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Young baby and cold sores?
I have suffered from cold sores for about 8 years, with at least two outbreaks a year. I recently had a baby, and she will be 7 weeks old tomorrow. I am incredibly stressed out though because I have struggled with cold sores since her birth, getting one right after the other. I understand that my daughter should be protected by my antibodies until 3-6 months, and that they are very protective, but may not be 100%. I have been very careful not to kiss her and to wash my hands before I touch her. However, with such a small baby, it is so difficult to avoid all possibly unsafe contact. Yesterday, for instance, I had an incident which panicked me. I was playing with her, making funny faces and noises, when I noticed a small amount of spit fly out of my mouth. I am so worried that it went into her open mouth or into her eyes since she was only about a foot in front of me. I was literally in tears about this incident, and am so scared of infecting her that it is making it difficult to just enjoy this time with her.
1.Is there a point at which the effects of my daughter contracting HSV1 would be less statistically frightening? The description of neonatal herpes is terrifying. I think the concern is mostly for infants who contract it at birth or in the first four weeks, but want to make sure. I asked a question on the Herpes expert forum when my daughter was about 5 weeks, and the expert reassured me that she would already be better off than a younger newborn. I am hoping that, at one day shy of 7 weeks, my daughter may be past that point where I have to worry about this as excessively as I am since she is no longer a neonate. While still being very cautious to not infect her, is it OK to relax a little bit and know that she would be able to fight the infection off at this point without it causing her great harm?
2. Is the incident with the spit a big cause for concern? Not sure if this is relevant to know, but I exclusively breastfeed and started Valtrex four days ago.
1.Is there a point at which the effects of my daughter contracting HSV1 would be less statistically frightening? The description of neonatal herpes is terrifying. I think the concern is mostly for infants who contract it at birth or in the first four weeks, but want to make sure. I asked a question on the Herpes expert forum when my daughter was about 5 weeks, and the expert reassured me that she would already be better off than a younger newborn. I am hoping that, at one day shy of 7 weeks, my daughter may be past that point where I have to worry about this as excessively as I am since she is no longer a neonate. While still being very cautious to not infect her, is it OK to relax a little bit and know that she would be able to fight the infection off at this point without it causing her great harm?
2. Is the incident with the spit a big cause for concern? Not sure if this is relevant to know, but I exclusively breastfeed and started Valtrex four days ago.
Thank you so much for your detailed responses! I will follow up with my doctor regarding testing for HSV, just to make sure I know what I'm dealing with for sure. You have given me so much peace of mind regarding my daughter too. I will continue to be very cautious, of course, but I am relieved that her symptoms would not be catastrophic if she somehow did manage to get the virus.
MEDICAL PROFESSIONAL
Your description of your oral lesions is very typical for oral herpes; I agree the diagnosis is virtually certain. Still, during some future outbreak, I would recommend testing to confirm the diagnosis and, most important, to confirm the virus type. Oral HSV-2 is rare, but it's still good to be certain you have HSV-1, as expected.
There's actually no evidence that stress or exhaustion triggers herpes outbreaks. Most outbreaks appear to occur randomly, perhaps with increased frequency during the natural immunosuppression of pregnancy.
Oral herpes is easily treated with a single 2 g (2,000 mg) dose of valacyclovir. However, it's perfectly OK to use more prolonged treatment for severe outbreaks. Now that you're on 1 g daily, I suggest you continue it as prescribed.
I'm not a pediatrician or immunologist and can't tell you exactly why the chance of severe HSV declines rapidly after about 1 month of age. Presumably it's just the natural, gradual maturing of the baby's immune system. But the fact is that dangerous herpes, i.e. like typical neonatal herpes, is uncommon after about a month.
There's actually no evidence that stress or exhaustion triggers herpes outbreaks. Most outbreaks appear to occur randomly, perhaps with increased frequency during the natural immunosuppression of pregnancy.
Oral herpes is easily treated with a single 2 g (2,000 mg) dose of valacyclovir. However, it's perfectly OK to use more prolonged treatment for severe outbreaks. Now that you're on 1 g daily, I suggest you continue it as prescribed.
I'm not a pediatrician or immunologist and can't tell you exactly why the chance of severe HSV declines rapidly after about 1 month of age. Presumably it's just the natural, gradual maturing of the baby's immune system. But the fact is that dangerous herpes, i.e. like typical neonatal herpes, is uncommon after about a month.
I think we just posted our last comments simultaneously...my OB gave me a dose of 1000 mg a day for 7 days, which someone on the community board told me is not standard for a cold sore outbreak...so I am confused, but have not been able to follow up yet. I am very concerned about this long outbreak as well. This same thing happened once during my second trimester as well. I am in grad school and went back full time the week I had my daughter, so I attributed it all to exhaustion and stress. I was never tested for HSV1 (maybe I should do so), but two doctors have confirmed they are cold sores. When I get them, they look like small whiteheads (I will usually get one at a time) on the edge of my lip or on my chin that eventually turn a bit yellow and scab off. I feel tingling to the region before they appear...
Also, I am just curious, why is an infant at 7 weeks old so much more well-equipped to handle this infection than an infant at 4 weeks old? I am surprised (but very relieved) that 3 weeks make such a big difference!
MEDICAL PROFESSIONAL
Are you sure your oral lesions are cold sores? Such frequent recurrences are possible, as the result of the normal immune suppressing of pregnancy. However, your immune system should be pretty much back to normal by now. If there is any doubt, see your doctor for possible diagnostic testing, i.e. a swab from the sore for an HSV PCR test.
However, this does change my advice about Valtrex. If herpes indeed seems likely, it is reasonable for you to continue that treatment for the time being. What dose are you taking? The normal dose of Valtrex for oral HSV-1 is higher than for genital herpes.
However, this does change my advice about Valtrex. If herpes indeed seems likely, it is reasonable for you to continue that treatment for the time being. What dose are you taking? The normal dose of Valtrex for oral HSV-1 is higher than for genital herpes.
Thank you so much! You have no idea how much better I feel :-) The problem is that I have two active cold sores now (sigh)....I have had at least one active cold sore at all times for the past month...every time one starts to go away, I get another. It is beyond frustrating! I have been giving my daughter lots of snuggles and trying to keep my mouth far away from her. I feel so much better that she is past the danger period though, so I can stop panicking about this!
MEDICAL PROFESSIONAL
Welcome to the forum. However, you had accurate replies from Terri Warren on the herpes professional forum, so my comments are brief.
1) Your daughter is beyond the danger period. If she got herpes, it would no longer be classified as neonatal herpes (that definition is only used before 4 weeks of age). At her age, her symptoms would not be serious; and with early diagnosis, treatment would be very effective in promptly clearing it up.
2) You are very unilkely to transmit the virus when you're not having an obvious cold sore outbreak. The saliva exposure isn't a significant risk, and the virus is not transmitted by nursing.
You should be snuggling and kissing your baby just as any parent would; as your pediatrician will tell you, this is much too important to ignore. Babies NEED that kind of contact for healthy development. If and when you have an actual cold sore outbreak, avoid kissing your baby until it heals. Otherwise, you need not take any precautions. You really don't need to be taking Valtrex, in my opinion.
Look at it this way: depending on age, race, and other factors, 10-50% of all young mothers have oral HSV-1. But how often have you ever heard of a friend, or a baby in your extended family, who had severe herpes under a year of age. And all those mothers were hugging, snuggling, and kissing their babies.
Do do your best to stop worrying about this!
Best wishes-- HHH, MD
1) Your daughter is beyond the danger period. If she got herpes, it would no longer be classified as neonatal herpes (that definition is only used before 4 weeks of age). At her age, her symptoms would not be serious; and with early diagnosis, treatment would be very effective in promptly clearing it up.
2) You are very unilkely to transmit the virus when you're not having an obvious cold sore outbreak. The saliva exposure isn't a significant risk, and the virus is not transmitted by nursing.
You should be snuggling and kissing your baby just as any parent would; as your pediatrician will tell you, this is much too important to ignore. Babies NEED that kind of contact for healthy development. If and when you have an actual cold sore outbreak, avoid kissing your baby until it heals. Otherwise, you need not take any precautions. You really don't need to be taking Valtrex, in my opinion.
Look at it this way: depending on age, race, and other factors, 10-50% of all young mothers have oral HSV-1. But how often have you ever heard of a friend, or a baby in your extended family, who had severe herpes under a year of age. And all those mothers were hugging, snuggling, and kissing their babies.
Do do your best to stop worrying about this!
Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
