Chickenpox, caused by the varicella-zoster virus (VZV), is a highly contagious illness often associated with childhood. While many believe it primarily affects older children, babies can contract chickenpox. Understanding how infants are susceptible, recognizing symptoms, and knowing the best approaches for protection and treatment is important for caregivers.
How Babies Contract Chickenpox
Chickenpox spreads easily through respiratory droplets from coughing or sneezing, and direct contact with fluid from blisters. Babies can acquire the virus through exposure to infected family members or other close contacts.
Maternal immunity plays a significant role in protecting newborns. Antibodies from a mother’s past chickenpox infection or vaccination are transferred across the placenta during the final trimester of pregnancy. This passive immunity offers temporary protection.
However, these protective antibodies decline rapidly, leaving infants susceptible to infection as early as one to three months of age. By six months, nearly all infants may become susceptible, even if their mothers were immune. Premature babies are at higher risk because they receive fewer maternal antibodies.
Recognizing Chickenpox in Infants
The initial signs of chickenpox in infants can resemble general illness, including fever, fussiness, fatigue, or decreased appetite. These symptoms may appear a day or two before the characteristic rash. The rash typically begins as small red spots on the torso, face, or scalp, then spreads across the body. These spots progress into fluid-filled blisters that eventually burst and scab over. It is common to see spots at different stages of development simultaneously.
Symptoms can be more pronounced in very young infants or those who did not receive sufficient maternal antibodies. While usually mild, chickenpox can lead to complications, particularly in infants. These may include bacterial skin infections, pneumonia, or inflammation of the brain (encephalitis). Seek prompt medical attention if chickenpox is suspected in an infant, especially if they show signs of severe illness or complications.
Protecting and Treating Your Baby
Infants cannot receive the chickenpox vaccine until at least 12 months of age. The varicella vaccine for older children and adults contributes to “herd immunity,” which indirectly protects infants by reducing the overall spread of the virus. This community-wide vaccination significantly lowers the risk of exposure for unvaccinated babies. Minimizing exposure to anyone with active chickenpox is important, particularly for infants under six months or those whose mothers are not immune.
If an infant is suspected of having chickenpox, consulting a pediatrician is recommended. Treatment focuses on supportive care to alleviate symptoms. This includes managing fever with acetaminophen, while aspirin should be avoided due to the risk of Reye’s syndrome.
Keeping the baby hydrated and preventing scratching by trimming fingernails can help reduce the risk of secondary bacterial infections. Cool baths with baking soda or oatmeal and calamine lotion can help soothe itching. In some severe cases or for high-risk infants, antiviral medications like acyclovir may be prescribed under medical supervision, ideally within 24 hours of rash onset.