What you need to know about neonatal herpes

Hi Readers!

According to the World Health Organization, there are approximately 14,000 cases of neonatal herpes annually (based on data from 2010-2015), roughly 10 cases per 100,000 live births worldwide. 

Neonatal herpes is a rare complication of genital herpes during pregnancy, which can cause brain damage, breathing problems, seizures and even death. The infection can occur when an infant is exposed to herpes simplex virus types 1 or 2 in a woman’s genital tract during birth.

The younger the baby, the more vulnerable they are to the harmful effects of infection, as their immune system will not have fully developed to fight off the virus. A baby is most at risk of getting herpes infection in the first 4 weeks after birth.  

How does a newborn contract herpes?

A baby can contract the virus during pregnancy or during labour. The newborn is at risk if the mother had genital herpes for the first time within the last 6 weeks of her pregnancy. That being said, the risk is lower if the mother has had genital herpes prior to the pregnancy. There is a risk of transmission if the mother has a vaginal delivery. 

The herpes simplex virus can be passed to a baby after birth if any person with a cold sore kisses the baby. Therefore, if you have a cold sore do not kiss a baby, or anyone else for that matter – and do not perform oral sex on your partner. Cold sores and blisters caused by the herpes virus are most contagious when they burst. They remain contagious until completely healed. The virus can also be contracted by a baby if the mother has a herpes blister on her breast and she feeds the baby with the affected breast or pumped breast milk from her affected breast.  

What to look out for

As mentioned above, newborns have an undeveloped immune system and can quickly become ill after contracting the virus. Call your healthcare professional as soon as you notice the following early warning signs in your baby:

  • is lethargic or irritable
  • Is not feeding
  • Has a high temperature (fever)
  • Has a rash or sores on the skin, eyes and inside the mouth
Call your country’s emergency line immediately if your baby:
  • is lacking energy 
  • Is becoming floppy and unresponsive
  • Is difficult to wake up from sleep
  • Has breathing difficulties or starts grunting
  • Breathes rapidly
  • Has a blue tongue and skin (cyanosis)

Babies can become unwell very quickly, so you need to act fast. 

Treatment for neonatal herpes

Neonatal herpes is usually treated with antiviral drugs given intravenously. This treatment can last several weeks. Any related complications will also need to be treated. 

The baby can be breastfed while receiving treatment unless the mother has herpes sores around her nipples. If the mother is on antiviral treatment, this can be found in her breast milk, but it has not been proven to be harmful to the baby. It is important to discuss this with your healthcare professional.  

Neonatal herpes prevention

If you are pregnant and have a history of genital herpes, tell your healthcare professional. You may need to take medication during the last month of pregnancy to prevent an outbreak of vaginal sores during labour. 

A caesarean is recommended if genital herpes has occurred for the first time in the last 6 weeks of pregnancy.

If you develop a cold sore or have any signs of a herpes infection, take the following precaution and please continue to do so until the sore has fully recovered (some of these precautions are taken from the NHS website): 

  • Do not kiss any babies
  • Do not kiss anyone or give oral sex
  • Wash your hands before contact with a baby
  • Wash your hands before breastfeeding
  • Cover up any cold sores, lesions or signs of a herpes infection anywhere on your body to avoid passing on the virus. 

Be kind to one another

Julia, Sexologist


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