Clinical update

Preventing herpes in newborn babies

Although rare, the effects of herpes in newborn babies can be devastating, so it is important that parents are aware of the infection and how to avoid it

Although rare, the effects of herpes in newborn babies can be devastating, so it is important that parents are aware of the infection and how to avoid it

Babies can be infected with herpes by kisses from people with cold sores. Picture: iStock

Essential facts

Neonatal herpes is a serious infection that affects newborn babies and has high rates of mortality and morbidity. It is caused by herpes simplex, a highly contagious virus that can cause cold sores and genital ulcers in adults. If it affects the baby's eyes, mouth or skin, there is generally a complete recovery with antiviral treatment. But if it spreads to the infant’s organs, nearly a third of children die, even after they've had treatment. Rates in the UK are generally low, with an estimated incidence of 17.5 per 100,000 live births.

What’s new

The What’s in a Kiss campaign highlights the risk to babies of contact with people with cold sores, especially in the first six weeks of life, and highlights the needs for swift action if there are any signs of infection.

Signs and symptoms

A newborn baby infected with herpes may be listless, sleepy, floppy, have a high or low temperature and may stop feeding. They may have a high-pitched cry, breathe rapidly, have cyanosis and a rash. They can have convulsions and appear to deteriorate.

Causes and risk factors

The risk of herpes in newborn babies is greatest when a mother acquires genital herpes (HSV-2) for the first time in late pregnancy. Women who have genital herpes before they become pregnant are at very low risk of transmitting HSV to their infant, as they will pass on their immunity. HSV can also be passed on to a newborn baby if a person has a cold sore (HSV-1) and kisses the baby, or a mother breastfeeds with herpes sores on her breast, which can develop after touching her cold sore and then her breast.

How you can help your patient

Advise all parents on infection control measures such as handwashing and not putting dummies or bottles into their mouths, particularly if they have a cold sore. People with or who may be developing a cold sore should not kiss babies and should wash their hands before any contact with a baby. Mothers should wash their hands before breastfeeding, and cover any cold sores to avoid accidently touching their mouth and then their breast. Healthcare professionals should educate new parents on the signs that could indicate an infection in newborn babies.

Expert comment

Royal College of Midwives practice and standards professional adviser Mervi Jokinen 

‘The HSV infection is rare, but it is serious and needs swift action on the part of parents and healthcare professionals. Midwives, nurses and health visitors should instruct new parents on the signs that could indicate infection, including HSV, in small babies, and stress the importance of seeking prompt health advice if they are at all worried. They should also emphasise the importance of basic infection control measures, such as handwashing.

‘As infections can quickly become serious in small babies, parents should tell nurses and midwives if they have any concerns. Parents know the child best and are best placed to pick up changes. Any concerns about any infections should be escalated quickly by healthcare professionals.’

Erin Dean is a freelance health journalist 

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