Herpes in babies - how dangerous is it?


Herpes is one of the infectious diseases that manifests itself when the skin and mucous membranes are attacked by the so-called herpes simplex virus.

In most cases, a herpes infection is not dangerous for adults. Since the immune system of newborns is usually not yet sufficiently developed to effectively fight the virus and prevent the pathogen from spreading, serious courses can develop, which in the worst case can be fatal. Herpes infection can be very dangerous, especially in the first 4–8 weeks after the birth.

The herpes virus

The herpes infection is triggered by the herpes simplex virus, which can be divided into two types.
Type 1 preferentially affects the skin and mucous membrane in the facial area and occurs mainly in adults and adolescents (cold sores). Type 2 mainly causes genital herpes and is mostly responsible for diseases of the fetus and newborns. The peculiarity of these groups of viruses is that they can remain in the body after being infected and subsequently combated by the immune system and can trigger diseases.

More information on this topic: Duration of genital herpes

Is herpes dangerous in babies?

Infecting a baby with herpes virus in general is not extremely dangerous. However, complications are more common in newborns than in adults.
The complications of infection with the herpes virus can be very dangerous in babies. If the herpes infection spreads through the bloodstream, blood poisoning (Herpes sepsis) develop. The viruses can also infect internal organs such as the lungs, liver and kidneys via the bloodstream.

Involvement of the brain is particularly serious. The inflammation of the meninges can lead to seizures, vomiting, and stopping breathing. As a result, damage to intellectual development can arise.

If young babies already have other skin diseases, such as inflammatory neonatal eczema, an infection with the herpes virus can lead to what is known as eczema herpeticatum. The virus particles can penetrate the previously damaged skin more quickly and vesicles form.

If the mother is infected for the first time during pregnancy and the blood system is infected with the virus, the child can be infected via the placenta in the womb. This can lead to disorders of child development as well as miscarriages and developmental defects.

Herpes encephalitis

Herpes encephalitis is a very serious complication that can occur, especially when a newborn is infected with herpes. The virus spreads to the brain and leads to a very life-threatening inflammation.

The first signs are initially unspecific and are described as flu-like. After this phase, which is accompanied by a slight fever, there is a sudden rapid rise in body temperature, which is associated with confusion and impaired consciousness in the child.

If no treatment is followed, a coma can occur. Herpes encephalitis is considered an absolute emergency in medicine. Antiviral therapy is initiated immediately as soon as this disease is suspected. Only then does a reliable diagnosis with MRI and a lumbar puncture follow. An antibiotic is also often given until a bacterial cause can be ruled out. If no signs of encephalitis are found, the therapy can be discontinued immediately.

Read more on the subject at: Herpes encephalitis


The herpes disease occurs as a result of infection with the herpes simplex virus. The virus is highly contagious and can be transmitted through a kiss or by sharing the drink (smear infection or droplet transmission).

There is also a 50% risk that a mother with a primary herpes infection will infect her baby during childbirth. In these cases, however, there is no great danger for the newborn, since antibodies from the mother against the virus were transferred to the child during pregnancy and it is thus well protected in the first weeks of life, which is known as nest protection.

However, if the mother falls ill with herpes shortly before birth, this nest protection is not guaranteed. The antibodies that are formed at this stage cannot be transmitted to the baby through the placenta.

Read our article on this:

  • Neonatal infection
  • Nest protection - what is it?

How high is the risk of infection if I have kissed my child with herpes?

The infection with the herpes virus type 1 occurs through close contact with the infected mother or infected people. In addition, the kissing and caressing of the baby is particularly tough. The infectious virus particles that are contained in typical cold sores can quickly be transferred to the baby's mucous membranes.

Basically, the herpes simplex infection is considered a smear infection and is thus transmitted via body secretions such as saliva. There is a high risk of infection for the child, especially if parents have an open cold sore on their lip or in their mouth. The herpes virus can be transmitted by kissing the child or by sharing cutlery or glasses.

Since a herpes infection can be dangerous, especially in the first year and a half of a child's life, parents with herpes should take certain precautionary measures during this time to avoid infecting the child. This includes covering the cold sore with plasters or special creams and good hand hygiene. In addition, parents should avoid kissing their babies while they have cold sores around their mouths. There is no need to refrain from breastfeeding the child unless there are cold sores around the nipple.

Contagion during pregnancy and childbirth

There is a great risk of contagion during the birth process. Most babies acquire the virus during birth when they pass through the birth canal if the mother has genital herpes. If the virus rises in the mother's vagina as part of an infection, it can also be transmitted to the child if the bladder ruptures prematurely.

If the mother is infected for the first time during pregnancy, the virus can also be transmitted to the unborn child. If the virus has infected the mother's entire body, it can spread through the placenta (placenta) transferred into the child's blood. In this case, serious complications, massive malformations and increased premature births often occur.

Signs and accompanying symptoms

The first signs a present herpes infection in babies diverse and usually show up 1 - 26 days after infection.

Is there an infection Type 1 Herpes viruses are predominantly the Skin and mucous membranes im Facial area affected. It can be very painful, small vesicles in the oral cavity that can quickly ignite and burst (Please also read: Herpes in the mouth). This inflammation can spread through the Thumb sucking transferred to the fingers in babies. If the blisters open in the mouth, it can develop Bad breath develop.

With a further spread in the mouth area usually also occur fever and a Swelling of the cervical lymph nodes on. The babies also stand out because they are very restless will be a lot cry and the Refuse to drinkbecause the vesicles in the mouth are very painful are.

If the initial infection with the herpes virus type 1 is over, the viruses initially linger in the ganglia, which are formed by nerve cells and are present in the head area. They can be reactivated if the immune system weakens again. The cold sore is not common in babies because it is usually a secondary infection.

When infected with type 2 herpes viruses, the skin and mucous membranes in the genital area are affected. Here, too, small vesicles develop (on the labia or on the foreskin), which on the one hand are very painful and on the other hand can be associated with urination problems and urethral infections.

Here, too, the babies can develop a fever and swelling of the lymph nodes in addition to the skin symptoms mentioned. If an infection occurs during childbirth, the first symptoms appear in the first few weeks after the birth. The babies often appear exhausted and limp, have a grayish complexion, develop a fever and refuse to drink.

Read more on the topic: Fever in baby

These are the symptoms I can tell my baby is getting herpes

The occurrence of herpes in babies is usually not as clearly recognizable as in adults.
Children can have the typical cold sores in the corners of the mouth and around the mouth, but they can also have other symptoms. For example, an inflamed, easily runny nose or thick, reddened eyes, which are more likely to suggest conjunctivitis.

Also read: Conjunctivitis in the baby

Herpes in the baby on the lip and in the mouth

After infection with the herpes virus, blisters first form on the lip, which often spread to the mouth area. Herpes usually causes apthens in the mouth. This is a painful inflammation of the lining of the mouth that is less than an inch in size and is usually white in color.

They heal in about one to two weeks. If the infection is more severe, the pain from the apthens can make babies difficult to swallow and refuse to eat. To relieve pain, special ointments for the mouth with the active ingredients lidocaine or polidocanol can be applied to the appropriate area.

The symptoms of recurrent herpes are often milder and are usually limited to blisters on the lip, which are accompanied by redness, itching and burning. No scars remain after the incrustation and subsequent healing. These recurrences are summarized under the term cold sores.

Read more on the subject at:

  • Herpes in the mouth
  • Oral rot- The herpes infection on the oral mucosa

Baby herpes on the eye

Also caused by the herpes virus type 1, infections of the eye can develop. In most cases, the virus material is spread through smear infection. The small herpes sores usually appear in the area of ​​the eyelid and the cornea is often involved. The babies have reddened, watery eyes and can be very sensitive to light. There is a risk of scarring from inflammation of the cornea. In the further course of the disease, a significant reduction in vision can develop and the child can go blind.

Read more on this topic: Reddened eyes in children and babies

Herpes on the baby's bottom

Cold sores on the baby's bottom or genital area are caused by the type 2 herpes simplex virus. In the case of a primary infection, these are usually larger, increased and are associated with an increased body temperature. Recurrences, which can occur again and again, are usually mild and often unnoticed.


The diagnosis of herpes infection is one in most babies Eye diagnosis. The small Blisters on the face, mouth, or genital area are often very easy to recognize. If babies have symptoms that reinforce the suspicion of a herpes infection, this may be due to Blood tests, Trade-offs from the Mouth and throat or the Fluid in the vesicles or one CSF puncture Virus DNA or Virus components to be isolated.

If there is a pregnant woman infected and there is a possibility that the virus could affect the unborn child transfer is can one Amniotic fluid puncture become necessary to detect the virus.

If there is a suspicion in newborns that the herpes pathogen is the Brain infected has and become one Encephalitis (Encephalitis), this can be done by CSF puncture or im MRI and EEG be checked.


A therapy that leads to the complete destruction of the herpes virus is not known. There is also no vaccine available that can prevent infection with the virus. Since the virus remains in the body even after the symptoms have subsided, a new outbreak can occur at any time if the body's immune system becomes weak or in stressful situations.

If the herpes infection is mild, only symptoms such as fever, itching and skin symptoms are treated.

If the virus spreads through the blood and develops herpes sepsis or the infestation and infection of other internal organs, antiviral therapy via the vein is necessary for 2-3 weeks. The disease-causing viruses are thus prevented from multiplying further. Aciclovir is usually used as an antiviral drug. This relieves the pain and itching, prevents the virus from multiplying further and is intended to minimize possible consequential damage as far as possible. The decisive condition for the treatment of severe herpes infections is the initiation of treatment within the first 24 hours after the onset of symptoms.

Therefore, in the event of encephalitis, antiviral therapy must be initiated if it is suspected. If it turns out that there is no herpes encephalitis, the antiviral therapy can be stopped immediately.

Only in a few cases is herpes treated with topical drugs. This is especially the case with eye involvement, such as conjunctivitis, that is treated with an ointment made from acyclovir or other antiviral agents.

Read more on the subject at: Ocular herpes

Duration and forecast

The duration of the herpes symptoms are depending on age and whether it is a new infection or a reactivation of the virus. A Initial infectionassociated with a mild fever and fatigue usually subsides within two weeks.

At severe forms or complications like herpes encephalitis can be the Duration vary a lot. It usually only occurs later Reactivation of the herpesassociated with blistering. These heal afterwards about a week by itself and leave no scars.

Is the baby's herpes infection just one? locali.e. on a specific area of ​​the skin or mucous membrane limited inflammation, is the Prognosis as well to watch. Especially with small babies, because the immune system is not yet fully developed, you always have to make sure that the infection does not spread does not spread further.

Are those with a herpes infection Brain or other organs affected pulled, she lies mortality rate in babies despite adequate therapy around 50–80%. If the affected child survives the severe infection, there is still a high risk of them permanent damage retains. These include, for example, a Decrease in intelligence, mental disability, a Convulsions or damage to the eyes.

How long is herpes dangerous for children?

Herpes is dangerous for children as long as their immune system is not yet fully able to fight the virus effectively and contain the infection. According to publications by the German Green Cross, herpes is dangerous for the baby, especially in the first six weeks, and can lead to serious clinical pictures. After that, the risk continues to decrease as the immune system becomes stronger. At around one and a half years of age, herpes is no longer a major threat for children with an intact immune system.

You might also be interested in this topic: Mouth rot in the baby


Prophylactically, the Risk of herpes infection with the child through the Observation of some important notes minimized become.

Is the birth of a child imminent and is that mother with a Genital herpes affected, the attending physician should have one Caesarean section carry out to protect the baby from infection.

Is there a acute Herpes infection you should in general refrain from visiting a babyuntil the acute phase has subsided, the vesicles dried up and the crusts have peeled off.

If parents or people who are in close contact with the baby suffer from cold sores, they should refrain from wearing one Mouthguard be respected. Affected parents can share the cold sore Acyclovir cream treat and with one band Aid cover.

It is also important to be strict Hygiene measures adhere to like the regular To wash and Disinfect of the hands. In addition, the Kissing and petting with the baby waived become. Everything that can come into contact with the infectious vesicles, such as dishes, glasses or towels, should Not with others divided become.

Even when breastfeeding should be Mouthguard be worn. Are the Mother's nipples infested with cold sores, the child should first Not continued to breastfeed become.

What is the nest protection?

The so-called nest protection describes the fact that newborns and babies are relatively unsusceptible to diseases in their first months of life because they have received part of the maternal immune system.

During pregnancy, certain antibodies from the child's mother can also enter the baby's bloodstream with the help of the blood. Since the newborn's immune system needs a few months before it can independently deal with diseases that arise, these maternal antibodies help protect the baby in the first few weeks and months.

However, the maternal antibodies do not last forever, but rather perish after some time, which is why this protection evaporates over time.
Nonetheless, the nest protection helps to protect the baby effectively against potential bacterial or viral diseases in the beginning.

Read more on the topic: Nest protection - what is it?