Concerns about health conditions like herpes can raise questions for breastfeeding parents. Individuals with herpes simplex virus (HSV) can often continue to breastfeed their infants. Following specific precautions and healthcare guidance helps ensure the baby’s safety.
General Principles of Breastfeeding with Herpes
Herpes simplex virus (HSV), including types 1 and 2, transmits primarily through direct skin-to-skin contact with active lesions. These viruses cause blisters or sores anywhere on the body, including on or near the breasts. While HSV-1 often causes oral cold sores and HSV-2 is linked to genital herpes, both can affect any skin area.
The herpes virus is not transmitted through breast milk itself. The main risk of transmission to an infant is direct contact with an active herpes lesion. Though rare, neonatal herpes infections can be serious for newborns due to their developing immune systems. Mothers with a herpes infection before or during pregnancy may pass protective antibodies to their baby through the placenta, offering some defense.
Managing Active Herpes Lesions
If active herpes lesions are present on the breast, nipple, or surrounding area, temporarily stop direct breastfeeding from that affected breast. If lesions are on other body parts, such as the mouth or face, cover them completely to avoid accidental infant contact.
Practice strict hygiene during an outbreak. Thorough handwashing with soap and water should be done before and after touching the baby, breasts, or any breast pump equipment. If milk is expressed from an affected breast, discard it if it contacted a lesion.
If one breast has active lesions, breastfeeding can continue from the unaffected breast, provided no lesions are present there. Express milk from the affected breast to maintain supply and prevent discomfort, but do not give this milk to the baby. Thoroughly wash and sterilize all pump parts that contact active lesions after each use. Consult a healthcare provider to confirm when lesions have fully healed and direct breastfeeding can safely resume.
Antiviral Medications and Breastfeeding
Antiviral medications, such as acyclovir (Zovirax) and valacyclovir (Valtrex), are prescribed to manage herpes outbreaks. These medications are safe for breastfeeding individuals. Acyclovir is often preferred, and valacyclovir converts quickly to acyclovir in the body.
Research shows only very small amounts of these antiviral drugs pass into breast milk. This minimal transfer means adverse effects in breastfed infants are not expected. For example, a breastfed infant’s acyclovir dosage is often less than 1% of a typical infant dosage. Always discuss medication use with a healthcare provider.