Neonatal herpes is a herpes infection affecting a younger baby. A highly contagious herpes simplex virus, which causes genital and oral herpes in adults, is responsible for infection in babies. This infection is manageable in adults but may cause severe complications in kids.

The younger the baby, the higher is the risk of complications related to herpes. So, it can be severe for a young baby whose immune system is not completely developed to fight the infection. But the good news is that the prevalence of neonatal herpes is rare and can be prevented with simple precautions.

Let us understand more about this condition, how it can be prevented, and its management.

What Is Neonatal Herpes?

Neonatal herpes is a herpes infection that affects a younger baby either during delivery or weeks after that. Two types of herpes simplex virus can cause neonatal herpes, HSV-1 and HSV-2. But HSV-2 is more likely to cause herpes in babies than HSV-1.

(You can read our previous blog on the herpes simplex virus here)

The virus can be transmitted either from another infected neonate or through an infected maternal genital tract. Babies with herpes infection have a system-wide infection (systemic infection) or a localized skin infection, or both. In severe cases, herpes may cause the following complications:

  • Breathing problems
  • Brain damage
  • Seizures

Who Gets HSV & How It Spreads in Newborn?

Anyone can get HSV, but the following factors increase your risk:

  • Having sex at a younger age
  • Have a weakened immune system
  • Being female
  • Having multiple sex partners
  • Having other sexually transmitted infection
  • Atopic dermatitis
  • Anti-rejection drugs for organ transplants
  • Cancer chemotherapy

An infected individual can then transmit the infection to a baby. The most common way of spread is from an infected mother to her baby. It can happen in the following ways:

During Pregnancy and Labor

The risk of transferring the infection is higher if the mother has herpes infection for the first time during the last six weeks of pregnancy. The risk is even higher if she has an active infection with genital sores and undergoes a vaginal delivery.

However, the risk is lower if you have had the infection before the pregnancy.

If you have an active infection during pregnancy, your doctor may advise a C-section instead of a vaginal delivery to prevent the spread of the virus to the baby.

After Birth

It is also possible to pass the infection if you have oral herpes and kiss the baby. The herpes virus can also be spread if the mother has a blister on her breast and feeds the baby.

The risk of infection is highest during the first month after birth. To protect the baby, you should not kiss the baby if you have a cold sore. These sores are most infectious when they burst.

Symptoms of HSV Infection in Newborn

Symptoms of HSV appear within a few days to weeks after the infection. The most common symptom is fluid-filled blisters or sores. They are similar to oral or genital sores in adults. The blisters can also burst and crust.

In severe cases, the baby may have the following symptoms:

  • High temperature
  • Sores or rash in the eyes, skin, and inside the mouth
  • Not taking feed
  • Fatigue
  • Irritability
  • Becoming unresponsive and floppy
  • Breathing difficulties
  • Sleepiness
  • Blue skin and tongue
  • Rapid breathing

If the baby becomes unwell suddenly or has the mentioned symptoms, contact your doctor immediately and seek emergency treatment.


The systemic herpes infection may cause serious complications, including:

  • Blindness
  • Respiratory illness
  • Seizures
  • Eye problems

The infection also affects the baby’s important organs, including the kidneys, lungs, brain, and liver.


There is no cure for the virus, and treatment involves the management of the symptoms. Some medicines can also help to lower the risk of recurrence.

Your child’s pediatrician may prescribe an antiviral medicine to be given intravenously. Acyclovir (Zovrax) is the most common choice of drug to manage neonatal herpes. This treatment may last for few weeks.

The management may also involve additional medicines to control shock or seizures.

You can breastfeed the baby during the baby unless you have sores on your breast. Besides, you can also breastfeed if you are on antivirals as these medicines are not seen to cause any harm to the baby.


For Genital Herpes

Like any other sexually transmitted disease, the best way to prevent genital herpes is to practice safe sex. A barrier method of contraception such as a condom can prevent transmission and limit exposure to an active herpes infection.

Avoid unprotected sex unless you are confident about your partner’s health status. You can also discuss the history of herpes or other infections with your partner.

If you are pregnant or planning for a pregnancy and have had herpes in the past, it is best to discuss it with your doctor.

They may give you antivirals for a month before your due date to lower the risk of transmitting the disease to your baby. If you have active genital lesions, you may be advised a cesarean delivery instead of a normal vaginal delivery.

For Oral Herpes

If you have oral herpes or any signs of herpes infection, the following precautions will help:

  • Wash your hands thoroughly with soap and water
  • Clean your hands before touching your baby
  • Wash your hands before breastfeeding
  • Do not kiss your baby
  • Keep your sores clean and dry

You can also cover any sores or blisters to prevent the risk of spread to other body parts and your baby.

Final Thoughts

Herpes is a common infection and may affect younger babies too, a condition known as neonatal herpes. The baby mainly gets the infection from the mother having a genital herpes infection. This can happen during pregnancy or delivery or after birth.

In rare cases, a baby can get oral herpes if an infected individual kisses the baby.

Neonatal herpes may be localized to the skin or cause a systemic infection. The latter may cause severe complications such as coma, seizures, or respiratory problems.

However, the most common manifestation of neonatal herpes is blisters or sores on the skin. Some cases may also be asymptomatic. Once infected, the virus stays dormant in the body and may be triggered by factors such as fever or illness. 

As there is no cure for herpes, you should closely observe your baby for signs of herpes infection. Early management of the infection significantly reduces the risk of complications and spreading the virus to others.

If your child gets unwell suddenly or has symptoms of complications, consult a doctor immediately.

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