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Column originally published Jul 12, 2011
Column last revised/updated on Jul 30, 2018

Protect Premature Baby From Pertussis And Influenze

Question: Our first grandson was born a couple of weeks ago. He was born almost one month before the due date. Although he is small, he has done very well. He was in the incubator for a few days, and it took him a while to start breast feeding. He should be coming home fairly soon. I wonder whether there is anything special that we need to do to prevent him for getting sick.


It is wonderful to hear that your grandson is doing so well. Premature babies that are born several weeks early are generally healthy and wonʼt require intensive care treatment. However, they are often not quite ready to feed like full-term babies do. As a result, they have to stay in hospital longer and require skilled nurses to help them to feed and gain weight.

I am very pleased to hear that his mother is breastfeeding him. Breast milk is excellent for all babies, and especially for those that are born prematurely. It is not only that breast milk is easier to digest than formula, the iron in breast milk is easier to absorb than the iron in formula. More importantly, breast milk contains antibodies and immune cells from the mother that can help babies to fight infections.

Recent research has also shown that normal germs that babies acquire from the mother through breast feeding are very important for their health. These normal germs grow inside their intestines and prevent bad germs from infecting them. You may have heard of probiotics that are added to many manufactured foods. These probiotics are the same good germs present in healthy peopleʼs intestines, and babies get them through breastfeeding from their mothers. Science is trying to catch up with nature!

Because babyʼs immune system is not fully developed, they are more susceptible to infections. However, it doesnʼt mean that we should sterilize everything around them. I donʼt advice families to use hand-sanitizers regularly unless someone is sick. It is quite sufficient to wash your hands with soap and water for 20 seconds, and dry them with clean towels. Research has shown that bad germs can be removed this way.

If you are sick with a cold, you should not care for your grandson, if it can be avoided. When a person coughs, drops of secretion can land as far as 1 meter, or three feet, from him. Therefore, keeping him away from your grandson can help. If his parents are sick, they can wear a face mask, and wash their hands frequently (here they can use hand-sanitizer). Both of these can reduce the chance of spreading the virus to their son.

I donʼt recommend using disinfectants like Lysol to clean every surface and door knob. Doing this can increase anxiety and create a false sense of security. I donʼt think exposing a newborn to these chemicals is good.

There is no need to keep him indoor all the time. If the weather is good, it is perfectly safe to take him outside. Children under 6 months of age should not be exposed to direct sunlight, and sunscreens are not approved until that age. However, you should not let every passer-by to touch or kiss him; they can adore him from a distance. Similarly, I suggest parents not to take their newborn babies to baby shower; you wonʼt know who may be sick. In todayʼs digital world, his parents can take lots of pictures and show their friends with a laptop computer or one of the portable devices.

In recent years, a number of young infants have developed whooping cough (also called pertussis) from adult care-takers. As you probably know, all young children should receive pertussis vaccine. It is very effective, but the immunity doesnʼt last a lifetime. Many adults have lost their immunity to pertussis. As a result, it is not uncommon for adults to develop whooping cough and infect those around them. These adults are often misdiagnosed with bronchitis. They can have a nagging cough for a long time.

Infants receive their pertussis vaccine at 2, 4, and six months of age. However, they donʼt develop effective immunity until after the third dose of the vaccine. If they get infected with whooping cough bacteria from adults around them before they develop their own immunity, they can get very sick. There have been outbreaks of pertussis in young infants in Canada and United States, some of them have died.

In order to prevent this, a number of provinces and states have started immunizing adults, especially parents and grandparents of newborn babies, with pertussis vaccine shortly after delivery. This can boost the adultsʼ immunity to pertussis, prevent them from getting infected, and then spread the bacteria to their babies before they have time to build up their own immunity from vaccination.

Some provinces have even started vaccinating pregnant women with pertussis vaccine during pregnancy; the babies would get pertussis antibodies from the mother through the placenta before they are born.  As a result, these babies can be protected in the first few months of life, when they are most vulnerable to severe whooping cough.

Similarly, pregnant women are recommended to get flu shot during pregnancy.  The immunity can pass from the mother to the baby before delivery and protect them from serious influenza infection in the first few months of life. Babies can get flu shot at six months of age, but not before.

I would recommend both parents, grandparents, other adults who will be looking after the baby, as well as others living in the babyʼs home, to receive a booster pertussis vaccine and the flu shot. This will keep both germs from infecting him when he is most vulnerable, until he can develop his own immunity against pertussis, or old enough to receive the flu shot himself.