Herpes and your baby

By: Dr. Karen Lidoshore- Fuld, Pediatric Health Associates (Plainview, NY)

Many of you have seen or heard about the recent death of an 18 day old baby girl following infection with Herpes Simplex Virus from a kiss.  It is important for us to remember that this type of transmission to a newborn and extent of disease is an extremely rare occurrence.  It is also important to understand how we as parents can do our best to prevent HSV transmission.

There are 2 types of Herpes Simplex infection; HSV-1 which usually causes cold sores and fever blisters on the mouth and lips, and HSV-2 which causes most cases of genital herpes.  According to the World Health Organization close to 70% of people under the age of 50 are infected with HSV-1.  Approximately 16% of people age 14-49 test positive for HSV-2.

Herpes affects about 1 in 3,500 babies in the United States each year.  Transmission to a newborn can occur either in utero (extremely rare), during labor and birth, or after birth.  During labor or birth is the most common way that a newborn can acquire the virus.  After birth, a parent or another family member or friend can pass the virus to the newborn as occurred in this case.  Unfortunately, most people can shed the virus in their saliva without any symptoms, though sometimes they will have a cold sore on their lips.

Symptoms of HSV-1 in babies (seen 2-12 days after exposure).

  • Fever (100.4 or greater –rectally)
  • Poor feeding
  • Irritability
  • Itching and/or burning around the mouth or lips (Does your child pull away and begin crying during breastfeeding, or when the lips or mouth come in contact with an object, or when you touch them?)
  • Floppiness (of the body)
  • Redness of the gums
  • Swollen, tender lymph glands
  • Cold sores (on, inside or around the lips and/or mouth; may also occur on the face)

Prevention of transmission of HSV to the newborn is possible in most cases.  If you are pregnant and have a history or signs and symptoms of genital HSV-2 infection, tell your doctor as soon as possible. A C-section delivery is recommended if a mother has an HSV-2 outbreak near the time of birth.  In terms of HSV-1 transmission, it is essential that you have anyone who will touch the baby wash their hands thoroughly with soap and water.  Also, do not kiss your baby or let others kiss your baby on the lips, whether or not there are visible cold sores.

Contact your doctor immediately if there are any signs of HSV infection in your baby.  Remember that all newborns should be seen by the pediatrician in the first week of life.