Cold Sores and Babies: Can Cold Sores Harm my Child?

Becoming a parent transforms your life and shifts your priorities. Your child becomes your world, and when your child is a baby, they’re dependent on you for everything, including their health.

Cold sores are a common health concern among adults worldwide. If you experience cold sores yourself, you may wonder whether they can affect your baby. Can babies get cold sores? Can sores harm your child?

Let’s take a closer look at how babies may contract cold sores, why they’re harmful, and what to do if your child displays cold sore symptoms.

Can Babies Get Cold Sores?

First, can babies get cold sores?

Unfortunately, the answer is yes. Babies can contract cold sores the same way adults and older kids do — through close contact with someone who carries the herpes simplex virus, or HSV.

There are two types of herpes simplex virus. The herpes simplex virus type 1, or HSV-1, typically causes cold sores, while the herpes simplex virus type 2, or HSV-2, leads to genital herpes. Both are contagious and spread from person to person through close physical contact.

In this article, we’ll focus on HSV-1 and how it can cause babies to develop cold sores and other symptoms.

Cold sores develop on the lips or around the mouth. When a cold sore develops, it goes through five stages:

1. A tingling or itchy sensation occurs on the spot where the cold sore is developing.
2. The sore develops fluid-filled blisters, becoming increasingly painful and contagious.
3. The blisters break open, releasing their liquid and leaving a red, painful, highly contagious open sore behind.
4. The sore crusts over to begin healing, though it remains contagious. Allowing the scab to fall off naturally facilitates the best healing.
5. The scab falls off. The skin beneath should be healed. If not, a new scab may form. 

A cold sore outbreak is considered fully healed when the skin beneath the scab returns to normal. A faint red or dark spot may remain, but it will fade over time.

Transmission of HSV-1 most often comes from a person who has an active cold sore — especially between stages two and four. However, you can transmit the virus to another person even if you don’t see any signs of a sore — perhaps during stage one, when a cold sore is preparing to form, or due to asymptomatic shedding.

In babies, a herpes infection is called neonatal herpes, and it can be extremely serious for infants. Though HSV-2 causes most cases of neonatal herpes, HSV-1 causes between 15 and 30%.

A common form of viral transmission is from an adult caregiver or even healthcare worker. An adult who has a cold sore should be extra careful when caring for a baby. Kissing the baby, touching your face to the baby’s face, or touching your mouth and then touching the baby can all lead to infection. Sharing eating or drinking utensils can also pass the virus to the baby.

There are a few other ways a baby can contract a neonatal herpes:

• An infant may get a cold sore during vaginal delivery when an active genital herpes outbreak is present. During a known active outbreak, the doctor can intervene to drastically lower the risk of transmission.
• A baby can contract the virus when breastfeeding from a person with an HSV blister on or near their breast, or from any other contact with the breast.
• The virus may be contracted from feeding on breast milk pumped from a breast with an active infection.
• During pregnancy, neonatal herpes may develop if an active genital herpes outbreak occurs for the first time within the final six weeks before delivery. In this case, a doctor can intervene to reduce the risk of transmission.

If you’re caring for a baby and have an active cold sore, take these precautions:

• Don’t touch the sore or any part of your face or mouth while you’re with the baby.
• Keep the baby’s fingers, toes, or other body parts away from your face and mouth.
• Use only sterile feeding utensils, cloths, towels, and anything else that will touch the baby.
• Wash your hands thoroughly before touching the baby and often while caring for them.

Infant Cold Sores

Newborns are most susceptible to contracting a serious case of neonatal herpes during the first month of their life. They do not have fully developed immune systems and are particularly vulnerable to infections and illnesses. If you have a baby this young, take extra precautions to protect them from an active herpes outbreak or cold sore.

At any stage of life, an individual’s first HSV outbreak is typically the most severe because the body needs to develop the ability to fight the virus. In small babies, this process can be especially dangerous.

The Risks

While babies can develop cold sores as a result of herpes simplex virus exposure, their reaction can go beyond a sore on the skin. It’s important to learn the signs so you can tell when you have an emergency.

Infants and small babies can’t tell you how they feel, so you must pay close attention to their symptoms. Contact your baby’s doctor right away if you notice any the following symptoms:

• Sores on the skin
• Sores around the eyes
• Sores inside the mouth
• A skin rash
• A fever
• Lack of appetite
• Lethargy
• Uncharacteristic irritability

Seek immediate emergency medical attention if you notice any of these symptoms:

• Difficult to wake up
• Unresponsive
• Very low energy
• Seems lifeless
• Difficulty breathing
• Rapid breathing
• Making grunting sounds
• Bluish color to the skin or lips
• Bluish color to the tongue

Three Types of Infections

When a baby develops neonatal herpes, the virus can take hold in three different ways:

• Localized skin infection: A localized skin infection presents like a cold sore. Babies develop small, fluid-filled blisters around the mouth and the eyes. They may also experience discomfort while eating.
• Encephalitis: With this more severe infection, HSV causes swelling of the brain, which can cause neural and spinal problems. Seizures can be a symptom of this type of infection.
• Disseminated herpes infection: The most dangerous type of herpes simplex infection, disseminated herpes spreads throughout an infant’s body and can affect the kidneys, lungs, brain, liver, and more. It can also lead to meningitis.

Babies who contract the herpes simplex virus may only show a few symptoms, which may take time to develop. Most symptoms will develop within the first week of the initial infection, but issues with the central nervous system may not become apparent until the second week.

While many babies make a full recovery from neonatal herpes, some do not. Though their occurrence is rare, encephalitis and disseminated herpes infections can be deadly and prompt treatment is essential. If you notice your baby has symptoms of a herpes infection, seek professional treatment right away.

Prevention Is Key

If you’re a new parent, you may want to be polite to every friend and relative who wants to hold, kiss, and touch your baby. However, this can be dangerous, especially in the first few weeks of life.

If you decide to allow relatives and friends to spend time around your baby in the first few weeks after they’re born, ask that everyone follow the same protocol:

• If they’re sick, or if they think they may be developing a cold sore, stay home.
• Do not come to see the baby with an active cold sore.
• Always wash hands thoroughly with soapy, warm water before holding the baby.
• Do not kiss the baby, even if you don’t feel sick.

While it may make you uncomfortable to enforce rules around people who simply want to show your baby affection, it’s important for protecting your baby’s health. Many people don’t consider — or don’t know — the risks a simple kiss can pose to an infant. Explaining your rationale should help friends and loved ones understand.

Think Your Child Was Exposed? What to Do Next

If you have a cold sore and kissed your baby, know that you’re not the first person to do so, and it’s likely your baby will be fine. It can be nerve-wracking to know your child may have been exposed to the herpes simplex virus, but learning the signs of neonatal herpes can put your mind at ease.

If you absentmindedly kiss your baby while you have a cold sore, keep an eye out for signs of the virus. If your child is older, the situation is less serious. Monitor them for blisters, swollen lymph nodes, and/or a sore throat.

Reach out to your pediatrician if your baby is less than six months old and may have been exposed to a cold sore. For older children, home remedies and treatments can help ease the pain of cold sores.

Treatment Options

While the answer to the question “Can babies get cold sores?” isn’t perhaps what most people would like the hear, the methods of prevention are fairly effective. But since the risk is never 0%, knowing the signs and symptoms of neonatal herpes is also important so you can seek treatment right away.

If an older child contracts a cold sore, it’s still a good idea to see a doctor, and you can also use a number of home remedies to reduce pain and facilitate healing.

Applying a cold compress can ease the discomfort of a cold sore. Antiviral supplements like lemon balm or over-the-counter treatments designed for cold sores may be effective in limiting the severity of an outbreak. Sunscreen can protect a healing cold sore from being damaged while your child is outside. The list goes on.

Remember to always check labels and speak with your pediatrician before using any treatment or home remedy to verify it’s safe for your child’s age.

Light Therapy

If your family suffers from frequent cold sores, consider a safe, gentle treatment like light therapy. The Luminance RED Lip Sore Treatment Device is designed to use low-level laser therapy to stimulate the skin’s natural healing mechanisms and provide immune cells with the energy to effectively attack a cold sore outbreak. 

The Luminance RED puts safety first, and clinical data has shown no negative side effects when light therapy is used to treat a wide variety of conditions in children. Still, consult with your child’s doctor before purchase.