When a pregnant individual develops cold sores, it is natural to feel concerned about the potential effects on their unborn baby. Cold sores are a common viral infection, and understanding their nature during pregnancy alleviates anxiety. While these lesions are uncomfortable and contagious, effective management strategies and precautions exist to protect both the pregnant person and the newborn.
Cold Sores and Pregnancy Basics
Cold sores are caused by the herpes simplex virus type 1 (HSV-1), a common virus that remains in the body for life. Although many people carry HSV-1, they may not experience frequent outbreaks. During pregnancy, however, hormonal fluctuations, increased stress, and shifts in the immune system can trigger or increase cold sore outbreaks.
Having cold sores during pregnancy is a common experience. It typically does not pose an immediate cause for alarm for the developing fetus. Any active viral lesions during pregnancy warrant attention and discussion with a healthcare provider for proper management.
Risks to Your Baby
The primary concern is transmitting the virus to the baby, particularly around birth. If a pregnant person experiences a primary HSV infection during pregnancy, especially in the later stages, there is a rare but higher risk of the virus being passed to the fetus. However, if the pregnant individual has had cold sores before pregnancy, their immune system has developed antibodies that can offer some protection to the baby, significantly reducing the risk of in-utero transmission.
The more significant risk occurs if the baby is exposed to the virus during vaginal delivery when the mother has active cold sores or genital herpes lesions. This can lead to neonatal herpes, a serious, potentially life-threatening infection for a newborn. Neonatal herpes can affect the baby’s skin, eyes, mouth, central nervous system, and internal organs. Symptoms can include high fever, irritability, skin rash, feeding difficulties, or breathing problems, and typically appear within days to weeks after birth.
Treating Cold Sores Safely
Managing cold sores during pregnancy involves safe, approved methods under healthcare provider guidance. Antiviral medications like acyclovir and valacyclovir are commonly prescribed and generally considered safe during pregnancy. These oral medications shorten the duration and reduce the severity of an outbreak. Topical acyclovir cream is also safe to apply directly to the cold sore.
For comfort, cold compresses numb the pain and reduce swelling. Over-the-counter pain relievers, such as acetaminophen, are also considered safe during pregnancy to manage discomfort. Some topical remedies like aloe vera gel or lemon balm lip balms may offer soothing relief. All treatment decisions should be discussed with a doctor to confirm suitability during pregnancy.
Protecting Your Newborn
After birth, preventing the transmission of the herpes simplex virus to the newborn is a priority, as infants have immature immune systems. Meticulous handwashing is important for anyone with a cold sore before touching the baby. Avoid kissing the newborn, especially on the face, if you have an active cold sore.
Covering active cold sore lesions with a patch or face mask can help prevent accidental transmission. Avoid touching the cold sore directly; if you do, wash your hands thoroughly before handling the baby. If a cold sore develops on the breast, avoid breastfeeding from the affected breast until the lesion has completely healed.