What You Should Know About Herpes And Breastfeeding
Herpes is caused by a virus knows as HSV or herpes simplex virus and is a sexually transmitted disease. There exist two kinds of herpes virus: HSV-1 and HSV-2 . Although either kind of virus can cause mouth/lip or genital herpes HSV1 usually results in herpes on the lips and mouth, often referred to as fever blisters or cold sores and HSV2 results in genital herpes. Can you breastfeed with herpes? Genital herpes is quite common STD in the USA. Once infected, the herpes virus lives in your body for your entire life. However, there are effective medicines available to treat an outbreak of herpes.
How Does Herpes Affect Pregnancy
A pregnant person usually experiences the same herpes symptoms as nonpregnant individuals.
Around 75% of women with herpes will experience a flare-up during pregnancy, but there is no evidence that pregnancy triggers flare-ups.
If a person has herpes for the first time while pregnant, the risks to an unborn fetus are higher than if they have caught herpes before being pregnant. Initial herpes infections are also usually more severe than recurrent infections.
A doctor may prescribe antiviral drugs, such as acyclovir, to treat herpes during pregnancy. These can cause side effects in some people.
, including brain damage, eye issues, or even infant death.
The risk of neonatal herpes is highest when a pregnant person contracts HSV in the third trimester of their pregnancy. The risk is also higher if a pregnant person has an outbreak around the time of childbirth. During natural childbirth, a baby can come into contact with the virus as they move through the cervix and vaginal canal.
The risk of neonatal herpes is lower if a person develops herpes before or at the beginning of pregnancy. The body will have enough time to produce protective antibodies, which the pregnant individual will pass on to the child through the placenta.
What Herpes Of The Breast Looks And Feels Like
Herpes on the breast looks like tiny fluid-filled bumps on a red base that are tender. Some people will experience flu-like symptoms with a herpes outbreak, especially the first one. Future outbreaks may occur, but they almost always last a shorter time and are not as painful.
In people with HIV, herpes outbreaks can be more severe and last longer due to their impaired immune system.
It’s important to see your healthcare provider for a diagnosis, as herpes of the breast can resemble a yeast or bacterial infection or plugged milk ducts.
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Is It Safe For A Mother To Give Her Infant Hand Expressed Or Pumped Breast Milk If She Has Active Herpetic Lesions On Her Breast
No. Breast milk can be contaminated if it comes in contact with active herpetic lesions through touching the breast during hand expression or via the pump. Therefore, if a mother has herpetic lesions on her breast, she should discard expressed breast milk from the affected side until the lesions have healed. Expressing breast milk will be important for maintaining milk production while not directly breastfeeding from the affected breast. Mothers should be vigilant about practicing appropriate hand hygiene and cleaning the pump parts thoroughly. Mothers should talk with their healthcare provider to determine if their lesions have healed and they can resume breastfeeding or expressing milk from the affected breast.
It is safe to use expressed breast milk from the unaffected breast, as long as the mother ensures that the lesions on the affected breast are completely covered to avoid transmission. Appropriate hand hygiene and cleaning the pump parts thoroughly are still important.
For more information about managing breastfeeding with specific medical conditions, read Lawrence RA, Lawrence R. Breastfeeding: A guide for the medical profession, 8th Edition.
What Are The Types Of Herpes Viruses
Herpes is a group of contagious viruses that cause blisters and sores. Some of the more common herpes viruses include:
- Type 1: HSV-1, or oral herpes, causes cold sores to form on your lips, gums, tongue and inside of your mouth. It can cause genital herpes in some cases. This type usually spreads through saliva when you kiss someone with open herpes sores. You can also get HSV-1 by sharing items like toothbrushes, lipsticks or eating utensils.
- Type 2: HSV-2 causes genital herpes.
- Herpes zoster: This virus causes chickenpox and shingles.
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Does A Cold Sore On My Mouth Mean I Have Genital Herpes
No, a cold sore on your mouth usually means you have herpes simplex virus type 1 . You can get HSV-1 by kissing someone or sharing utensils, towels, razors, or lipstick with someone who has HSV-1.
HSV-1 cannot turn into HSV-2 , but you can get a cold sore on your mouth from HSV-2 if you give oral sex to someone with HSV-2. Cold sores caused by HSV-1 or HSV-2 are contagious. You can spread it to other people or other parts of your body if you touch an open sore and then touch another part of your body. That means if you have a cold sore and give oral sex to someone, that person will get the herpes virus on his or her genitals.
Avoid touching your cold sore as much as possible. If you touch your cold sore, wash your hands right away to avoid spreading the infection to other parts of your body or other people.
How Is Genital Herpes Diagnosed
Often, your doctor can diagnose genital herpes by looking at visible sores. Your doctor or nurse may also use a cotton swab to take a fluid sample from a sore to test in a lab.
Genital herpes can be hard to diagnose, especially between outbreaks. Blood tests that look for antibodies to the herpes virus can help diagnose herpes in women without symptoms or between outbreaks.
A Pap test is not used to detect genital herpes.
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How Genital Herpes Can Affect Your Pregnancy
If you have genital herpes, its possible to spread the virus to your baby. A woman can spread it to her baby while she is:
-
Taking care of her newborn
If the baby gets the virus while in the womb, the mother may have a miscarriage or deliver the baby too early, causing the baby to be premature.
When the baby catches the virus during birth or shortly thereafter, this can be deadly for the baby. Be sure your OB/GYN knows that you have genital herpes so that precautions can be taken.
Consult Your Doctor Or Midwife Regarding Hsv
When it comes to conditions as serious as neonatal herpes, its always best to consult your doctor or midwife. Prevention is the very best way to ensure your herpes infection never impacts your child.
The medical experts supporting you through your pregnancy know better than anyone how to identify signs of herpes and prevent the spread of your infection to your newborn.
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Maple Syrup Urine Disease
A baby born with maple syrup urine disease cannot break down the amino acids leucine, isoleucine, and valine. When these amino acids accumulate in the baby’s blood, they give off a sweet maple syrup scent that is noticeable in the urine, ear wax, and sweat. The build-up of these amino acids can cause sleepiness, poor feeding, vomiting, seizures, coma, and death.
To fulfill the baby’s nutritional needs, your baby’s doctor will order a special infant formula that does not contain the three amino acids leucine, isoleucine, valine. The doctor may also recommend partial breastfeeding if the amount of breast milk is carefully measured and the baby is monitored closely.
How Do Stis Affect Pregnant Women
STIs can cause many of the same health problems in pregnant women as in women who are not pregnant. But having an STI also can hurt the unborn babys health.
Having an STI during pregnancy can cause:
- Premature labor . Early birth is the number one cause of infant death and can lead to long-term developmental and health problems in children.1
- Infection in the uterus after birth
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Q: Why Do I Get Cold Sores When I Go To The Beach Or To The Snow
A: Sun exposure is the most common trigger in people who get recurrent cold sores. UV radiation from the sun suppresses the immune system and this allows the cold sore virus to reactivate.
UV radiation is extremely high at the beach and also at the snow .
Make sure you wear plenty of sun protection, including lip balm and sunscreen with a very high SPF to protect yourself from both sunburn and cold sores.
How Is Neonatal Herpes Treated
Neonatal herpes is usually treated with antiviral drugs given directly into the babys vein .
This treatment may be needed for several weeks.
Any related complications, such as fits , 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 taking antiviral treatment too, this can be excreted in her breast milk, but is not thought to cause any harm to the baby.
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Can Genital Herpes Cause Other Problems
For most women, genital herpes does not usually cause serious health problems.
Women with HIV can have severe herpes outbreaks that are long-lasting. Herpes also may play a role in the spread of HIV. Herpes sores can make it easier for HIV to get into your body. Also, herpes can make people who are HIV-positive more likely to spread the infection to someone else.
What Should I Do If I Have Genital Herpes
If you have genital herpes:
- See a doctor or nurse as soon as possible for testing and treatment.
- Take all of the medicine. Even if symptoms go away, you need to finish all of the antiviral medicine.
- Tell your sex partner so they can be tested and treated if necessary.
- Avoid any sexual contact while you are being treated for genital herpes or while you have an outbreak.
- Remember that genital herpes is a lifelong disease. Even though you may not have a genital herpes outbreak for long periods of time, you can still pass the virus to another person at any time. Talk with your doctor or nurse about how to prevent passing the virus to another person.
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Genital Herpes Treatment During Pregnancy
Women taking antiviral drugs for herpes — either daily suppressive therapy or occasional therapy for outbreaks — should consult their doctor about whether to take the drugs during pregnancy. The answer is not set in stone: You and your doctor have to discuss the risks and benefits to decide what’s right for you.
For pregnant women with a history of genital herpes, the doctor might recommend daily doses of an antiviral medication during the month before their due date.
Herpes infection in a newborn is also serious. Do not allow anyone with a cold sore on the mouth to kiss the baby. If you have a cold sore, don’t kiss the baby, and wash hands with soap and water before touching the baby.
Will I Be Tested For Herpes While Pregnant
Currently, across the world, theres no routine testing of women for HSV in pregnancy. This is because testing women with no symptoms makes little difference, as the infection has no cure.
Women who have active symptoms, or know they have HSV, should speak to their doctor or midwife for information about treatment during pregnancy.
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Can You Give Birth Naturally If You Have Herpes
Most people with herpes can have a vaginal birth. A doctor can test the skin for signs of herpes shortly before the birth. If a person shows signs of infection, doctors may recommend a C-section to lower the risk of transmitting the infection to the baby.
C-sections lower this risk by delivering the baby through incisions in the abdomen and uterus. This prevents them from contracting the virus in the birth canal.
I’m Pregnant What Can I Do To Prevent Problems From Stis
You can prevent some of the health problems caused by STIs and pregnancy with regular prenatal care. Your doctor will test you for STIs early in your pregnancy and again closer to childbirth, if needed.
- STIs caused by bacteria, such as chlamydia and gonorrhea, can be cured with antibiotics. Some antibiotics are safe to take during pregnancy. Your doctor can prescribe antibiotics for chlamydia, gonorrhea, syphilis, and trichomoniasis during pregnancy.
- STIs caused by viruses, such as genital herpes and HIV, have no cure.
- If you have herpes, antiviral medicine may help reduce symptoms. If you have symptoms of herpes or active genital herpes sores at the start of labor, you may need a cesarean section . This can help lower the risk of passing the infection to your baby.
- If you have HIV, antiviral medicines can lower the risk of giving HIV to your baby to less than 1%.2 You also may need to have a C-section.
You also can take steps to lower your risk of getting an STI during pregnancy.
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Is Herpes Passed On Through Breast Milk
The risk of catching herpes from breast milk is very low. Authors Wambach & Spencer state it is doubtful that HSV infection can be transmitted via human milk. Transmission during lactation is more likely to occur with direct contact with an active lesion or blister.12
The following paper also states the risk of viral transmission via breast milk is very low and that breastfeeding ought not be interrupted unless the sores are on the breasts:
Excerpt From
Recommendations for breastfeeding during maternal infections J Pediatr , Lamounier et al, 2004
The risk of viral transmission via breast milk is very low. In nursing mothers with herpes, breastfeeding should not be interrupted, except when the herpetic vesicles are located on the breasts. Active lesions in other body parts should be covered, and the nursing mothers hygiene should not be overlooked so that breastfeeding can be maintained.
Can You Have A Healthy Pregnancy With Herpes
A person with herpes has a good chance of having a healthy pregnancy. Because herpes lies dormant for months or years at a time, some pregnant individuals may not experience an outbreak during their pregnancy.
Most people with herpes have mild symptoms, although first-time infections can be more severe.
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What Are The Warning Signs In Babies
Because newborn babies have underdeveloped immune systems, they can quickly become seriously ill after catching the virus.
- is lethargic or irritable
- has a rash or sores on the skin, eyes and inside the mouth
These are early warning signs that your baby may be unwell.
- is lacking in energy
- is becoming floppy and unresponsive
- is difficult to wake up from sleep
- has breathing difficulties or starts grunting
- breathes rapidly
How Does Herpes Simplex Spread
Herpes spreads through close contact with a person who has the infection. The virus can be found in skin and saliva. If you have herpes simplex, you are most likely to pass the virus to another person when you have sores. But you can infect someone else even if you have no symptoms. Healthcare providers call this asymptomatic viral shedding.
People may get HSV-1 through
- Touching a persons skin near the mouth.
- Sharing food utensils, lip balm or razors.
- If you receive oral sex from someone who has a cold sore, it may spread a herpes infection to your genitals.
People may get HSV-2 through
- Oral sex with someone whos infected.
- Skin-to-skin contact without ejaculation.
- Touching open sores, including while breastfeeding.
- Childbirth by a mother or gestational parent who has an active infection.
You cant get genital herpes from objects like toilet seats. But you could pass genital herpes through shared sex toys.
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How Is Herpes Simplex Treated
Some people have few to no herpes outbreaks and choose not to have treatment. But many people prefer to use medications that shorten outbreaks and reduce symptoms.
During an outbreak, you may use an antiviral ointment or cream to help lessen your symptoms and help them go away faster, but it only works if you start it soon after you start an outbreak. Many people with HSV-2 take daily oral medications to keep outbreaks at bay.
Your provider may prescribe a topical medication or oral medication such as:
What Happens If I Get Cold Sores Or Genital Herpes During Pregnancy
Having the HSV virus does not affect your chance of becoming pregnant.
It is quite common for women to have a cold sore during their pregnancy, even if they havent had one for a long time. Cold sores should not affect your unborn baby. But they are infectious, so its a good idea to treat them.
Genital herpes should not affect the baby if you have your first outbreak or it comes back in the first 34 weeks. But it can be transferred to your baby during the birth, especially if its your first outbreak.
If youve ever had a cold sore or genital herpes and you become pregnant, or you develop these conditions during pregnancy, its important to tell your doctor or midwife about it. Together you can make a plan for managing herpes during pregnancy and birth.
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How To Protect Your Baby From Hsv
Protecting your baby from herpes is relatively easy when using these precautions:
- -Do not have sex with new partners
- -If your partner has herpes, do not engage in sex during any active outbreaks
- -Deliver via Cesarean section if you have an active outbreak at the time of delivery
- -Take antiviral medication to prevent the spread of herpes during and after labor
- -Do not kiss your baby when you have a cold sore and ask others not to
- -Always wash your hands before touching your baby
- -Ask your doctor to test your newborns blood for herpes to determine any potential need for antiviral treatment
Thanks to the accessibility of antiviral medication and the C-section alternative to vaginal birth, its completely possible to protect your baby from an active herpes infection.