Then comes the long 'whoop' as the child breathes in. After a series of these they may fall asleep, exhausted. Looking after someone during this phase is particularly tiring and time consuming. They must be kept calm and quiet as excitement and exertion provoke the coughing attacks. During a spasm of coughing the child should be held in the recovery position to avoid the inhalation of vomit.
Some small babies require suction and oxygen after a spasm has ended.
It is important to make sure that they get enough to drink - the best time to offer fluids is after an attack as it is less likely to be vomited. During the last fortnight the symptoms usually start to resolve. The whoops and the vomiting become less frequent so the child sleeps more at night and starts to regain weight. After recovery, a cough or cold during the following year may start off a series of whoops as will exposure to cigarette smoke. Although it is difficult to diagnose whooping cough in the first week because it is so like an ordinary cough or cold, the standard advice is that antibiotics given at this time will reduce the severity and duration of the illness, and giving them to siblings who have no symptoms may reduce spread to others.