Casey here. This morning my sister (who has a 3-month-old) messaged me expressing her concerns about a cold sore outbreak – she was worried about passing it on to her baby.
This is an understandable concern! While they are uncomfortable for us adults when it comes to babies, exposure to the Herpes Simplex Virus can be serious.
It made me think back to when my kids were babies, and every lip tingle or little lump sent me into a Google frenzy about preventing the spread of cold sores, how to spot the virus in little ones, and whether it was safe to breastfeed or even be around my baby with a cold sore outbreak!
There are actually multiple strains of this virus, this blog focuses on HSV-1, specifically in the context of oral cold sores (and not HSV-2, which is commonly associated with sexually transmitted infections).
Side note – the herpes virus can be passed on to a baby during vaginal delivery if the birthing parent has genital herpes. Genital herpes needs to be treated during pregnancy to prevent transmission of the herpes virus to the baby at birth. A primary or initial infection (infection acquired for the first time during pregnancy) has the highest rate of transmission to the baby. Be sure to speak to your midwife or Doctor if you think you have genital herpes during pregnancy.
Tips on preventing the spread
Here are some ways you can help to prevent your little one from becoming infected if you are suffering from a cold sore outbreak;
- No kissing! We know this one is hard but it is important.
- Avoid touching the affected areas – and always wash your hands if you touch the affected area.
- Try not to share things like spoons, towels, blankets, etc.
- Try not to pick at a cold sore as this can lead to further infection and/or scarring.
- Wash your hands before touching your little one.
- Cover up! You can use a mask when handling or breastfeeding bub, especially if they are a face grabber.
- Treat your outbreak – getting your infection under control is vital. Aciclovir cream, aciclovir, or valaciclovir tablets are all considered safe while breastfeeding. If you are concerned, speak with your GP or pharmacist and they can guide you.
- HSV cannot be passed on through breast milk unless you have a blister caused by herpes on your breast and you feed your baby with the affected breast or expressed breast milk from the affected breast.
What are the signs of a cold sore outbreak in babies?
Because newborn babies have underdeveloped immune systems, they can quickly become seriously ill after catching the virus. Herpes simplex gingivostomatitis is inflammation of the gums and lips caused by the herpes virus – the same virus that later causes cold sores. This inflammation damages the skin, resulting in painful ulcers in the mouth and blisters on the lips.
Early symptoms of a herpes simplex virus infection in babies can include;
- Fever
- Reluctance to feed
- A rash or sores on the skin, eyes, and inside the mouth
- Lethargic and irritable
This can then quickly develop into more severe symptoms such as:
- Floppy and unresponsive
- Difficult to wake up from sleep
- Breathing difficulties or rapid breathing
- Mottled skin or a blue tongue and skin (cyanosis) – if they have a darker skin tone, this may be easier to see on their lips, tongue and gums, under their nails, and around their eyes.
Sometimes, babies will not have any specific herpes symptoms, such as a rash.
If you suspect your little one is infected with herpes – even in the early stages – seek urgent medical attention.
And of course, don’t forget to book your baby + child CPR & First Aid Class so that you have the skills and confidence to respond in an emergency involving your baby or child.
References
Healthdirect – Cold Sore Fact Sheet
Mothersafe – Royal Hospital For Women Face Sheet – Cold Sores in Pregnancy and Breastfeeding
Royal Children’s Hospital – Herpes simplex gingivostomatitis Fact Sheet
American Academy of Pediatrics – Cold Sores in Children: About the Herpes Simplex Virus
