19 month old with cold sore: Advise Please

[parent1]

Hey there,

Our situation is as follows; we have a 19 month old who has HSV 1 on his lip. He had his first outbreak at about 8 months old and is having his second outbreak now.

Being 19 months old he is hard to control in regards to what he touches and what goes in his mouth. In fact he puts most things in his mouth. He often uses a soother, which is great as it keeps him from putting his hands or other things in his mouth, but that means he always has a soother in.

My questions are as follows:

1. How likely is it that he will transfer the infection to his eyes and or genitals and how likely is it for people with HSV in their eyes to go blind?
2. Do you think it’s best to allow him to use his soother (preventing him from putting other things in his mouth), or take the soother away to let the sore dry out?
3. Is it okay to bath him while he has the cold sore, he will more than likely touch his genitals if he does not have a diaper on, and I cannot guarantee he will not touch his face.

Thank you

[Terri Warren]

1. How likely is it that he will transfer the infection to his eyes and or genitals and how likely is it for people with HSV in their eyes to go blind?

Once a person (including a child) has an infection in one location on their body, it is highly unlikely that they will transfer it to a new location on their body. But you should remember that the eye is also innervated by the same nerve group that supplies the lip. Given that, we still don’t see ocular herpes often.

2. Do you think it’s best to allow him to use his soother (preventing him from putting other things in his mouth), or take the soother away to let the sore dry out?

Oh, I would let him use the soother.

3. Is it okay to bath him while he has the cold sore, he will more than likely touch his genitals if he does not have a diaper on, and I cannot guarantee he will not touch his face.

I think of coure you should let him bathe while he has a cold sore. Again, if there is soap involved, it destroys the lipid layer that surrounds the virus and destroys it.

Terri

[parent1]

Great thank you! Not sure how this works if I have another question, or not, but if I do it is as follows.

I am having a baby at the beginning of February, obviously I do not want my toddler giving HSV1 to my infant, can you give me some advise?

If my toddler has a cold sore present do I not allow him to hold/handle the baby? What if he has no cold sore present can he hug or kiss the baby? Thoughts? Is it true that a HSV1 can be passed via sharing utensils and cups? Can children still go to the park/daycare/ be in close proximity to other children when they have cold sores present?

• This reply was modified 1 year, 7 months ago by parent1.

[Terri Warren]

Yes, I would say if your toddler has a cold sore, he should not touch the new baby. If he has no cold sore, he could hold the baby BUT I would suggest that you teach him not to kiss the baby on the lips. I think herpes experts would agree that it is highly unlikely that herpes would be transmitted via utensils or cups.
The question about daycare would have to be raised with the individual daycare center. I don’t know those policies, unfortunately.

Terri

[parent1]

Thank you!!!!!

So, when I have two toddlers in the house and the infected one has an outbreak I don’t need to be overly obsessed with them sharing a cup or mouthing the same toys?

When breastfeeding my son I acquired an HSV 1 infection on my breasts, I am having a baby in February, do you think it will be safe to breastfeed the new baby if I am on medication? My health care provider thinks is id okay, but I want a second opinion.

Thanks again for you’re service, its very helpful.

• This reply was modified 1 year, 7 months ago by parent1.

[Terri Warren]

I don’t think you need to be overly concerned with this, but when you talk about mouthing the toys, I supposed there is some risk there.
I would say that if you don’t have a lesion on the breast AND you are taking antiviral medication, the risk of transmission to the newborn is low. I would agree with your provider.

Terri

[parent1]

I have a couple more questions about breastfeeding with a previous HSV1 infection of the breasts. I had a previous HSV1 infection in both breasts (as mentioned), specifically in the area where the nipple and the areola connect. I have scarring on both breasts.

Questions:

1.If you do not have an active lesion on the breast/s do you shed the virus prior to having visible sores on the breast/s?
2.If so could the baby contract the virus before a lesion is visible?

If the answer to this is no could you explain this to me, as I am so so confused. I have read that if a breastfeeding infant gets a cold sore the mother should continue to breastfeed, as the mother will have already been exposed to the virus a day or two before the child’s sore is visible, does this not happen in reverse? If a breastfeeding mother gets a HSV1 lesion on the breast, has the baby not been exposed to the virus a day or two before the mothers sore is visible?

3.Is asymptomatic shedding of HSV1 from the breast possible and is it frequent?
4.If you do shed asymptomatically at any time from the breast could the baby contract the virus at that time, considering the amount of time spent at the breast and the friction caused by sucking?

5.If one were pumping milk (using a breast pump) and asymptomatic shedding from the breast was occurring could the viral shedding contaminate the breast milk?
6.Could the contaminated milk infect the baby?

7.How effective would antivirals be in reducing the risk of a reoccurring outbreak on the breasts?

8.How effective would antivirals be in reducing the risk of asymptomatic shedding from the breasts?

Thank you

[Terri Warren]

1.If you do not have an active lesion on the breast/s do you shed the virus prior to having visible sores on the breast/s?
I don’t know the answer to that. There is a physician named David Kimberlin who specializes in neonatal herpes and he might be able to help you with that. He is at the University of Alabama, Birmingham
2.If so could the baby contract the virus before a lesion is visible?
Again, I don’t now.

If the answer to this is no could you explain this to me, as I am so so confused. I have read that if a breastfeeding infant gets a cold sore the mother should continue to breastfeed, as the mother will have already been exposed to the virus a day or two before the child’s sore is visible, does this not happen in reverse? If a breastfeeding mother gets a HSV1 lesion on the breast, has the baby not been exposed to the virus a day or two before the mothers sore is visible?
I know that happens, I don’t know if the reverse happens or not

3.Is asymptomatic shedding of HSV1 from the breast possible and is it frequent?
I don’t know that either, so sorry. And I don’t know the answer to the questions below either. However, I do have a colleague who might know the answer to all of your questions, I’ll ask and if I find out, I’ll come back here to answer them

4.If you do shed asymptomatically at any time from the breast could the baby contract the virus at that time, considering the amount of time spent at the breast and the friction caused by sucking?

5.If one were pumping milk (using a breast pump) and asymptomatic shedding from the breast was occurring could the viral shedding contaminate the breast milk?
6.Could the contaminated milk infect the baby?

7.How effective would antivirals be in reducing the risk of a reoccurring outbreak on the breasts?

8.How effective would antivirals be in reducing the risk of asymptomatic shedding from the breasts?

[parent1]

Thank you so much.

Its it okay for my newborn to use bottles that my HSV1 toddler has used (almost over a year ago) if they have been washed with soap and water? Is there any likelihood of contracting the virus if the bottle has been washed with soap? I assuming this is 100 percent fine but wanted to be safe.

Thanks again for all of your help

[Terri Warren]

Of course, that’s just fine. There is zero risk from your newborn using those bottles.

Terri

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