Herpes infections are a common concern, and parents often have questions about potential transmission to infants, especially during breastfeeding. Understanding how herpes simplex virus (HSV) works and how it can or cannot be passed to a baby is important for informed decision-making and safe breastfeeding.
Herpes Types and How They Spread
Herpes simplex virus (HSV) is widespread, primarily occurring in two main types: type 1 (HSV-1) and type 2 (HSV-2). HSV-1 is commonly associated with oral herpes, such as cold sores. HSV-2 is typically linked to genital herpes. Both HSV-1 and HSV-2 can cause infections in either oral or genital regions, depending on the route of transmission.
Transmission primarily occurs through direct contact with active lesions or skin-to-skin contact when the virus is shedding, even if no visible sores are present. This can happen through kissing, sexual contact, or touching an active sore and then another person. The virus does not spread through casual contact, such as sharing towels or toilet seats, in typical household settings.
Can Breast Milk Transmit Herpes?
The herpes simplex virus is not transmitted through breast milk itself. Scientific consensus indicates the virus does not enter the milk supply, making direct transmission to an infant via breast milk extremely rare.
The primary risk of herpes transmission to an infant during breastfeeding comes from direct contact with active herpes lesions. If a mother has an active sore on her breast or nipple, the baby can acquire the virus by touching or coming into contact with that lesion during feeding. Transmission can also occur if the baby comes into contact with lesions on other parts of the mother’s body, such as the mouth or fingers, or if the mother touches a lesion and then touches the baby without proper hand hygiene.
If an active lesion is present on the breast or nipple, it is advised to avoid direct breastfeeding from that affected breast. Any breast milk expressed from the affected breast should be discarded.
Breastfeeding Safely with Herpes
Mothers with herpes can breastfeed safely by implementing specific precautions. If active herpes lesions are on parts of the body other than the breast, cover them carefully to prevent direct contact with the infant.
Meticulous hand hygiene is important. Wash hands thoroughly with soap and water before and after touching the baby, breasts, or any lesions to reduce viral spread. If a lesion is present on a breast or nipple, temporarily avoid breastfeeding from that breast until the sore has completely healed.
During an outbreak on a breast, mothers can maintain their milk supply by pumping from the affected side, but the expressed milk from that breast should be discarded. Breastfeeding can continue from the unaffected breast, provided no lesions are present on that side and proper covering of any active lesions is maintained. Antiviral medications may be prescribed by a healthcare provider to shorten the duration of outbreaks, and some are considered safe for use while breastfeeding.