Yes, a mother can pass herpes to her baby, especially around birth, but good care usually keeps the risk low.
Many parents hear the word “herpes” in pregnancy and feel a jolt of fear. The big question is simple: can a mother pass herpes to her baby? The answer is yes in some situations, yet with the right care the chance of transmission stays low for most families.
Can A Mother Pass Herpes To Her Baby? Birth Risk Overview
The herpes simplex virus (HSV) spreads through skin and mucous contact. During a vaginal birth, a baby can pick up the virus while passing through the birth canal, especially if there are fresh genital sores or high viral shedding.
Transmission during pregnancy through the placenta is rare. Most neonatal herpes cases happen around the time of birth when the virus is present in genital secretions. A small portion of babies pick up herpes after birth from close contact with cold sores or infected skin.
Doctors pay close attention to the timing of a mother’s herpes infection. A new genital herpes infection in the last weeks of pregnancy carries the highest risk for the baby, while long-standing, recurrent herpes tends to carry a much lower risk because the mother has protective antibodies.
Herpes In Pregnancy And Your Baby’s Risk
Herpes simplex comes in two main types. HSV-1 most often causes cold sores around the mouth, while HSV-2 more often affects the genital area. Either type can infect the genitals and either type can pass to a baby.
Risk for the baby relates to when the mother first met the virus and what is happening near delivery:
| Mother’s Situation | Approximate Baby Risk At Birth | Typical Medical Plan |
|---|---|---|
| Had genital herpes years before pregnancy, no outbreak at birth | Less than 1% | Vaginal birth usually fine; suppressive antivirals may be offered in late pregnancy |
| Had genital herpes before pregnancy, mild outbreak near due date | Still under 1% with treatment | Daily antiviral tablets in the last month, careful exam in labour |
| First-ever genital herpes in first half of pregnancy | Under 1% by the time of birth | Antiviral treatment during the episode, close follow-up with obstetric team |
| First-ever genital herpes in last 6 weeks of pregnancy | Around 30–50% without protective steps | Urgent specialist review, strong advice for antiviral treatment and usually caesarean birth |
| Active genital sores or burning pain at the start of labour | Higher risk if vaginal birth goes ahead | Caesarean section usually recommended to lower baby’s exposure |
| No genital signs, but history of cold sores | Very low risk during birth | Standard birth plan; extra care to avoid kissing the baby during cold sore outbreaks later |
| Family member has an active cold sore after birth | Risk comes from direct contact with the baby’s skin or mouth | No kissing the baby, good hand-washing, avoid sharing cups or utensils |
These figures come from large studies used by public health agencies and obstetric groups. Advice from the U.S. Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists follows this pattern, with special care for women who catch genital herpes close to delivery.
How Herpes Passes From Mother To Baby
To understand the question “can a mother pass herpes to her baby?” it helps to break the perinatal period into clear stages.
During Pregnancy
Transmission through the placenta, before birth, is possible but rare. When it happens, the baby may have growth problems, eye or brain changes, or skin scars. Most babies with herpes pick it up around delivery, not months earlier in pregnancy.
During Labour And Birth
This is the main window of risk. The virus lives in genital skin and mucous tissue. If the virus is active at the time of labour, it can pass to the baby’s skin, eyes, or mouth. Even when sores are not obvious, viral shedding can still occur.
Staff ask about tingling, burning, or pain in the genital area when labour starts. A quick, honest chat helps your team offer the safest plan, including caesarean birth when needed.
After Birth
Once the baby is home, herpes usually spreads from cold sores or infected skin. Kissing a newborn while a cold sore is present, or touching the baby’s face after touching a sore, can pass the virus. Breastfeeding is usually safe as long as there are no sores on the breast itself.
Signs Of Herpes In Newborn Babies
Neonatal herpes often appears in the first four weeks of life. Some babies show clear blisters on the skin. Others seem unwell with no rash at all. Because newborns can get sick fast, any worry about herpes in a baby needs same-day medical review.
General Warning Signs
Watch for any mix of these changes in your baby:
- Poor feeding or refusal to feed
- Unusual sleepiness or floppy tone
- High or low temperature
- Fast breathing, grunting, or pauses in breathing
- Pale, blotchy, or yellow skin
- Jitteriness, staring spells, or seizures
Doctors use blood tests, swabs, and sometimes lumbar puncture to check for HSV along with other infections.
Skin, Eye, And Mouth Infection
Some newborns develop small clusters of clear blisters on red skin, often around the scalp (where monitoring electrodes sat), eyes, or mouth. These lesions may be few in number yet carry the same risk as a wider rash.
Quick swabs from the blisters and other body sites help confirm the diagnosis. Treatment usually begins before test results come back, because delay can lead to deeper infection.
Widespread Or Brain Infection
In other babies, herpes spreads inside the body. The liver, lungs, and brain can all be involved. These babies often look severely unwell, with breathing problems, poor circulation, and seizures. Intensive care and long courses of intravenous antiviral medicine are needed.
Medical Steps That Reduce Transmission Risk
Good antenatal and labour care can lower the chance that herpes passes from mother to baby. Teams draw on national guidelines, such as those used by obstetric colleges and neonatal units, to shape these steps.
Antiviral Medicine In Late Pregnancy
Women with known genital herpes are often offered daily antiviral tablets, such as acyclovir or valacyclovir, from around 36 weeks of pregnancy. This lowers the chance of an outbreak at term and cuts down viral shedding.
When a mother has her first genital herpes infection in the last weeks before birth, stronger treatment and closer monitoring are used. The goal is to calm the infection before labour or to plan a caesarean if viral shedding is still likely.
Choosing Caesarean Or Vaginal Birth
If there are active genital sores or strong burning pain at the time labour starts, a caesarean section usually reduces the baby’s exposure to the virus. This does not remove risk completely, yet it lowers it a great deal compared with vaginal birth through infected secretions.
When there is a past history of genital herpes but no sores or symptoms at term, guidelines usually favour vaginal birth. The care team still checks carefully during labour and stays ready to change the plan if new sores appear.
Newborn Testing And Treatment
Babies born in higher-risk situations may have swabs taken from the mouth, eyes, and bottom, as well as blood tests. Some units start intravenous acyclovir even before symptoms, especially when the mother’s first infection happened close to delivery.
If tests later come back negative and the baby stays well, treatment can stop. If HSV is confirmed, the team continues antivirals for weeks and arranges follow-up with paediatric and eye specialists.
Everyday Steps Parents Can Take
While doctors manage the big medical decisions around birth, parents play a strong part in reducing exposure once the baby arrives.
| Situation | What Parents Notice | Typical Medical Response |
|---|---|---|
| Baby exposed to genital herpes during birth | Baby seems well in the first days | Swabs and blood tests; baby watched closely, treatment started if tests or symptoms point to HSV |
| Baby develops small blisters on skin, eyes, or mouth | Clusters of clear vesicles on red skin | Urgent hospital review, swabs, and intravenous antivirals |
| Baby seems unusually sleepy, feeds poorly, or has a fever | Low energy, fewer wet nappies | Immediate assessment for sepsis and HSV, blood tests, and hospital admission |
| Parent or visitor has a cold sore | Sore or crust on lip or around mouth | No kissing the baby, mask use in hospital, strict hand-washing |
| Sore or blister on the breast | Painful patch near the nipple or areola | Feed from the other breast; avoid pumping from the affected side until healed |
| Mother on long-term antiviral tablets | Daily acyclovir or valacyclovir | Medication usually continues as advised; breastfeeding often still encouraged |
Hygiene And Contact Rules
Good hand-washing with soap and water before touching the baby’s face, mouth, or any healing cord stump reduces the spread of many infections, including HSV. Anyone with a cold sore should avoid kissing the baby and should wash hands after touching their own mouth.
Family members who feel unwell with flu-like symptoms, mouth ulcers, or unexplained rashes should stay away from newborns until they feel better or have been checked by a doctor.
Talking With Your Care Team
If you have a history of genital herpes or cold sores, tell your midwife or doctor early in pregnancy. Bring it up again around 36 weeks so that a clear plan is in place.
When To Seek Urgent Help For Your Baby
Call emergency services or go to the nearest emergency department straight away if your baby has any combination of the following:
- Fits or repeated jerking movements
- Blue, grey, or unusually pale skin
- Long pauses in breathing
- Extreme sleepiness or difficulty waking
Contact your doctor the same day if your baby feeds less, seems more floppy or irritable, has a fever, or develops a new rash or blisters. Early antiviral treatment can save lives and protect long-term health.
For parents asking, can a mother pass herpes to her baby?, the honest answer is yes, but with open communication, good hygiene, and timely medical care, most babies born to mothers with herpes stay healthy and thrive over time.