This was never intended to become a breast vs. bottle discussion. Again, my original point was that there is no conclusive evidence that breastfed children are healthier than bottle-fed children. There is no study to date that has proven there are any long-term advantages beyond the first eight weeks of life.

      November 1, 2010 at 19:45 | Report abuse |
    • Chris

      Actually Susan, you are incorrect. There is an overwhelming amount of evidence supporting the conclusion that breast feeding improves infant resistance to infections. There is also a growing body of evidence demonstrating psychological benefits of breastfeeding for children as well.

      Even the makers of baby formulas concede that breastfeeding is the gold standard. I know, I work for Abbott Nutrition, the makers of Similac, Elecare, Pedialyte, and other infant formulas. Even Abbott recommends breastfeeding as a better option to their products.

      I suggest you do some research beyond popular media.

      November 27, 2010 at 15:34 | Report abuse |
    • Chris

      Susan,

      I missed the point that you have been a pediatrician for over 35 years. I can't help but wonder if that experience has shaped your paradigm. 35 years ago mothers were discouraged from breastfeeding. I mean no offense at all, but being a PhD neuropsychologist cannot help but wonder if there is some confirmation bias at play in your position. I regularly read medical and psychological journals, as well as participate in new product research at Abbott, and have seen overwhelming evidence of the benefits of breastfeeding (not just the milk, but the neuropsychological development advantages as well) over formula.

      This is an emotive topic for many, and I would never say that a child cannot be healthy of he or she if formula fed. That would be insensitive and incorrect. However, there is no question that breastfeeding is the better option for both physical and psychological health of the child.

      November 27, 2010 at 15:41 | Report abuse |
    • Katherine

      Susan: as a pediatrician, it is in your best interest to court your clients and sing a politically correct song. So I understand. I also respect other parents rights to raise their children as they see fit. That being said, the sugary and GMO in_gredients in formula, combined with my own immunities and many studies plus historical evidence (when formula was popular sixty years ago baby illness and deaths increased) make me much more inclined to breastfeed.
      Our country should be about freedom, yes, but opinions should be listened to, parents who formula feed should not be babies into believing that formula is equal, but given situational-specific advice. Parents who choose not to vaccine should equally not be mocked, but given situational specific advice. Freedom in this country isn't about freedom to go with the grain, but freedom to go against. Some people have terrible reactions to vaccines, and the lack of respect is abysmal.

      November 8, 2013 at 12:43 | Report abuse |
  6. KDW

    A lot of people miss the point that the most likely vector for an infant getting pertussis is an adult. When my son was born I was offered the Tdap vaccine in the hospital. I got it. It should be standard procedure for all adults to get immunized when they see their doctors, not just those who recently gave birth.

    November 1, 2010 at 14:36 | Report abuse | Reply
  7. john tyler

    Brent,
    You are a mean-spirited man. Let's hope for your children's sake, you don't pass along this trait. No amount of breastmilk will prevent poor character...especially when it's demonstrated so ably by an arrogant parent.
    Cheers!

    November 1, 2010 at 14:52 | Report abuse | Reply
    • Joanna

      I don't see Brent being so mean-spirited. "susan" made an ignorant and stupid statement that was positively laughable in its idiocy. She deserved a little feedback on that one.

      November 1, 2010 at 15:06 | Report abuse |
    • Susan

      Joanna, as a pediatrician I can assure you that my original statement, that I support both breastfeeding and formula-feeding mothers, was far from ignorant. It is important to look past what is the current accepted norm when making informed choices. As for Brent's statement, I have no words for someone with mean-spirited social myopia.

      November 1, 2010 at 16:04 | Report abuse |
  8. Carla

    The vagueness of this article is deplorable. Indeed, more simple facts can be learned from the comments – what is it with CNN reporters (including doctors)?

    - yes, if mom is healthy, breastfeeding is proven to improve the babies' immune system because mom's antibodies are passed along. (just one of the many components missing from processed, denatured formula food).
    - as mentioned above, if mom does not have antibodies against pertussis then obviously she can't pass them on. seems simple enough but Dr Shu wasn't even able to state this.
    - it is also important to mention that people and adults who do have antibodies, can still transmit disease. the virus or bacteria can linger in their noses, mouths, etc and spread (ie sneezing) even if the person has immunity and isn't getting sick. this means that even if you are immune, you must take excellent precautions (washing hands, disinfecting, etc etc) so as to no spread the disease to someone who is more vulnerable.

    Personally, I think Dr Shu could have added that small infants, especially in a disease outbreak situation, don't belong in malls, movie theaters, crowded restaurants or airports, and in fact ideally not into daycare either. These places are very very germ-prone and should be avoided as much as possible.

    November 1, 2010 at 15:26 | Report abuse | Reply
  9. KDW

    I also feel Brent was overly harsh. Yes there is plenty of research showing that breastfeeding provides antibodies. Other research is not as clear. For instance the idea that breastfeeding provides an IQ boost has been shown to be incorrect. When variables such as socioeconomic status and IQ of parents are controlled for the IQ boost disappeared. Also there has been no study that has shown any differences in bonding, later psychosocial development, or future health between breastfed and formula fed infants. The antibodies may help when the children are very young but as of yet there is no evidence that it leads to any positive increases in future health. That said breast is best, but I would never be judgmental of someone who chose not to do it, for whatever reason.

    November 1, 2010 at 15:33 | Report abuse | Reply
    • KDW

      This was supposed to go under John Tyler. Not sure why it didn't.

      November 1, 2010 at 15:33 | Report abuse |
  10. Marie

    I was pleasantly surprised to notice that Dr. Shu acknowledged the Midwife's role in the above article. Thank you for remembering that not everyone goes to an OBGYN or Pediatrician for their birth and infant's care, and for acknowledging that it is a safe and well informed choice!

    November 1, 2010 at 15:34 | Report abuse | Reply
    • NotMe

      I noticed that too, excellent. As for us dumbasses that should get vaccinated...you cannot be vaccinated against Pertussis while you're pregnant, unfortunately.

      November 1, 2010 at 16:36 | Report abuse |
  11. Angela

    Two points:
    If the mom was vaccinated or had contracted pertussis, then she could confer some immunity. The headline makes it sound as if breastfeeding itself magically prevented pertussis.
    Note that breastfeeding could help with immunity but it doesn't seem to be 100% effective. In other words, if you have 100 breastfed babies (and moms had immunity) and 100 bottlefed babies, there would be fewer cases in the breastfed group, NOT that there would be none. The fact that some babies will still get pertussis doesn't mean that breastfeeding doesn't help, just that it's not perfect . It's not a substitute for taking precautions against exposure to sick people and isn't a substitute for vaccinating the baby as soon as medically indicated.

    November 1, 2010 at 15:51 | Report abuse | Reply
  12. ne1home

    @Joanna – I was bottle-fed as an infant, so by your calculations I am "subnormal"? I take more than a little offense to that sweeping stroke of bs. While everyone has, and is entitled to, their opinion, I would say it is time for you to climb down off that high horse and stop being so judgmental.

    November 1, 2010 at 15:55 | Report abuse | Reply
    • FatSean

      I think formula-fed babies turn into wusses.

      November 1, 2010 at 16:13 | Report abuse |
  13. OKWA

    The vaccine schedule for DtaP absolutely must change so that kids get a booster at their age 10 checkup (not age 11). Age 11-12 is too long; immunity has worn off. In my son's middle school (5th & 6th grade), 15 fifth-graders have contracted pertussis so far. Each of the kids who get pertussis had not yet received their booster because they were not yet 11. Interestingly, not one sixth grader got the disease - all sixth graders had received boosters. My son was one of the kids to get pertussis. Because they still have some immunity, these infected children had coughs that really were NOT that suspicious, or even that terrible. However, the cough did last a long time. The big concern is usually not these 10-year old infected kids; they generally recover easily - even without antibiotics. But the problem is the people who may be infected by these kids - the babies, elderly, etc., who may not have strong immune systems.

    I hope that the Department of Health or CDC - or whomever sets these schedules - sees fit to change booster schedule so that 10-year olds get the booster and don't wait until age 11-12.

    November 1, 2010 at 16:08 | Report abuse | Reply
    • Katherine

      I got mumps and rubella as a teen because my MMR wore off. Everyone is different, these shots wear off at different times. That being said, I would not change anything. As a child/teen, these diseases are usually light, don't need treatment, and confer lifelong immunity. As an adult, if a booster is skipped or wears off early, the diseases are much worse. The vaccine industry is creating a worse problem for the world through our dependency. It would be better if our research focussed on quick treatment rather than relying solely on toxic, unreliable, dependency-invoking, understaffed but overplayed, culturally shoved-down-our-throats shots.
      Pediatricians go to med schools run by pharmaceuticals, who make formula and shots. But many rely on them instead of taking time to look up studies. Let me ask you this: if autism was studied and linked to a combo of vaccines, would the public ever be told, or would it be buried for the "greater good" aka, to prevent a financial crash of the vaccine industry and the terrible outbreaks the lack would cause? Just some thoughts.

      November 8, 2013 at 13:00 | Report abuse |
  14. ne1home

    @FatSean – I think trolls need to stay in their caves. The next time someone insults you in any way you find harmful or hurtful (whether you actually admit it to yourself or not), I hope you remember what a shining light your maturity is for those around you. That way the memory can comfort you when nobody comes to help you when you're down.

    November 1, 2010 at 16:23 | Report abuse | Reply
  15. umi

    I have finished my six month exclusive breastfeeding for my daughter. During breastfeeding period, she had ever got whooping cough. I had concerned to increase the quality of my breast milk through more drink lactating milk, and some herb medicine. I just continu and increase my breastfeeding frequency.Not too long, she's recovery. I believe that breast milk is the best medicine for our baby (especially under six months). I had ever read about Salma Hayek who Breastfeed a Hungry african child from mother who was unable to provide milk for her malnourished one-week-old son. This story really inspire me. She’s different with another actrees, Salma hayek deep concern about important and benefit breastfeeding, so without hesitation, she breastfeeds a stranger baby to help him. This is can be breastfeeding motivation story for all.
    http://allsupportbreastfeeding.blogspot.com/2011/05/salma-hayek-breastfeed-hungry-african.html

    May 16, 2011 at 12:53 | Report abuse | Reply

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